基于Th1/Th2失衡初探益气温阳护卫法对哮喘炎症白三烯通道干预作用

支气管哮喘(简称哮喘)是慢性气道炎症为特点的一种异质性疾病,有多种细胞及细胞组分共同参与,涉及多机制多通路。白三烯通道是哮喘气道炎症重要的通道。以T细胞为细胞免疫应答的Th2占优势的Th1/Th2失衡是哮喘发病机制,Th1/Th2失衡与白三烯通道共同参与哮喘气道炎症形成,相互影响。气阳虚弱为哮喘气道炎症产生根本所在。文章就Th1/Th2失衡与白三烯通道在哮喘气道炎症方面的关系及益气温阳护卫法是否通过调节Th1/Th2失衡影响炎症白三烯通道展开初步探讨。     

基于Th17/Treg免疫失衡的益气温阳护卫法防治哮喘作用机制初探

目的支气管哮喘为呼吸系统常见病,其主要病理特征为慢性气道炎症、气道高反应性及气道重塑,该病发病机制较为复杂,涉及多种细胞和炎症介质参与,而T淋巴细胞在其中发挥重要作用。细胞免疫失衡是哮喘发病的重要机制之一,目前,Thl7/Treg失衡在哮喘中的作用是国内外研究热点。免疫功能与中医学正气相应,正气虚弱易致免疫力低下。卫气不足、气阳虚弱为哮喘发病的根本内因,而益气温阳护卫法正是基于此内因提出的防治哮喘的治法。文章就Th17/Treg免疫失衡与哮喘的关系,对益气温阳护卫法是否通过调节Th17/Treg失衡达到防治哮喘作用展开初步理论探讨。     

射干麻黄汤对哮喘大鼠气道炎症及外周血Th1/Th2平衡的影响

目的 观察射干麻黄汤对哮喘大鼠气道炎症及对外周血T辅助细胞(Th):Th1/Th2平衡的影响,探讨其治疗哮喘的作用机理.方法 40只雌性SD大鼠随机分为正常对照组、哮喘组、地塞米松组和射干麻黄汤组.构建哮喘模型后,采用瑞氏染色对哮喘大鼠支气管肺泡灌洗液(BALF)中的细胞进行分类及计数,用ELISA方法测定外周血中白细胞介素4(IL-4)和γ-干扰素(IFN-γ)水平.结果 (1)射干麻黄汤可有效对抗哮喘大鼠症状发作.(2)射干麻黄汤能显著减少哮喘组大鼠中性粒细胞、嗜酸性粒细胞、淋巴细胞等气道炎症细胞计数,与地塞米松组相比有差异.(3)射干麻黄汤可以显著降低IL-4水平,提高IFN-γ/IL-4比率,与地塞米松相近.结论 射干麻黄汤可以减轻哮喘大鼠气道炎症,调节哮喘Th1/Th2失衡,降低气道高反应性,达到治疗哮喘的作用,这可能是其治疗支气管哮喘的作用机制之一.     

中医药调节免疫平衡治疗咳嗽变异性哮喘研究进展

咳嗽变异性哮喘（CVA）是以咳嗽为主要症状的慢性呼吸系统疾病。CVA的发生与非特异性气道炎症密切相关，发病机制涉及环境、遗传、免疫等因素。近年来，中医药在CVA治疗中的优势得到国内外专家学者的关注，尤其在调节免疫平衡缓解CVA患者咳嗽症状、减少复发次数等方面具有突出作用。辅助性T细胞（Th）1、Th2、Th17、调节性T细胞（Treg）由CD4⁺ T细胞分化而来，Th1/Th2、Th17/Treg免疫失衡是CVA发病机制研究中的新热点，也是中医药治疗CVA的潜在关键靶标。Th细胞亚群生理情况下处于动态平衡，维持促炎细胞因子与抑炎细胞因子平衡的呼吸道免疫稳态。CVA发病阶段，未成熟的辅助T细胞（Th0）受微环境中细胞因子类型影响分化为Th1、Th2、Th17、Treg等细胞亚群，Th2细胞增殖引发嗜酸性粒细胞性气道炎症，Th17细胞过度分化诱发中性粒细胞性气道炎症的产生。Th1/Th2、Th17/Treg细胞在数量及功能上相互制约，Th1/Th2、Th17/Treg免疫失衡易加剧炎症反应的产生，恢复免疫平衡对CVA的气道抗炎治疗尤为重要。该文对Th1/Th2、Th17/Treg失衡与CVA发病机制进行系统阐述，同时对中药复方、单味中药及其有效成分调控免疫失衡治疗CVA的最新研究进行梳理，为揭示中医药调节免疫平衡治疗CVA的科学内涵及CVA临床治疗和基础研究的开展提供思路和借鉴。     

中医药对哮喘Th17/Treg失衡作用机制研究进展

综述中医药对哮喘Th17/Treg失衡作用机制研究进展。Th17/Treg失衡在哮喘发病机制中有重要作用,研究表明中药单体(黄芩苷、淫羊藿苷等)、多种复方(固本防哮汤、平喘方等)、外治法(针灸)可通过调节Th17/Treg细胞数量、相关炎症因子等,减轻气道炎症,改善哮喘症状。     

中医药治疗支气管哮喘实验研究述略

从气道炎症和炎症介质、Th1/Th2失衡、气道高反应性、气道重建、细胞因子、细胞凋亡、相关基因研究等综述支气管哮喘的实验研究。指出:治疗哮喘的中药剂型日趋丰富,对重要单味及有效单体的研究日趋量化、科学化。     

“邵氏五针法”对慢性哮喘大鼠GATA-3/T-bet表达的影响

目的:探讨"邵氏五针法"对慢性哮喘大鼠Thl/Th2细胞失衡相关因子的影响。方法:SD大鼠40只按随机数字表法分为空白组、模型组、针刺组、艾灸组,通过HE染色观察各组大鼠肺组织病理学变化,通过酶联免疫吸附法检测各组大鼠血清白介素(IL)-5、γ干扰素(IFN-γ)含量,荧光定量PCR检测各组大鼠肺组织中GATA结合蛋白3(GATA-3)、T盒子转录因子(T-bet)mRNA表达水平。结果:肺组织病理显示针刺组和艾灸组大鼠气道炎症较模型组明显减轻,针刺组和艾灸组大鼠血清中IL-5含量及肺组织中GATA-3mRNA表达明显低于模型组,血清IFN-γ含量及肺组织T-betmRNA表达明显高于模型组。结论:针刺和艾灸能降低哮喘大鼠气道炎症,抑制Th2特异性转录因子GATA-3的表达,促进Thl特异性转录因子T-bet的表达,可能通过纠正Th1/Th2失衡,调控哮喘大鼠免疫功能,从而降低哮喘大鼠的气道高反应性及慢性炎症,达到防治哮喘的作用。     

STAT信号通路对支气管哮喘的影响及中医药干预作用研究进展

综述信号转导与转录活化因子(STAT)信号通路对支气管哮喘的影响及中医药干预作用研究进展。STAT1可活化细胞间黏附分子,加重气道炎症反应;活化后的STAT2与磷酸化的STAT1形成的二聚体,可影响辅助型T淋巴细胞2(Th2)细胞分化,诱导免疫球蛋白E(IgE)分泌和炎性细胞浸润,致使哮喘发生;STAT3可诱导白介素6(IL-6)的免疫反应,促进辅助型T淋巴细胞17(Th17)细胞分化,引起机体炎性反应;磷酸化后的STAT4可诱导调节性T细胞(Treg)相应转录因子表达,拮抗Th17细胞分化;活化后的STAT5可诱导嗜酸性粒细胞(EOS)分化、增殖,抑制EOS凋亡,导致哮喘发作时EOS生成增多;STAT6可通过影响Th2细胞的免疫反应,参与哮喘的发生与发展。中医药可通过调节Janus激酶/信号转导与转录活化因子(JAK/STAT)相关信号通路,缓解哮喘症状,减轻气道炎症及气道重塑。     

中医药对哮喘Th17细胞/Treg细胞免疫失衡影响的研究进展＊

免疫失衡机制在哮喘的发病中占有主导地位，既往认为Th1/Th2比例失衡是哮喘的主要免疫发病机制，但近年来，Th17/Treg免疫失衡与哮喘关系的研究越来越多，大量的实验和临床研究表明：Th17细胞比例的上调、Treg细胞比例的下降导致的Th17/Treg免疫失衡与哮喘发病和严重程度密切相关。中医药治疗哮喘历史悠久，利用现代科学技术来阐释中医药治疗哮喘的机制是现阶段研究的热点，不仅为中医药治疗哮喘赋予科学内涵，也为更多的哮喘患者带来福音。本文通过阐释Th17、Treg细胞在哮喘中的作用，对近十年来中医药对哮喘Th17/Treg免疫失衡影响的研究进展进行综述，以供同仁互鉴。     

哮喘小鼠肺组织中SDF-1的表达及意义

目的探讨哮喘小鼠肺组织中基质细胞衍生因子1(SDF-1)的表达与气道炎症的关系。方法清洁级雌性昆明小鼠随机分为对照组、哮喘组,每组10只。建立卵白蛋白致敏的哮喘小鼠模型,用免疫组织化学方法检测各组小鼠肺组织中SDF-1的表达,分别用HE染色和Wright-Giemsa染色方法对各组小鼠气道炎症细胞及支气管肺泡灌洗液(BALF)中炎症细胞情况进行评估。结果哮喘组小鼠的支气管黏膜上皮细胞破坏、增生,管周有大量的炎细胞浸润,SDF-1的表达明显高于对照组;哮喘组BALF中炎细胞总数及嗜酸性粒细胞、中性粒细胞及淋巴细胞明显高于对照组;SDF-1表达量与气道炎症细胞总数、嗜酸性粒细胞、中性粒细胞及淋巴细胞呈正相关。结论 SDF-1在哮喘小鼠气道炎症细胞募集中可能有重要作用。     

Gynostemma pentaphyllum decreases allergic reactions in a murine asthmatic model

The increasing incidence of asthma in developing countries emphasizes the importance of identifying more effective treatments that have low cost. Gynostemma pentaphyllum (Thunb.) Makino (Cucurbitaceae), a common herbal tea in China, has been used to treat lung inflammation. Since the Th2 cytokines are the major mediators in the pathogenesis of asthma, Th1-biased immune responses caused by G. pentaphyllum might have the potential to relieve asthmatic symptoms. We hypothesized that oral administration of G. pentaphyllum extracts might suppress Th2 cytokine-induced airway inflammation responses in ovalbumin (OVA)-sensitive mice. BALB/c mice were sensitized with intraperitoneal injection and challenged 3 times with OVA inhalation (IH) (the IH3 model). G. pentaphyllum was orally administered for 7 consecutive days before the end of the OVA challenge. In the IH5 model, 2 more OVA challenges were administered to mimic the encounter with an allergen after drug treatment. G. pentaphyllum extracts significantly attenuated airway hyperresponsiveness (AHR) and inhibited eosinophil infiltration in mice in both models. Serum OVA-specific antibodies were also reduced with the treatment. Decreased Th2-type cytokines and increased IFN-gamma were detected in the cultures of OVA-activated splenocytes from treated mice. Our results suggest that G. pentaphyllum extracts might be beneficial for asthma airway inflammation through the suppression of Th2 activity.     

Liriopis tuber inhibit OVA-induced airway inflammation and bronchial hyperresponsiveness in murine model of asthma

Liriope platyphylla is one of the well-known herb used in oriental medicine for treatment asthma and bronchial and lung inflammation. Anti-asthmatic effects of Liriope platyphylla in the development of OVA-induced airway inflammation and murine asthma model have not been fully investigated in vivo. Asthma is a chronic inflammatory disease of the mucosa and is associated with excess production of Th2 cytokines and eosinophil accumulation in lung. To clarify the anti-inflammatory and anti-asthmatic effects of Liriope platyphylla, we examined the influence of liriopis tuber (LRT) on the development of pulmonary eosinophilic inflammation in murine model of asthma. Our results have shown that LRT were demonstrated on the accumulation of eosinophills into airways, with reduction of eosinophil, total lung leukocytes numbers by reduction IL-5, IL-13, IL-4 and IgE levels in the BALF and serum. Moreover, LRT decreased eosinophil CCR3 expression and CD11b expression in lung cells. These results indicate that LRT has a deep inhibitory effects on airway inflammation and hyperresponsiveness in murine model of asthma and play an crucial role as a immunomodulator which possess anti-inflammatory and anti-asthmatic property by modulating the relationship between Th1/Th2 cytokine imbalance.     

小青龙颗粒对支气管哮喘患者外周血Th17/Treg平衡影响的研究

目的探讨小青龙颗粒对支气管哮喘患者外周血Th17/Treg平衡的影响。方法将60例支气管哮喘急性发作期患者随机分为2组:治疗组给予小青龙汤治疗,对照组给予西医常规治疗组,治疗7 d后评定疗效。治疗前后采集标本进行Th17细胞、Treg细胞检测。结果 2组治疗后外周血Th17细胞百分率和Th17/Treg细胞的比值均下降,Treg细胞的百分率均上升;治疗后治疗组外周血IL-17细胞百分率、IL-17/TGF-β1的比值均低于对照组,TGF-β1细胞百分率高于对照组。结论小青龙颗粒可有效调控Th17/Treg失衡,在支气管哮喘发作期治疗和调节免疫上有应用价值。     

从祛瘀化痰法探讨平喘方及拆方对哮喘小鼠Th1/Th2免疫失衡的干预机制

目的研究平喘方及拆方干预哮喘小鼠Th1/Th2免疫失衡的作用机制,并探究"化痰"与"祛瘀"两种治法干预气道炎症的疗效。方法对60只BALB/c雄性小鼠按随机数字表分为空白对照组、哮喘模型组、地塞米松组、平喘方组、拆方1(祛瘀方)组、拆方2(化痰方)组共6组,每组10只,运用卵蛋白(OVA)和氢氧化铝腹腔注射致敏并雾化吸入激发,建立小鼠支气管哮喘模型,末次激发后给药7 d并杀检取材,运用HE染色观察各组小鼠气道及肺组织病理改变,酶联免疫吸附法(ELISA)检测小鼠肺泡灌洗液(BALF)中白介素4(IL-4)、干扰素γ(INF-γ)、白介素17(IL-17)、白介素10(IL-10)表达,蛋白质印迹法法(Western Blot)检测肺组织中转录因子GATA结合蛋白3(GATA-3)、T盒子转录因子(T-bet)蛋白表达。结果与空白组比较,模型组病理染色显示炎症细胞侵润明显,管壁及肺组织结构受到破坏,周围组织伴有炎性物质渗出,IL-4、IL-17、GATA-3表达增高(P<0.05),INF-γ、IL-10、T-bet表达减低(P<0.05)。与模型组对比,平喘方及拆方组可显著减少病理染色中的气道炎症程度,减低IL-4、IL-17、GATA-3表达(P<0.05),升高INF-γ、IL-10、T-bet表达(P<0.05),拆方组间比较祛瘀方在改善气道病理优于化痰方,在降低IL-4、IL-17、GATA-3因子水平具有优于化痰方的统计学趋势。结论:平喘方及拆方可减少哮喘小鼠IL-4、IL-17、GATA-3表达,升高INF-γ、IL-10、T-bet表达,改善Th1/Th2免疫失衡,祛瘀与化痰两种治法相比较,祛瘀法在改善气道炎症方面疗效较优。     

玉屏风散对气道变态反应性小鼠IL-17和IL-6的影响

目的通过建立系统性气道变态反应性小鼠模型,观察玉屏风散对小鼠肺部IL-17和IL-6的影响。方法40只Balb／c小鼠随机分成正常对照组、哮喘模型组、地寒米松治疗组和玉屏风散治疗组。建立用OVA诱导激发的上、下呼吸道变态反应性炎症模型,采用ELISA和免疫组织化学标记法分别测定和标记肺部IL-17和IL-6,治疗组在激发同时分别给予地塞米松（2mg／kg,7d）或玉屏风散（771mg／kg,7d）腹腔注射。结果哮喘动物模型激发同时给予玉屏风散治疗后,肺匀浆IL-17和IL-6均下降（P≤0．05）。模型组肺部免疫组化标记IL-17显著表达在小支气管柱状上皮,经治疗后表达下降;IL-6免疫组化也表达在支气管柱状上皮,较IL-17低。各实验组IL-6测定和表达结果类似于IL-17。结论Th17细胞参与了哮喘发病的病理过程,玉屏风散对小鼠系统性气道变态反应模型IL-17和IL-6在激发期有治疗作用,即玉屏风散对Th17细胞参与哮喘的病理过程有抑制作用。     

Glycyrrhiza uralensis Flavonoids Present in Anti‐Asthma Formula,ASHMITM, Inhibit Memory Th2 Responses in Vitro and in Vivo

Allergic asthma is associated with Th2‐mediated inflammation. Several flavonoids were isolated from Glycyrrhiza uralensis, one of the herbs in the anti‐asthma herbal medicine intervention. The aim of this investigation was to determine whether Glycyrrhiza uralensis flavonoids have inhibitory effects on memory Th2 responses in vitro and antigen‐induced Th2 inflammation in vivo. The effects of three Glycyrrhiza uralensis flavonoids on effector memory Th2 cells, D10.G4.1 (D10 cells), were determined by measuring Th2 cytokine production. Isoliquiritigenin, 7, 4′‐dihydroxyflavone (7, 4′‐DHF) and liquiritigenin significantly suppressed IL‐4 and IL‐5 production in a dose‐dependent manner, 7, 4′‐DHF being most potent. It was also evaluated for effects on D10 cell proliferation, GATA‐3 expression and IL‐4 mRNA expression, which were suppressed, with no loss of cell viability. Chronic treatment with 7, 4′‐DHF in a murine model of allergic asthma not only significantly reduced eosinophilic pulmonary inflammation, serum IgE levels, IL‐4 and IL‐13 levels, but also increased IFN‐γ production in lung cell cultures in response to antigen stimulation. Copyright © 2012 John Wiley & Sons, Ltd.     

三拗汤对支气管哮喘大鼠Th1,Th2转录调节机制的研究

目的:重点探讨三拗汤对哮喘大鼠Th1/Th2细胞的调节作用,并深入研究其对转录因子GATA-3和T-bet水平的干预作用.方法:以鸡卵清蛋白腹腔注射并雾化吸入复制大鼠哮喘模型,分别以不同剂量三拗汤及地塞米松灌服,检测用药前后哮喘大鼠肺泡灌洗液中细胞因子IL-4和IFN-γ含量;RT-PCR方法检测肺组织中T-bet和GATA-3 mRNA表达水平.结果:中药中剂量组大鼠BALF中IL-4水平较其他组明显减低,IFN-γ水平升高,IL-4/IFN-γ较哮喘组明显减小,肺组织GATA-3和T-bet转录因子mRNA表达水平分别与IL-4及IFN-γ变化水平相一致.结论:中药三拗汤可能通过对哮喘大鼠Th1/Th2细胞转录因子的调节作用,达到抑制哮喘大鼠气道炎症的目的.