王冠,王靜怡,奚悅
三黃糖腎康對(duì)2型糖尿病大鼠骨組織腫瘤壞死因子-α、白細(xì)胞介素-6表達(dá)的影響
王冠,王靜怡,奚悅△
目的觀察三黃糖腎康顆粒對(duì)2型糖尿病大鼠骨組織腫瘤壞死因子(TNF)-α、白細(xì)胞介素(IL)-6表達(dá)的影響。方法取雌性Wistar大鼠,正常對(duì)照組10只,制作骨質(zhì)疏松模型10只和糖尿病模型50只。糖尿病模型大鼠進(jìn)一步分成模型對(duì)照組,中藥預(yù)防、高、低劑量組和鈣爾奇碳酸鈣D3(西藥)組,每組10只。7組分別給予相應(yīng)干預(yù),喂養(yǎng)20周后取材,全自動(dòng)生化儀檢測(cè)空腹血糖(FBG);酶聯(lián)免疫吸附法(ELISA)檢測(cè)血清TNF-α和IL-6水平;雙能X線骨密度儀(DXA)檢測(cè)骨密度,實(shí)時(shí)定量聚合酶鏈反應(yīng)(RT-PCR)檢測(cè)骨組織TNF-α和IL-6 mRNA水平;蛋白免疫印跡法(Western blot)檢測(cè)骨組織TNF-α和IL-6蛋白水平。結(jié)果與骨質(zhì)疏松模型組比較,中藥預(yù)防、高、低劑量組及西藥組骨密度升高,血清TNF-α、IL-6下降,骨組織IL-6 mRNA及蛋白表達(dá)下降(P<0.05),中藥預(yù)防、高劑量組和西藥組骨組織TNF-α mRNA及蛋白表達(dá)下降(P<0.05)。與糖尿病模型對(duì)照組比較,中藥預(yù)防、高、低劑量組及西藥組FBG、血清TNF-α、IL-6均明顯下降(P<0.05),中藥預(yù)防組、中藥高劑量組和西藥組骨組織TNF-α mRNA及蛋白表達(dá)下降(P<0.05),中藥預(yù)防、低劑量和西藥組骨組織IL-6 mRNA及蛋白表達(dá)下降(P<0.05)。結(jié)論糖尿病大鼠血清和骨組織TNF-α、IL-6表達(dá)增高,三黃糖腎康顆粒能夠改善糖尿病大鼠的炎癥狀況。
糖尿病,2型;腫瘤壞死因子α;白細(xì)胞介素6;骨和骨組織;骨折;大鼠,Wistar;疾病模型,動(dòng)物;三黃糖腎康
糖尿病是一種慢性低度炎癥性疾病,患病過程會(huì)有持續(xù)的低度炎癥反應(yīng)[1]。腫瘤壞死因子(TNF)-α和白細(xì)胞介素(IL)-6伴隨糖尿病病情的發(fā)展,可誘發(fā)胰島素抵抗[2],也參與骨質(zhì)疏松的發(fā)病進(jìn)程[3]。糖尿病性骨質(zhì)疏松是一種常見且嚴(yán)重的慢性并發(fā)癥,臨床缺乏有效治療藥物。三黃糖腎康是由多味中藥組成的驗(yàn)方,前期研究證明其可有效防治糖尿病腎?。?],而其對(duì)糖尿病性骨質(zhì)疏松的作用尚少見相關(guān)報(bào)道。本研究旨在觀察三黃糖腎康對(duì)2型糖尿病大鼠骨組織TNF-α和IL-6表達(dá)的影響。
1.1 實(shí)驗(yàn)動(dòng)物3月齡SPF級(jí)雌性Wistar大鼠90只購于遼寧長生生物技術(shù)有限公司,體質(zhì)量(280±20)g(動(dòng)物合格證號(hào):SCDK2010-0001)。自由進(jìn)食飲水,室溫21~24℃。
1.2 主要藥品及試劑三黃糖腎康方劑為:黃精40 g、黃芪40 g、黃連6 g、虎杖30 g、澤蘭20 g、水蛭粉6 g。常規(guī)水沖煮,以上為成人1日服用量。免煎顆粒為江陰制藥廠生產(chǎn)。鈣爾奇碳酸鈣D3片(惠氏制藥有限公司,產(chǎn)品編號(hào):C1320203236),普通飼料、高脂飼料(沈陽市前民飼料加工廠),鏈脲佐菌素(STZ,Sigma公司),血清TNF-α和IL-6酶聯(lián)免疫吸附測(cè)定(ELISA)試劑盒(上海江萊生物科技有限公司),Trizol(Invitrogen公司),RT-PCR試劑盒、DNA marker(北京全式金生物技術(shù)有限公司)。
1.3 方法
1.3.1 造模90只Wistar大鼠隨機(jī)數(shù)字表法分為正常對(duì)照組10只,骨質(zhì)疏松造模組15只,糖尿病造模組65只。骨質(zhì)疏松造模組于正常飼料喂養(yǎng)1周時(shí)行雙側(cè)卵巢切除術(shù),5周時(shí)處死3只取股骨測(cè)骨密度,組織學(xué)觀察骨組織微觀結(jié)構(gòu),可見股骨上段、中段、下段骨密度明顯降低;骨組織形態(tài)學(xué)改變:骨小梁稀疏,細(xì)小,厚度變薄,排列紊亂,體積明顯減少,提示骨質(zhì)疏松模型成功。糖尿病造模組于高糖高脂飼料喂養(yǎng)5周時(shí),按35 mg/kg一次性尾靜脈注射溶于枸椽酸鹽緩沖液(pH 4.2)的STZ,3 d后取尾血測(cè)空腹血糖(FBG)≥16.7 mmol/L為糖尿病大鼠造模成功,未成模及死亡大鼠淘汰出組9只。
1.3.2 分組造模成功后,12只骨質(zhì)疏松模型大鼠中隨機(jī)抽取10只入骨質(zhì)疏松模型組,56只糖尿病模型大鼠中隨機(jī)抽取50只,分為糖尿病模型對(duì)照組、中藥預(yù)防組、中藥高劑量組、中藥低劑量組及西藥組,每組各10只。正常對(duì)照組、骨質(zhì)疏松模型組和糖尿病模型對(duì)照組均于造模成功2周始給予1 mL·100 g-1·d-1蒸餾水灌胃,連續(xù)給藥18周。三黃糖腎康顆粒溶于蒸餾水制成濃度為3.84 g/mL的藥液,中藥預(yù)防組自糖尿病造模成功之日起連續(xù)以3.84 g·mL-1·100 g-1·d-1灌胃給藥20周。中藥高劑量組和低劑量組均于造模成功2周開始,以三黃糖腎康顆粒濃度3.84 g/mL和1.28 g/mL連續(xù)以3.84和1.28 g·mL-1·100 g-1·d-1灌胃給藥18周。西藥組以鈣爾奇碳酸鈣D3片溶于蒸餾水制成的0.18 g/L的藥液,以0.18 g-1·L-1·200 g-1·d-1連續(xù)灌胃給藥18周。
1.4 指標(biāo)檢測(cè)第20周,禁食12 h后處死各組大鼠。1%氯胺酮麻醉后,心尖取血約5 mL,離心取上層血清,-20℃保存。完整離斷腰椎(L3~L6)、左側(cè)股骨,仔細(xì)剝離軟組織,生理鹽水浸濕的紗布包裹,-20℃保存。右側(cè)脛骨近端置于70%乙醇溶液中,4℃保存。(1)比較各組血糖、骨密度和血清TNF-α、IL-6水平。全自動(dòng)生化儀檢測(cè)FBG,酶聯(lián)免疫吸附試驗(yàn)(ELISA)試劑盒檢測(cè)血清TNF-α和IL-6。雙能X線骨密度儀(DXA)測(cè)定骨密度。(2)比較各組骨組織TNF-α和IL-6 mRNA及蛋白的表達(dá)水平。RT-PCR法測(cè)定骨組織TNF-α和IL-6 mRNA表達(dá)。各組大鼠骨組織以Trizol法提取總RNA,反轉(zhuǎn)錄成cDNA,PCR擴(kuò)增,目的基因及引物序列,見表1??偡磻?yīng)體系50 μL:2×SuperMixⅡ25 μL,上下游引物10 μmol/L各1 μL,cDNA 2 μL,焦磷酸二乙酯(DEPC)水21 μL。TNF-α反應(yīng)條件:94℃預(yù)變性5 min,94℃30 s,55℃30 s,72℃30 s,30個(gè)循環(huán);終末延伸72℃10 min。IL-6反應(yīng)條件:94℃預(yù)變性5 min,94℃30 s,55℃30 s,72℃40 s,35個(gè)循環(huán);終末延伸72℃10 min。β-actin:94℃預(yù)變性5 min,94℃30 s,60℃30 s,72℃40 s,40個(gè)循環(huán);終末延伸72℃10 min。PCR產(chǎn)物行瓊脂糖凝膠電泳,紫外透射儀下觀察拍照,各組擴(kuò)增靶基因產(chǎn)物與相應(yīng)內(nèi)參β-actin條帶的光密度積分值的比值即mRNA的表達(dá)水平。骨組織TNF-α和IL-6蛋白表達(dá)采用Western Blot檢測(cè),各組蛋白條帶的灰度值與相應(yīng)內(nèi)參β-actin條帶灰度值的比值即為蛋白相對(duì)表達(dá)量。
Tab.1The target gene and primer sequences表1 目的基因及引物序列
1.5 統(tǒng)計(jì)學(xué)方法采用SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。符合正態(tài)分布的計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差表示,多組間均數(shù)比較用方差分析,組間多重比較用LSD-t法。P<0.05為差異有統(tǒng)計(jì)學(xué)意義。
2.1 各組FBG、骨密度和血清TNF-α、IL-6的比較與正常對(duì)照組比較,骨質(zhì)疏松模型組骨密度下
降,TNF-α、IL-6升高(均P<0.05);糖尿病模型對(duì)照組FBG、血清TNF-α、IL-6升高,骨密度下降(均P<0.05)。藥物干預(yù)后,與糖尿病模型對(duì)照組比較,中藥低劑量組骨密度升高,中藥各治療組與西藥組FBG、TNF-α和IL-6水平降低,且中藥預(yù)防組血清TNF-α和IL-6水平低于西藥組(均P<0.05),見表2。
2.2 各組大鼠骨組織TNF-α和IL-6 mRNA及蛋白的表達(dá)水平比較與正常對(duì)照組比較,骨質(zhì)疏松模型組和糖尿病模型對(duì)照組TNF-α mRNA、IL-6 mRNA及蛋白表達(dá)增高(P<0.05)。藥物干預(yù)后,與骨質(zhì)疏松模型組和糖尿病模型對(duì)照組比較,中藥預(yù)防組、中藥高劑量組和西藥組骨組織TNF-α mRNA及蛋白表達(dá)下降(P<0.05);與糖尿病模型對(duì)照組比較,中藥預(yù)防組、中藥低劑量組和西藥組IL-6 mRNA及蛋白表達(dá)下降(P<0.05),見表3。
Tab.2Comparison of rat blood glucose,bone density and serum TNF-α and IL-6 between different groups表2 各組大鼠FBG、骨密度和血清TNF-α、IL-6比較(n=10)
Tab.2Comparison of rat blood glucose,bone density and serum TNF-α and IL-6 between different groups表2 各組大鼠FBG、骨密度和血清TNF-α、IL-6比較(n=10)
*P<0.05,**P<0.01a與正常對(duì)照組比較,b與骨質(zhì)疏松模型組比較,c與糖尿病模型對(duì)照組比較,d與中藥預(yù)防組比較,P<0.05;表3同
F B G(m m o l / L)6 . 7 5 ± 0 . 9 7 7 . 0 6 ± 1 . 1 9 2 9 . 9 2 ± 1 . 6 6 a b 2 0 . 4 3 ± 1 . 6 3 a b c 2 2 . 1 2 ± 1 . 5 3 a b c 2 3 . 5 9 ± 1 . 7 0 a b c d 2 1 . 2 1 ± 1 . 7 6 a b c 3 2 4 . 2 9 9 * *組別正常對(duì)照組骨質(zhì)疏松模型組糖尿病模型對(duì)照組中藥預(yù)防組中藥高劑量組中藥低劑量組西藥組F骨密度(g / c m 2)0 . 2 1 7 ± 0 . 0 1 0 0 . 1 8 0 ± 0 . 0 1 2 a 0 . 1 9 8 ± 0 . 0 1 0 a b 0 . 2 0 8 ± 0 . 0 1 1 a b 0 . 2 0 3 ± 0 . 0 1 2 a b 0 . 2 1 0 ± 0 . 0 1 0 b c 0 . 2 0 5 ± 0 . 0 1 3 a b 1 0 . 5 8 8 * * T N F -α(n g / L)2 6 . 2 7 7 ± 2 . 5 2 7 7 8 . 5 0 6 ± 7 . 6 9 7 a 6 9 . 7 2 7 ± 8 . 1 0 8 a b 4 6 . 0 1 1 ± 4 . 6 1 1 a b c 5 4 . 7 3 4 ± 4 . 5 6 9 a b c 5 6 . 2 0 0 ± 4 . 9 7 6 a b c 5 4 . 0 7 7 ± 4 . 7 4 1 a b c d 8 8 . 6 6 2 * * I L -6(n g / L)9 . 1 9 6 ± 0 . 9 7 7 2 3 . 0 5 0 ± 2 . 0 8 4 a 2 1 . 0 0 5 ± 2 . 0 8 2 a b 1 4 . 5 7 2 ± 1 . 1 8 4 a b c d 1 6 . 9 2 9 ± 1 . 3 3 5 a b c 1 7 . 4 7 0 ± 1 . 3 5 3 a b c 1 6 . 8 6 4 ± 1 . 3 2 1 a b c d 8 5 . 1 8 9 * *
Tab.3Comparison of the mRNA and protein expression levels of TNF-α and IL-6 between different groups表3 各組大鼠骨組織TNF-α和IL-6mRNA及蛋白表達(dá)比較(n=10)
Tab.3Comparison of the mRNA and protein expression levels of TNF-α and IL-6 between different groups表3 各組大鼠骨組織TNF-α和IL-6mRNA及蛋白表達(dá)比較(n=10)
T N F -α m R N A 0 . 4 8 5 ± 0 . 0 5 3 0 . 6 7 2 ± 0 . 0 5 3 a 0 . 6 6 8 ± 0 . 0 3 4 a 0 . 5 9 7 ± 0 . 0 2 1 a b c 0 . 6 0 2 ± 0 . 0 5 0 a b c 0 . 6 4 2 ± 0 . 0 3 8 a d 0 . 6 2 0 ± 0 . 0 3 6 a b c 2 2 . 5 7 3 * *組別正常對(duì)照組骨質(zhì)疏松模型組糖尿病模型對(duì)照組中藥預(yù)防組中藥高劑量組中藥低劑量組西藥組F T N F -α 0 . 4 9 8 ± 0 . 0 2 5 0 . 5 8 4 ± 0 . 0 2 2 a 0 . 5 8 3 ± 0 . 0 1 6 a 0 . 5 5 0 ± 0 . 0 0 9 a b c 0 . 5 5 2 ± 0 . 0 2 2 a b c 0 . 5 7 0 ± 0 . 0 1 7 a d 0 . 5 6 1 ± 0 . 0 1 7 a b c 2 2 . 8 0 8 * * I L -6 m R N A 0 . 4 0 4 ± 0 . 0 4 2 0 . 7 3 1 ± 0 . 0 6 4 a 0 . 6 8 0 ± 0 . 0 2 4 a b 0 . 6 1 3 ± 0 . 0 3 7 a b c 0 . 6 5 0 ± 0 . 0 6 3 a b d 0 . 6 3 8 ± 0 . 0 5 1 a b c 0 . 6 2 2 ± 0 . 0 3 5 a b c 4 7 . 8 4 8 * * I L -6 0 . 4 7 1 ± 0 . 0 2 1 0 . 6 2 2 ± 0 . 0 2 5 a 0 . 5 9 9 ± 0 . 0 1 2 a b 0 . 5 6 8 ± 0 . 0 1 6 a b c 0 . 5 8 5 ± 0 . 0 2 9 a b d 0 . 5 7 9 ± 0 . 0 2 3 a b c 0 . 5 7 2 ± 0 . 0 1 6 a b c 5 1 . 0 2 9 * *
糖尿病的炎癥學(xué)說是近年來有關(guān)2型糖尿病發(fā)病機(jī)制的新觀念,該學(xué)說認(rèn)為糖尿病可能是免疫功能異常和相關(guān)細(xì)胞因子所致的炎癥反應(yīng)[5-7]。Mirza等[8]的一項(xiàng)橫斷面研究表明,糖尿病患者血清TNF-α、IL-6較正常者均升高。國內(nèi)一項(xiàng)Meta分析顯示,血清IL-6增高與糖尿病發(fā)生發(fā)展密切相關(guān),證實(shí)糖尿病是一種慢性炎癥[9]。一般情況下,在骨質(zhì)疏松發(fā)病過程中,體內(nèi)炎癥因子水平均異常增高,尤以血清TNF-α、IL-6增高最常見。本研究顯示,與正常對(duì)照組比較,骨質(zhì)疏松模型組和糖尿病模型對(duì)照組骨密度下降,同時(shí)血清TNF-α、IL-6升高,與以上研究結(jié)果一致,表明血清TNF-α、IL-6可能與骨密度有關(guān),TNF-α、IL-6增高可能引起糖尿病并發(fā)骨質(zhì)疏松。TNF-α可刺激基質(zhì)細(xì)胞分泌核因子κB配體受體激活劑(RANKL)和巨噬細(xì)胞集落刺激因子(M-CSF),進(jìn)而促進(jìn)破骨細(xì)胞分化,增強(qiáng)成熟破骨細(xì)胞活性,使骨吸收增強(qiáng),并刺激IL-6、基質(zhì)金屬蛋白酶-1和2的產(chǎn)生,抑制骨形成[10]。研究顯示,IL-6刺激破骨前體細(xì)胞分裂增殖,形成骨吸收陷窩,增加膠原酶釋放,進(jìn)而加強(qiáng)骨基質(zhì)降解,IL-6又可調(diào)節(jié)TNF-α對(duì)破骨細(xì)胞的影響,介導(dǎo)TNF-α激活的下丘腦腎上腺軸引起的糖皮質(zhì)激素的釋放,而糖皮質(zhì)激素也可引起骨丟失[11]。TNF-α的過度分泌又誘導(dǎo)胰島素抵抗,直接或間接影響胰島素信號(hào)傳導(dǎo)通路[12]。因此,TNF-α和IL-6通過多途徑多環(huán)節(jié)參與糖尿病性骨質(zhì)疏松的發(fā)生發(fā)展。
臨床上治療骨質(zhì)疏松癥的西藥包括鈣劑、雌激素及雙磷酸鹽等,但價(jià)格昂貴,長期使用不良反應(yīng)大。常用中藥有淫羊藿、強(qiáng)骨康疏膠囊等,但多針對(duì)
骨質(zhì)疏松單一病癥。中醫(yī)稱糖尿病性骨質(zhì)疏松為“消渴”合并“骨萎”,主要表現(xiàn)陰虛燥熱,脾腎虧虛,血瘀痰濕等。因此,本研究基于中醫(yī)“腎主骨”的理論,選擇滋陰補(bǔ)腎驗(yàn)方三黃糖腎康作為治療藥物。
朱貴忱等[13]研究認(rèn)為,淫羊藿聯(lián)合鈣爾奇D可降低老年骨質(zhì)疏松癥患者血清TNF-α、IL-6水平。本研究結(jié)果顯示,經(jīng)三黃糖腎康干預(yù)后,中藥各治療組血清TNF-α、IL-6水平較骨質(zhì)疏松組和糖尿病模型對(duì)照組下降,且中藥預(yù)防組血清TNF-α、IL-6水平低于西藥組,提示三黃糖腎康對(duì)2型糖尿病性骨質(zhì)疏松的發(fā)生有預(yù)防作用,且藥效優(yōu)于西藥鈣爾奇碳酸鈣D3,可有效地減輕全身炎癥反應(yīng),延緩骨質(zhì)疏松的發(fā)生。中藥預(yù)防組、高劑量組和西藥組大鼠骨組織TNF-α mRNA及蛋白表達(dá)水平較糖尿病模型對(duì)照組大鼠下降,但中藥低劑量組與其差異無統(tǒng)計(jì)學(xué)意義,表明預(yù)防給藥、高劑量的三黃糖腎康和鈣爾奇碳酸鈣D3均可下調(diào)糖尿病大鼠骨組織TNF-α的表達(dá),低劑量的三黃糖腎康發(fā)揮該作用并不明顯。中藥預(yù)防組、低劑量組和西藥組大鼠骨組織IL-6 mRNA及蛋白表達(dá)水平較糖尿病模型對(duì)照組下降,但中藥高劑量組與其差異無統(tǒng)計(jì)學(xué)意義,表明預(yù)防給藥、低劑量的三黃糖腎康和鈣爾奇碳酸鈣D3均可下調(diào)糖尿病大鼠骨組織IL-6的表達(dá),高劑量的三黃糖腎康發(fā)揮該作用并不明顯。因此,筆者認(rèn)為針對(duì)糖尿病大鼠骨組織不同炎癥因子,三黃糖腎康發(fā)揮的抑制炎癥因子表達(dá)的作用不同,且可能和給藥劑量和時(shí)間相關(guān)。
綜上所述,中藥三黃糖腎康能夠抑制全身炎癥因子及骨組織局部炎癥因子TNF-α、IL-6的表達(dá),改善糖尿病的低度炎癥狀態(tài)。
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(2015-02-12收稿 2015-05-29修回)
(本文編輯 陸榮展)
Effects of Sanhuangtangshenkang particles on expressions of TNF-α and IL-6 in bone tissue of T2DM rats
WANG Guan,WANG Jingyi,XI Yue△
The Third Affiliated Hospital of Liaoning Medical University,Jinzhou 121000,China△
ObjectiveTo observe the effects of Sanhuangtangshenkang particles on the expression levels of tumor ne?crosis factor(TNF)-α,interleukin(IL)-6 in bone tissue of type 2 diabetic(T2DM)rat model.MethodsThere were seven groups of rats in this study.Ten female Wistar rats were used as control.Ten rats were established for osteoporosis model,and fifty rats were established for diabetic model.Fifty diabetic model rats were further divided into model control group,tra?ditional Chinese medicine(TCM)prevention group(high-dose TCM group,low-dose TCM group)and Western medicine group,with 10 rats for each group.All rats were given the corresponding intervention for 20 weeks.Automatic biochemistry analyzer was used to determine fasting blood glucose(FBG).ELISA was used to detect serum TNF-α and IL-6.Dual-energy X-ray absorptiometry(DXA)was used to assess bone density.Real-time PCR was used to appraise the mRNA of TNF-α and IL-6 in bone tissue.Western blot assay was used to measure protein expressions of TNF-α and IL-6 in bone tissue.Re?sultsCompared with osteoporosis model group,bone density was significantly increased,serum levels of TNF-α and IL-6,the mRNA and protein expression level of IL-6 were significantly decreased in bone tissue of TCM groups and Western medi?cine group(P<0.05).The expression levels of TNF-α mRNA and protein were significantly decreased in bone tissue of in high-dose TCM prevention group and Western medicine group(P<0.05).Compared with the diabetic model group,the se?rum levels of FBG,TNF-α and IL-6 were significantly decreased in TCM groups and Western medicine group(P<0.05). The expression levels of TNF-α mRNA and protein were significantly decreased in high-dose TCM prevention group and Western medicine group(P<0.05).The mRNA and protein expression levels of IL-6 were significantly decreased in lowdose TCM prevention group and Western medicine group(P<0.05).ConclusionThe expression levels of TNF-α and IL-6 are increased in serum and bone tissue of diabetic rats.Sanhuangtangshenkang particles can improve the inflammatory
diabetes mellitus,type 2;tumor necrosis factor-alpha;interleukin-6;bone and bones;osteoporosis;rats,Wistar;disease models,animal;Sanhuangtangshenkang particles
R587.1
A
10.11958/j.issn.0253-9896.2015.11.019
遼寧省自然科學(xué)基金資助項(xiàng)目(201202147);錦州市科學(xué)技術(shù)計(jì)劃項(xiàng)目(11B2E03)
遼寧省錦州市,遼寧醫(yī)學(xué)院附屬第三醫(yī)院內(nèi)分泌與代謝病科(郵編121000)
王冠(1987),男,醫(yī)學(xué)學(xué)士,主要從事糖尿病并發(fā)癥的研究
△通訊作者E-mail:xiyue-ln@163.com
state to play prevention and therapeutic effect on diabetic rats.