中医药诱导免疫耐受治疗类风湿关节炎初探

类风湿关节炎是一种以关节骨质损害为特征的慢性自身免疫病。西医在临床上使用的主导治疗药物为免疫抑制剂。该类药物对肝、肾、骨髓、生殖系统和免疫系统有严重毒副作用。近20年来,人们借助免疫学及分子生物学领域高新技术的迅速发展,一直努力寻求能有效恢复患者自身免疫耐受的治疗方法,使机体免疫系统对自身抗原无免疫反应,而对其它外来抗原保持正常免疫应答,以最大限度地减少治疗的不良反应。目前进入临床研究较多的是口服免疫耐受和T细胞抗原受体疫苗注射,但实际疗效与预期目标相距甚远。笔者在长期临床工作中观察发现一些采用中医药治疗疗效显著的患者,在治疗早期阶段症状呈现先加重再减轻的变化。推测其疗效机理可能与中药诱导自身反应性T淋巴细胞活化后凋亡,从而形成免疫耐受有关。为此采用体外细胞培养、流式细胞仪检测方法,证实中药提取物确实可以诱导淋巴细胞活化后凋亡。现拟采用淋巴细胞TCR基因指纹图分析等方法,进一步观察中医药治疗对自身反应性T淋巴细胞克隆删除的效果,以期发展成为一种临床实用的免疫耐受治疗方法。

Primary Probe Into Traditional Chinese Medicine Inducing Autoimmune Tolerance To Treat Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by the damage of the joint bone. The main treatment in the western medicine is still depending on the immunodepressants which are harmful to Liver, Kidney, bone marrow, the genital system and the immune system. So people make efforts to explore the way to recover the patient's autoimmune tolerance, which makes the immune system have no response to the auto-antigens of the body and keep the normal reactions to the invaded antigens, making use of the advanced new techniques developed in the immunology and the molecular biology in recent 20 years. Most of the clinical studies is about the two methods, taking oral type collagen and injecting the vaccine of the T cell receptor(TCR), but their curative effects haven' t achieved the expectant targets. For a long time past in our clinical works,we have observed that some patients treated by traditional Chinese medicine have been cured and at the early stage of the treatment processes,their symptoms had become severer than before and then had been released gradually, so that we guess traditional Chinese medicine had promoted the activation-induced apoptosis of auto-reactive T lymphocytes and therefore those patients have recovered their autoimmune tolerance. We have confirmed by cell culture in vitro that the extracts of some Chinese herb medicine have the effect of promoting the activation-induced apoptosis of lymphocytes. Now we will observe whether or not traditional Chinese medicine can achieve the effect of deleting the clones of auto-reactive T lymphocytes, with the aid of the gene fingerprint techniques. This studies will be contributory to develop a kind of practical immune tolerance therapy of traditional Chinese medicine.