二陈汤加味对COPD急性期患者CC16，SP-D及HAT/HDAC的影响

目的:观察二陈汤加味对COPD急性期加重期(acute exacerbation period of COPD,AECOPD)患者血浆、呼气冷凝液(exhale breath condensat,EBC)中克拉拉细胞蛋白(Clara cell protein,CC16),肺表面活性蛋白-D(pulmonary surfactant associated protein-D,SP-D)含量及外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中组蛋白乙酰基转移酶(histone acetyl transferase,HAT)及组蛋白去乙酰基酶(histone deacetylase,HDAC)活性的影响,评价二陈汤加味对AECOPD的作用及机制。方法:选取符合纳入标准AECOPD患者200例,随机分成对照组和治疗组,每组100例。两组均在西医常规治疗的基础上,对照组给予安慰剂,治疗组接受二陈汤加味治疗,疗程14 d。检测肺功能,酶联免疫吸附试验(ELISA)法测定血浆,EBC中白细胞介素-17(interleukin-17,IL-17),C反应蛋白(C-reactive protein,CRP),CC16,SP-D及PBMC中HDAC1,HDAC2浓度。酶联免疫荧光法测定PBMC中HAT及HDAC活性。结果:与对照组治疗后比较,治疗组血浆及EBC中CRP,IL-17,CC16和SP-D水平均明显降低(P0.05,P0.01),PBMC中HAT活性明显降低(P0.05),HDAC活性,HDAC2含量均明显增高(P0.05)。结论:二陈汤加味可能调整HAT/HDAC的平衡,发挥抗炎作用,保护气道和肺的结构与功能。

Effect of Modified Erchentang on CC16, SP-D and HAT and HDAC in Patients at Acute Exacerbation Stage of COPD

Objective: To study of the effect and mechanism of modified Erchentang on Clara cell protein (CC16), pulmonary surfactant associated protein-D (SP-D), histone acetyl transferase (HAT) and histone deacetylase (HDAC) in patients at acute aggravating stage of COPD. Method: Totally 200 cases at acute exacerbation period of COPD (AECOPD) were randomly divided into modified Erchentang group and placebo-controlled group, with 100 cases in each group. In addition to western drugs, modified Erchentang was also used in the modified Erchentang group, and placebo was also used in control group for 14 days. Their pulmonary function was detected, and euzyme-linked immunosorbent assay was used to determine the levels of C-reactive protein (CRP), interleukin-17 (IL-17), CC16, SP-D, HDAC1 and HAD2 in plasma and exhaled breath condensate of all groups. The activities of HAT and HDAC were determinate by enzyme-linked immune fluorescence. Result: The activity of HDAC2 was higher significantly, but the levels of CRP, IL-17, CC16 and SP-D (P<0.05, P<0.01) in plasma and exhaled breath condensate, and the activity of HAT were significantly decreased in treatment group with modified Erchentang, compared with those in control group. Conclusion: Modified Erchentang may have an effect on COPD by adjusting the HAT/HDAC, reducing levels of CRP, IL-17, CC16 and SP-D, preventing inflammation progress and improving the structure and function of respiratory system and lungs.