中西医联合治疗对艾滋病肺部感染患者TLR/MyD88信号通路的影响

Effect of Combined Traditional Chinese and Western Medicine Therapy on TLR/MyD88 Signaling Pathway in Patients with Pulmonary Infection of AIDS

目的探讨中西医联合治疗对艾滋病肺部感染痰热壅肺证患者TLR/MyD88信号通路的影响。方法选择艾滋病肺部感染痰热壅肺证患者72例,随机分为36例试验组,36例对照组,试验组在西医基础治疗(对症、支持及抗生素治疗等)上加用清肺培元颗粒,对照组在西医基础治疗上加用清肺培元颗粒模拟剂,7 d为1个疗程,共治疗观察2个疗程,采用荧光定量PCR法检测患者外周血中TLR2、3、4、9及MyD88的基因表达。结果艾滋病合并肺部感染患者TLR/MyD88信号通路上不同基因相对表达存在显著差异,以MyD88表达量最高,TLR9表达量较低,TLR2、TLR3、TLR4表达量居中;清肺培元颗粒可以提高TLR2、3、9的基因表达。结论清肺培元颗粒治疗艾滋病合并肺部感染可能是通过TLR/MyD88信号通路途径。

Objective To investigate the effect of combined treatment of traditional Chinese and western medicine on TLR/MyD88 signaling pathway in patients with pulmonary infection of Acquired Immune Deficiency Syndrome(AIDS)with phlegm-heat obstructing lung syndrome.Methods Seventy-two patients with phlegm-heat syndrome of AIDS pulmonary infection were randomly divided into 36 cases in the experimental group and 36 cases in the control group.The experimental group was treated with Qingfei Peiyuan Granule(清肺培元颗粒)on the basis of Western medicine treatment(symptomatic,supportive and antibiotic treatment,etc.),and the control group was treated with Qingfei Peiyuan Granule on the basis of Western medicine.Seven days was a course of treatment,and a total of two courses of treatment were observed.The gene expressions of Toll like receptor(TLR)2,TLR3,TLR4,TLR9 and myeloid differentiation factor 88(MyD88)in patients′peripheral blood was detected by fluorescence quantitative PCR.Results There were significant differences in the relative expressions of different genes in the TLR/MyD88 signaling pathway in AIDS patients with pulmonary infection,with the highest expression level of MyD88,the lowest expression level of TLR9,and the middle expression levels of TLR2,TLR3 and TLR4.Qingfei Peiyuan Granule can improve the gene expressions of TLR2,TLR33 and TLR39.Conclusion Qingfei Peiyuan Granule may treat AIDS with pulmonary infection through TLR/MyD88 signaling pathway.