活血通络汤对激素性股骨头坏死造模兔PDGF、BMP-2及Notch3的影响

Effect of Huoxue Tongluo Decoction on PDGF,BMP-2 and Notch3 in Rabbits with Steroid Induced Osteonecrosis of the femoral Head

目的:观察活血通络汤防治兔激素性股骨头坏死(SANFH)的疗效及PDGF、BMP-2及Notch3的表达变化,并探讨相关机制。方法:将192只日本大耳兔随机分为预防+治疗组A、治疗组B、模型对照组C、空白对照组D,每组各48只。A、B、C三组均在第3周开始造模,造模周期6周。A组在造模前一周开始喂服中药;B组于造模时开始喂服中药饲料;C、D两组均喂服等量普通饲料。动态观察每组家兔的机能情况;于造模前、造模中、造模后相对应的时间点应用Elisa法、RT-PCR法检测家兔血中PDGF、BMP-2及Notch3的含量;并于造模结束后取股骨头做病理镜检观察骨细胞,计算空骨陷窝率。结果:①PDGF:第8周末时,A、B两组的含量均高于C组(P<0.05),且A组高于B组(P>0.05);②BMP-2:第8周末时,A、B两组的含量均显著高于C组(P<0.01),且A组的下降趋势较B组缓和;③Notch3:在第8周末时,A、B两组的表达值均低于C组(P<0.01、0.05),且A组低于B组(P>0.05)。结论:①SANFH的发生及骨坏死的进展与Notch3蛋白基因的表达呈正相关,而与PDGF、BMP-2的表达成反相关;②活血通络汤预防治疗SANFH的机制可能是通过抑制Notch3蛋白基因而上调PDGF、BMP-2的表达来刺激血管活性,改善股骨头血供并诱导BMSCs向成骨细胞分化增殖,促进骨修复而发挥预防治疗作用。

Objective:To observe the effect of Huoxue Tongluo Decoction on the treatment of steroid induced avascular necrosis of the femoral head(SANFH) and the expression changes of PDGF,BMP-2 and Notch3 in rabbits and explore the related mechanism.Methods:A total of 192 Japanese big ear rabbits were randomly divided into prevention and treatment group A,treatment group B,model group C,blank group D.A,B,C groups began to set up the model in the third week and the modeling cycle was 6 weeks.The group A began to feed traditional Chinese medicine a week before the establishment of the model.The group B began to feed traditional Chinese medicine at the time of modeling,and the groups of C and D were given the ordinary feed.Dynamic observation of the function of each group of rabbits,content of PDGF,BMP-2 and Notch3 in rabbit blood was detected by ELISA and RT-PCR at the corresponding time point before modeling,during modeling and after modeling.After the modeling of femoral bone pathology,we observed bone cells and calculated the ratio of empty lacuna.Results:PDGF:at the end of the eighth week,the contents of groups A and B were higher than those in group C(P<0.05).The group A′s was higher than that of group B(P>0.05).BMP-2:at the end of the eighth week,the contents of groups A and B were significantly higher than those in group C(P<0.01).The trend of decrease in group A was lower than that of group B.Notch3:at the eighth weekend,the expression values of A and B were lower than those of group C(P<0.01,P<0.05).The group A′s was lower than that of group B(P>0.05).Conclusion:The expression of Notch3 protein positive progress and gene and bone necrosis of SANFH and the correlation with the expressions of the PDGF and BMP-2 were inversely related.The prevention mechanism of Huoxue Tongluo Decoction of SANFH may inhibit Notch3 and up regulate the expressions of PDGF and BMP-2 to stimulate activity,improve the blood supply of the femoral head and BMSCs induced differentiation to osteoblast proliferation,promote bone repair and play a role in prevention and treatment.