基于VIP-cAMP-PKA-AQP8通路探讨痛泻要方对腹泻型肠易激综合征的治疗机制  

The therapeutic mechanism of Tongxie decoction for diarrhea-predominant irritable bowel syndrome based on VIP-cAMP-PKA-AQP8 pathway

作　　者：李贺元[1] 陈伟刚[1] 熊阿琴[1] 张雁[1] Li Heyuan;Chen Weigang;Xiong Aqin(Department of Gastroenterology,Panyu Hospital of Chinese Medicine,Guangzhou 510400)

机构地区：[1]广州市番禺区中医院消化内科,广东广州510400

出　　处：《中国现代医药杂志》2022年第8期1-5,共5页Modern Medicine Journal of China

基　　金：广东省中医药局科研课题(编号:20201281)。

摘　　要：目的基于VIP-cAMP-PKA-AQP8通路探讨痛泻要方对腹泻型肠易激综合征(IBS-D)的治疗机制。方法选取2020年7月~2021年8月在我院治疗的106例肠易激综合征(IBS)患者为研究对象,根据罗马Ⅲ诊断标准和IBS亚型分型标准将其分为腹泻型(IBS-D组,n=74)和便秘型(IBS-C组,n=32),同期选取30例健康志愿者作为健康对照组。采用RT-PCR检测三组研究对象AQP8 mRNA、VIP mRNA表达,分析AQP8、VIP基因表达的相关性。IBS-D组患者给予痛泻要方治疗,比较治疗前后AQP8 mRNA、VIP mRNA、蛋白激酶A(PKA)及环磷酸腺苷(cAMP)表达水平,并分析各指标与疗效的相关性。结果IBS-D组AQP8 mRNA表达水平低于IBS-C组和健康对照组,VIP mRNA表达水平高于IBS-C组和健康对照组,差异有统计学意义(P<0.05)。AQP8 mRNA与VIP mRNA表达量呈负相关(r=-0.534,P=0.000)。治疗后,IBS-D组患者AQP8 mRNA表达水平高于治疗前,VIP mRNA、PKA、cAMP表达水平低于治疗前,差异有统计学意义(P<0.05)。AQP8 mRNA表达水平与疗效呈正相关(r=0.671,P<0.05),而VIP mRNA、PKA、cAMP表达水平与疗效呈负相关(r=-0.423、-0.545、-0.397,P<0.05)。结论IBS患者症状与AQP8 mRNA、VIP mRNA表达密切相关,痛泻要方可能是基于VIP-cAMP-PKA-AQP8通路发挥其药理作用。Objective To explore the therapeutic mechanism of Tongxie decoction for diarrhea-predominant irritable bowel syndrome(IBS-D)based on VIP-cAMP-PKA-AQP8 pathway.Methods 106 patients with irritable bowel syndrome(IBS)treated in our hospital from Jul 2020 to Aug 2021 were selected as the research object.The patients were divided into IBS-D group(n=74)and constipation-predominant irritable bowel syndrom(IBS-C)group(n=32)according to RomeⅢdiagnostic criteria and IBS subtype classification criteria.30 healthy volunteers in the same period were selected as the healthy control group.RT-PCR was used to detect the mRNA expression of AQP8 and VIP in the three groups,and the correlation between AQP8 and VIP gene expression was analyzed.Patients in IBS-D group were treated with Tongxie decoction.The expression levels of AQP8 mRNA,VIP mRNA,protein kinase A(PKA)and cyclic adenosine monophosphate(cAMP)were compared before and after treatment,and the correlation between each index and curative effect was analyzed.Results The expression level of AQP-8 mRNA in IBS-D group was lower than that in IBS-C group and healthy control group,and the expression level of VIP mRNA was higher than that in IBS-C group and healthy control group(P<0.05).There was a negative correlation between the expression of AQP8 mRNA and VIP mRNA(r=-0.534,P=0.000).After treatment,the expression level of AQP8 mRNA in IBS-D group was higher than that before treatment,and the expression level of VIP mRNA,PKA and c AMP were lower than that before treatment(P<0.05).The expression of AQP8 mRNA was positively correlated with the curative effect(r=0.671,P<0.05),while the expression of VIP mRNA,PKA and c AMP was negatively correlated with the curative effect(r=-0.423,-0.545,-0.397,P<0.05).Conclusion The symptoms of IBS patients are closely related to the expression of AQP8 mRNA and VIP mRNA.Tongxie decoction may play its pharmacological role via VIP-cAMP-PKA-AQP8 pathway.

关 键 词：痛泻要方 腹泻型肠易激综合征 VIP-cAMP-PKA-AQP8通路 水通道蛋白 

分 类 号：R259[医药卫生—中西医结合]