[1]周婷婷,杨文广,胡艳婷,等.基于Toll样受体4/核因子κB信号通路探究苦参碱对类风湿关节炎风湿热痹证的治疗作用及机制[J].中医正骨,2022,34(10):1-9,26.
 ZHOU Tingting,YANG Wenguang,HU Yanting,et al.The therapeutic effects and mechanism of matrine on rheumatoid arthritis with wind-dampness-heat arthromyodynia via Toll-like receptor 4/nuclear factor-κB signaling pathway[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(10):1-9,26.
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基于Toll样受体4/核因子κB信号通路探究苦参碱对类风湿关节炎风湿热痹证的治疗作用及机制()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年10期
页码:
1-9,26
栏目:
基础研究
出版日期:
2022-10-20

文章信息/Info

Title:
The therapeutic effects and mechanism of matrine on rheumatoid arthritis with wind-dampness-heat arthromyodynia via Toll-like receptor 4/nuclear factor-κB signaling pathway
作者:
周婷婷1杨文广1胡艳婷1马俊福2
(1.商丘市中医院,河南 商丘 476000; 2.河南省中医院,河南 郑州 450002)
Author(s):
ZHOU Tingting1YANG Wenguang1HU Yanting1MA Junfu2
1.Shangqiu Hospital of Traditional Chinese Medicine,Shangqiu 476000,Henan,China 2.Henan Provincial Hospital of TCM,Zhengzhou 450002,Henan,China
关键词:
关节炎类风湿 风湿 热痹 苦参碱 Toll样受体4 NF-κB
Keywords:
arthritisrheumatoid wind dampness arthralgia due to heattoxicity matrine Toll-like receptor 4 NF-kappa B
摘要:
目的:基于Toll样受体4(Toll-like receptor 4,TLR4)/核因子κB(nuclear factor-κB,NF-κB)信号通路探究苦参碱对类风湿关节炎(rheumatoid arthritis,RA)风湿热痹证的治疗作用及机制。方法:将60只8周龄SPF级雄性SD大鼠随机分为正常组、模型组、甲氨蝶呤组及苦参碱低、中、高剂量组,每组10只。除正常组外,其余5组均采用牛Ⅱ型胶原诱导联合人工气候箱干预建立RA风湿热痹证模型。甲氨蝶呤组大鼠按照1.0 mg·kg-1以甲氨蝶呤灌胃,苦参碱低、中、高剂量组大鼠分别按照30 mg·kg-1、60 mg·kg-1、120 mg·kg-1以苦参碱灌胃,正常组和模型组大鼠则以等体积蒸馏水灌胃。药物干预均每周1次,共干预4次。观察大鼠的一般情况,测定足趾肿胀度、关节炎指数,以ELISA法检测血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)含量,HE染色观察膝关节滑膜组织病理学改变,以实时定量PCR法检测膝关节滑膜组织Bax mRNA、Bcl-2 mRNA、TLR4 mRNA、NF-κB p65 mRNA表达量,以Western Blot法检测膝关节滑膜组织Cleaved caspase-3蛋白、TLR4蛋白、NF-κB p65蛋白、磷酸化核因子κB p65(phosphorylated nuclear factor-κB p65,p-NF-κB p65)蛋白表达量。结果:①大鼠一般情况。正常组大鼠毛发顺滑有光泽,饮食、饮水正常,足趾无肿胀; 造模后模型组、甲氨蝶呤组及苦参碱低、中、高剂量组大鼠均出现毛发干燥无光泽,摄水量增加,易激惹、攻击性强,足趾肿胀、红热、蜷缩、僵硬等表现; 与模型组相比,药物干预后甲氨蝶呤组及苦参碱低、中、高剂量组大鼠毛发干燥无光泽、足趾肿胀等情况有所改善。②足趾肿胀度。6组大鼠的足趾肿胀度比较,差异有统计学意义(0.08±0.01,0.51±0.07,0.24±0.04,0.44±0.06,0.37±0.04,0.28±0.06,F=118.983,P=0.000)。模型组大鼠的足趾肿胀度高于其余5组(P=0.000; P=0.000; P=0.000; P=0.000; P=0.000),苦参碱低剂量组大鼠的足趾肿胀度高于甲氨蝶呤组和苦参碱中、高剂量组(P=0.007; P=0.000; P=0.000),苦参碱中剂量组大鼠的足趾肿胀度高于甲氨蝶呤组和苦参碱高剂量组(P=0.001; P=0.000),甲氨蝶呤组和苦参碱高剂量组大鼠足趾肿胀度的差异无统计学意义(P=0.096)。③关节炎指数。正常组大鼠足部未见异常,关节炎指数为0分; 其余5组大鼠关节炎指数比较,差异有统计学意义[(7.02±0.24)分,(4.36±0.12)分,(6.32±0.16)分,(5.58±0.20)分,(4.48±0.14)分,F=422.684,P=0.000]。模型组大鼠的关节炎指数高于甲氨蝶呤组和苦参碱低、中、高剂量组(P=0.000; P=0.000; P=0.000; P=0.000),苦参碱低剂量组大鼠的关节炎指数高于甲氨蝶呤组和苦参碱中、高剂量组(P=0.000; P=0.000; P=0.000),苦参碱中剂量组大鼠的关节炎指数高于甲氨蝶呤组和苦参碱高剂量组(P=0.000; P=0.000),甲氨蝶呤组和苦参碱高剂量组大鼠关节炎指数的差异无统计学意义(P=0.054)。④血清TNF-α、IL-1β含量。6组大鼠的血清TNF-α、IL-1β含量比较,组间差异均有统计学意义[TNF-α:(48.09±4.88)pg·mL-1,(351.49±32.39)pg·mL-1,(143.05±10.02)pg·mL-1,(281.51±26.50)pg·mL-1,(207.63±17.00)pg·mL-1,(154.40±14.23)pg·mL-1,F=311.253,P=0.000; IL-1β:(30.71±4.60)pg·mL-1,(258.14±20.85)pg·mL-1,(105.27±10.38)pg·mL-1,(201.57±16.51)pg·mL-1,(158.97±16.18)pg·mL-1,(114.37±10.48)pg·mL-1,F=337.119,P=0.000]。模型组大鼠的血清TNF-α、IL-1β含量均高于其余5组(P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000),苦参碱低剂量组大鼠的血清TNF-α、IL-1β含量均高于甲氨蝶呤组和苦参碱中、高剂量组(P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000),苦参碱中剂量组大鼠的血清TNF-α、IL-1β含量均高于甲氨蝶呤组和苦参碱高剂量组(P=0.000,P=0.000; P=0.000,P=0.000),甲氨蝶呤组和苦参碱高剂量组大鼠血清TNF-α、IL-1β含量的差异均无统计学意义(P=0.054; P=0.067)。⑤膝关节滑膜组织病理学观察结果。HE染色结果显示,正常组大鼠膝关节滑膜组织结构完整,细胞排列整齐,无炎症细胞浸润; 与正常组相比,模型组大鼠滑膜组织增生明显,有大量炎症细胞浸润,滑膜细胞排列紊乱,边界模糊不清; 与模型组相比,甲氨蝶呤组和苦参碱低、中、高剂量组滑膜组织增生程度减轻,滑膜细胞排列较整齐,炎症细胞浸润情况均得到不同程度改善。⑥膝关节滑膜组织Bax mRNA、Bcl-2 mRNA、TLR4 mRNA、NF-κB p65 mRNA表达量。6组大鼠膝关节滑膜组织Bax mRNA、Bcl-2 mRNA、TLR4 mRNA、NF-κB p65 mRNA表达量比较,组间差异均有统计学意义(Bax mRNA:0.80±0.07,0.40±0.03,0.72±0.08,0.53±0.05,0.63±0.05,0.71±
Abstract:
Objective:To investigate the therapeutic effects and mechanism of matrine on rheumatoid arthritis(RA)with wind-dampness-heat arthromyodynia via Toll-like receptor 4(TLR4)/nuclear factor κB(NF-κB)signaling pathway.Methods:Sixty 8-week-old specific pathogen-free(SPF)-grade male Sprague-Dawley(SD)rats were randomly assigned into normal group,RA model group,methotrexate group,matrine low-dose group,matrine medium-dose group and matrine high-dose group,10 cases in each group.The rats in RA model group,methotrexate group,matrine low-dose group,matrine medium-dose group and matrine high-dose group were intervened by bovine typeⅡcollagen in artificial climate chamber for inducing RA with wind-dampness-heat arthromyodynia.After successful modeling,the rats in methotrexate group were intragastric administrated with methotrexate in dosage of 1.0 mg/kg,the ones in matrine low-,medium- and high-dose groups with matrine in dosages of 30 mg/kg,60 mg/kg and 120 mg/kg respectively,and the ones in normal group and RA model group with the same dosage of distilled water,once a week for consecutive 4 times.The general condition of the rats was observed,the toe swelling degree and arthritis index were detected,and the synovial tissues of rat knee joints were stained with hematoxylin-eosin(HE)for observing the pathological changes.Furthermore,the serum levels of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were detected by using enzyme linked immunosorbent assay(ELISA),the mRNA expression levels of Bax,Bcl-2,TLR4 and NF-κB p65 as well as the protein expression levels of Cleaved caspase-3,TLR4,NF-κB p65 and phosphorylated nuclear factor-κB p65(p-NF-κB p65)in rat knee synovial tissues were detected by using real-time quantitative PCR(RT-qPCR)and Western-blot assays respectively.Results:①Rats with smooth and shiny furs,normal eating and drinking as well as healthy toes were observed in normal group.After modeling,the rats with such symptoms as dry and lusterless furs,polydipsia,irritability,aggression and the abnormal toes,manifesting as swelling,red-heat,curled up and stiffness were observed in RA model group,methotrexate group,matrine low-dose group,matrine medium-dose group and matrine high-dose group,however,compared to RA model group,the symptoms of dry and lusterless furs as well as swollen toes were improved after drug intervention in rats of methotrexate group,matrine low-dose group,matrine medium-dose group and matrine high-dose group.②There was statistical difference in toe swelling degree among the 6 groups(0.08±0.01,0.51±0.07,0.24±0.04,0.44±0.06,0.37±0.04,0.28±0.06,F=118.983,P=0.000).The degree of toe swelling in rats was higher in RA model group compared to the other five groups(P=0.000; P=0.000; P=0.000; P=0.000; P=0.000),and it was higher in the matrine low-dose group compared to methotrexate group,matrine medium-dose group and matrine high-dose group(P=0.007; P=0.000; P=0.000),and was higher in matrine medium-dose group compared to methotrexate group and matrine high-dose group(P=0.001; P=0.000),however,the difference was not significant between methotrexate group and matrine high-dose group(P=0.096).③No abnormality was found in the toes of rats in the normal group with arthritis index evaluated as 0 point,while there was statistical difference in arthritis index among the other 5 groups(7.02±0.24,4.36±0.12,6.32±0.16,5.58±0.20,4.48±0.14 points,F=422.684,P=0.000).The arthritis index was higher in RA model group compared to methotrexate group,matrine low-dose group,matrine medium-dose group and matrine high-dose group(P=0.000; P=0.000; P=0.000; P=0.000),and was higher in matrine low-dose group compared to methotrexate group,matrine medium-dose group and matrine high-dose group(P=0.000; P=0.000; P=0.000),and was higher in matrine medium-dose group compared to methotrexate group and matrine high-dose group(P=0.000; P=0.000),however,the difference was not significant between methotrexate group and matrine high-dose group(P=0.054).④There was statistical difference in serum levels of TNF-α and IL-1β among the 6 groups(TNF-α:48.09±4.88,351.49±32.39,143.05±10.02,281.51±26.50,207.63±17.00,154.40±14.23 pg/mL,F=311.253,P=0.000; IL-1β:30.71±4.60,258.14±20.85,105.27±10.38,201.57±16.51,158.97±16.18,114.37±10.48 pg/mL,F=337.119,P=0.000).The serum levels of TNF-α and IL-1β were higher in RA model group compared to the other 5 groups(P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000),and were higher in matrine low-dose group compared to methotrexate group,matrine medium-dose group and matrine high-dose group(P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000),and were higher in matrine medium-dose group compared to methotrexate group and matrine high-dose group(P=0.000,P=0.000; P=0.000,P=0.000),however,the difference was not significant between methotrexate group and matrine high-dose group(P=0.054; P=0.067).⑤The HE staining results showed that the complete structure and orderly arranged cells without infiltration by inflammatory cells were observed in knee synovial tissues of rats from normal group; compared to normal group,the obvious proliferation and disorderly arranged cells infiltrated by a large number of inflammatory cells with smeared-out boundary were observed in knee synovial tissues of rats from RA model group; compared to RA model group,the reduced proliferation and the relatively well-arranged cells with improved inflammatory cell infiltration in varying degrees were observed in knee synovial tissues of rats from methotrexate group,matrine low-dose group,matrine medium-dose group and matrine high-dose group.⑥There was statistical difference in mRNA expression levels of Bax,Bcl-2,TLR4 and NF-κB p65 in rat knee synovial tissues among the 6 groups(Bax mRNA:0.80±0.07,0.40±0.03,0.72±0.08,0.53±0.05,0.63±0.05,0.71±0.06,F=69.870,P=0.000; Bcl-2 mRNA:0.19±0.02,0.78±0.06,0.33±0.03,0.67±0.05,0.54±0.06,0.36±0.04,F=258.197,P=0.000; TLR4 mRNA:0.13±0.01,0.61±0.07,0.25±0.02,0.54±0.05,0.45±0.04,0.27±0.03,F=206.811,P=0.000; NF-κB p65 mRNA:0.17±0.01,0.56±0.04,0.26±0.02,0.46±0.04,0.34±0.04,0.28±0.03,F=220.358,P=0.000).The mRNA expression level of Bax in rat knee synovial tissues was lower,while the mRNA expression levels of Bcl-2,TLR4 and NF-κB p65 in rat knee synovial tissues were higher in RA model group compared to the other 5 groups(P=0.000; P=0.000; P=0.000; P=0.000; P=0.000; P=0.000,P=0.000,P=0.000; P=0.000,P=0.019,P=0.000; P=0.000,P=0.000,P=0.000; P=0.000,P=0.000,P=0.000; P=0.000,P=0.000,P=0.000).The mRNA expression level of Bax in rat knee synovial tissues was lower,while the mRNA expression levels of Bcl-2,TLR4 and NF-κB p65 in rat knee synovial tissues were higher in matrine low-dose group compared to methotrexate group,matrine medium-dose group and matrine high-dose groups(P=0.000; P=0.000; P=0.000; P=0.000,P=0.000,P=0.000; P=0.000,P=0.000,P=0.000; P=0.000,P=0.000,P=0.000).The mRNA expression level of Bax in rat knee synovial tissues was lower,while the mRNA expression levels of Bcl-2,TLR4 and NF-κB p65 in rat knee synovial tissues were higher in matrine medium-dose group compared to methotrexate group and matrine high-dose group(P=0.000; P=0.000; P=0.000,P=0.000,P=0.000; P=0.000,P=0.000,P=0.001).However,there was no statistical difference in the mRNA expression levels of Bax,Bcl-2,TLR4 and NF-κB p65 in rat knee synovial tissues between methotrexate group and matrine high-dose group(P=0.755,P=0.074,P=0.096,P=0.096).⑦There was statistical difference in protein expression levels of Cleaved caspase-3 and TLR4 as well as the ratio of protein expression level of p-NF-κB p65 to NF-κB p65 among the 6 group(Cleaved caspase-3 protein:0.74±0.06,0.32±0.03,0.62±0.05,0.39±0.04,0.47±0.05,0.58±0.05,F=127.351,P=0.001; TLR4 protein:0.17±0.02,0.67±0.06,0.25±0.03,0.43±0.05,0.35±0.03,0.27±0.02,F=216.610,P=0.001; the ratio of protein expression level of p-NF-κB p65 to NF-κB p65:0.24±0.02,0.64±0.07,0.27±0.03,0.49±0.05,0.36±0.04,0.29±0.03,F=129.880,P=0.001).The protein expression level of Cleaved caspase-3 was lower,while the protein expression level of TLR4 and the ratio of protein expression level of p-NF-κB p65 to NF-κB p65 were higher in RA model group compared to the other 5 groups(P=0.000; P=0.000; P=0.000; P=0.000; P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000).The protein expression level of Cleaved caspase-3 was lower,while the protein expression level of TLR4 and the ratio of protein expression level of p-NF-κB p65 to NF-κB p65 were higher in matrine low-dose group compared to methotrexate group,matrine medium-dose group and matrine high-dose group(P=0.000; P=0.001; P=0.000; P=0.000,P=0.000; P=0.000,P=0.000; P=0.000,P=0.000).The protein expression level of Cleaved caspase-3 was lower,while the protein expression level of TLR4 and the ratio of protein expression level of p-NF-κB p65 to NF-κB p65 were higher in matrine medium-dose group compared to methotrexate group and matrine high-dose group(P=0.000; P=0.000; P=0.000,P=0.000; P=0.000,P=0.000).However,there was no statistical difference in the protein expression levels of Cleaved caspase-3 and TLR4 as well as the ratio of protein expression level of p-NF-κB p65 to NF-κB p65 between methotrexate group and matrine high-dose group(P=0.090,P=0.096,P=0.153).Conclusion:The matrine can effectively improve the symptoms and physical signs in RA rat models with wind-dampness-heat arthromyodynia,and it exhibits dose-dependence in the efficacy.Its mechanisms may be that it can reduce inflammatory reaction and promote synovial cell apoptosis through inhibiting TLR4/Nf-κb signaling pathway.

参考文献/References:

[1] TEN KLOOSTER P M,OUDE VOSHAAR M,FAKHOURI W,et al.Long-term clinical,functional,and cost outcomes for early rheumatoid arthritis patients who did or did not achieve early remission in a real-world treat-to-target strategy[J].Clin Rheumatol,2019,38(10):2727-2736.
[2] LIU W,WU Y H,ZHANG L,et al.MicroRNA-146a suppresses rheumatoid arthritis fibroblast-like synoviocytes proliferation and inflammatory responses by inhibiting the TLR4/NF-kB signaling[J].Oncotarget,2018,9(35):23944-23959.
[3] SHI H J,ZHOU H,MA A L,et al.Oxymatrine therapy inhibited epidermal cell proliferation and apoptosis in severe plaque psoriasis[J].Br J Dermatol,2019,181(5):1028-1037.
[4] 詹静慧,王佩佩,崔振华,等.氧化苦参碱治疗小鼠胶原诱导性关节炎的作用机制[J].中国中药杂志,2021,46(22):5895-5901.
[5] 马天越,方宜梅,郭甘霖,等.二四汤对牛Ⅱ型胶原诱导大鼠类风湿关节炎的干预机制[J].中国实验方剂学杂志,2022,28(5):38-45.
[6] 陆麒瑾,李佳钰,蔡义思,等.当归拈痛汤对风湿热痹型佐剂性关节炎大鼠自噬蛋白LC3,Beclin1,p62表达的影响[J].中国实验方剂学杂志,2022,28(1):41-49.
[7] 刘利涛,朱华亮,周宗波,等.宣痹汤加减对风湿热痹型膝骨性关节炎发作期急性炎症的影响[J].中国实验方剂学杂志,2020,26(18):105-110.
[8] WU D,LI X,LIU J,et al.Wutou decoction attenuates rheumatoid arthritis by modulating the Ahr/LOC101928120/SHC1 pathway[J].Pharm Biol,2021,59(1):811-822.
[9] 黎威,张邵宁.氧化苦参碱调节免疫平衡的作用及其对类风湿性关节炎患者炎症水平的影响[J].中国当代医药,2019,26(24):18-21.
[10] 刘平,陈晓杰.苦参碱上调LncRNA BDNF-AS抑制宫颈鳞癌细胞增殖的机制研究[J].中草药,2020,51(6):1593-1599.
[11] 苗康,李超.苦参碱对前列腺炎大鼠前列腺组织炎症和miR-150表达的影响[J].中国老年学杂志,2021,41(22):5086-5088.
[12] NIU Y,DONG Q,LI R.Matrine regulates Th1/Th2 cytokine responses in rheumatoid arthritis by attenuating the NF-κB signaling[J].Cell Biol Int,2017,41(6):611-621.
[13] AO L,GAO H,JIA L,et al.Matrine inhibits synovial angiogenesis in collagen-induced arthritis rats by regulating HIF-VEGF-Ang and inhibiting the PI3K/Akt signaling pathway[J].Mol Immunol,2022,141:13-20.
[14] ZHAO Y,SUN X,LIN J,et al.Panaxynol induces fibroblast-like synovial cell apoptosis,inhibits proliferation and invasion through TLR4/NF-κB pathway to alleviate rheumatoid arthritis[J].Int Immunopharmacol,2021,101(Pt A):108321.
[15] ZENG M Y,TONG Q Y.Anti-inflammation effects of sinomenine on macrophages through suppressing activated TLR4/NF-κB signaling pathway[J].Curr Med Sci,2020,40(1):130-137.
[16] 燕丽君,佟胜全,刘静,等.白芍总苷介导TLR4/NF-κB信号通路对类风湿关节炎模型大鼠的治疗作用及其机制[J].吉林大学学报(医学版),2021,47(2):390-396.
[17] XU J,LU C,LIU Z,et al.Schizandrin B protects LPS-induced sepsis via TLR4/NF-κB/MyD88 signaling path-way[J].Am J Transl Res,2018,10(4):1155-1163.
[18] 曲道炜,冯博,王昕冉,等.痹通对佐剂性关节炎大鼠TLR4/MYD88/NF-κB信号通路的影响[J].辽宁中医药大学学报,2021,23(9):37-40.
[19] 孙静,赵荣华,郭姗姗,等.苦参碱氯化钠注射液对人冠状病毒肺炎寒湿疫毒袭肺证小鼠病证结合模型的治疗作用[J].药学学报,2020,55(3):366-373.
[20] 朱艳媚,祁岗,杨春燕,等.藏药十八味党参丸抑制CIA大鼠滑膜组织炎性因子表达和细胞凋亡诱导[J].中国高原医学与生物学杂志,2017,38(4):273-279.

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备注/Memo

备注/Memo:
基金项目:2022年度河南省中医药科学研究专项课题(2022ZY1062)
更新日期/Last Update: 1900-01-01