参地颗粒对原发性肾小球肾炎患者外周血PD-1/PD-L1水平的调节作用  

Effect of Shen Di Granules on the Expression of PD-1/PD-L1 in Peripheral Blood of Patients with Primary Glomerulonephritis

作　　者：张磊[1] 金华[1] 王东[1] 任克军[1] 吕勇[1] 王亿平[1] ZHANG Lei;JIN Hua;WANG Dong;REN Kejun;LYU Yong;WANG Yiping(Department of Nephrology,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031 Anhui,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中药新药与临床药理》2022年第9期1265-1270,共6页Traditional Chinese Drug Research and Clinical Pharmacology

基　　金：安徽省卫计委中医药科研课题(2016zy13);安徽省高等学校自然科学研究项目(重点项目,KJ2019a0441);国家自然科学基金青年基金项目(82004165);安徽省中医药领军人才项目(中医药发展秘[2018]23号);安徽省2021医疗卫生重点专科建设项目(皖卫函【2021】273号)。

摘　　要：目的 观察参地颗粒治疗原发性肾小球肾炎的临床疗效及其对患者外周血程序性细胞死亡蛋白1(PD-1)/程序性细胞死亡配体1(PD-L1)水平的调节作用。方法 采用随机数字表法,治疗组和对照组按照1∶1比例分配入组,分别入组20例原发性肾小球肾炎脾肾亏虚证患者。另选择4例健康志愿者作为正常对照。对照组服用缬沙坦胶囊治疗,治疗组在对照组治疗基础上加用参地颗粒,每次10 g,每日3次。疗程12周。观察两组患者治疗前及治疗第4、8、12周24 h尿蛋白定量、血肌酐、肾小球滤过率;治疗前后中医证候积分和外周血单个核细胞中PD-1、PD-L1、CD4~+T、CD8~+T表达水平。结果 治疗后,除对照组倦怠乏力外,两组患者各证候积分均较治疗前降低(P<0.05);且治疗组倦怠乏力、食少纳呆、胃脘胀满、便溏证候积分低于对照组(P<0.05)。治疗第4周、8周、12周治疗组24 h尿蛋白水平较治疗前降低(P<0.05),且治疗组第8周、12周治疗组24 h尿蛋白水平低于对照组(P<0.05)。治疗后,治疗组和对照组PD-1~+、PD-1~+CD4~+及PD-L1~+、PD-L1~+CD8~+表达水平均低于治疗前(P<0.05),且治疗组PD-1~+、PD-1~+CD4~+水平低于对照组(P<0.05);治疗后,治疗组CD4~+T细胞水平较治疗前升高,CD8~+T细胞水平较治疗前降低(P<0.05),且低于同期对照组(P<0.05)。结论 参地颗粒可以减轻原发性肾小球肾炎脾肾亏虚证患者的临床症状,降低24 h尿蛋白水平,其作用机制可能与下调外周血PD-1/PD-L1的表达,调节T细胞水平有关。Objective To observe the clinical efficacy of Shen Di Granules in the treatment of primary glomerulonephritis and its regulatory effect on the level of PD-1/PD-L1 in peripheral blood. Methods The random number table method was used for grouping. A total of 20 patients with spleen kidney deficiency syndrome of primary glomerulonephritis were divided into two groups:the treatment group and the control group according to the ratio of1∶1. Four healthy volunteers were served as normal controls. The treatment group was additionally treated with Shen Di Granules on the basis of the control group, 10 g each time, 3 times a day. The course of treatment was12 weeks. The 24-hour urinary protein, serum creatinine and glomerular filtration rate were measured before treatment and at the 4th,8th and 12th weeks of treatment. TCM syndrome score and the expression levels of PD-1,PD-L1,CD4T and CD8T in peripheral blood mononuclear cells before and after treatment were also detected.Results After treatment,the syndrome scores of fatigue,reduced appetite,gastric distension,and loose stool in the two groups were lower than those before treatment(P<0.05). And these syndrome scores in the treatment group were lower than those in the control group(P<0.05). At the 4th,8th,and 12th week of treatment,the 24-hour urinary protein levels in the treatment group decreased compared with that before treatment(P<0.05). At the 8th and 12th weeks in the treatment group,the 24-hour urinary protein levels were lower than that in the control group(P<0.05). After treatment,the expression levels of PD-1,PD-1CD4,PD-L1,PD-L1CD8in the treatment group and the control group were lower than those before treatment(P<0.05). The levels of PD-1,PD-1CD4in the treatment group were lower than those in the control group(P<0.05). After treatment,CD4T in the treatment group was higher than that before treatment,and CD8T cells were lower than that before treatment(P<0.05),and lower than that in the control group in the same period(P<0.05). Conclusion Shen Di Granules ca

关 键 词：参地颗粒 原发性肾小球肾炎 程序性细胞死亡蛋白1 程序性细胞死亡配体1 24 h尿蛋白定量 

分 类 号：R285.6[医药卫生—中药学]