葛根素联合替米沙坦对肥胖性高血压患者血管内皮细胞TLR/NF-κB炎症信号通路的影响

Effects of puerarin combined with telmisartan on Toll-like receptor/nuclear factor-κB inflammatory signal pathway in patients with obesity hypertension

目的观察葛根素联合替米沙坦对肥胖性高血压患者血管内皮细胞Toll样受体/核因子-κB(TLR/NF-κB)炎症信号通路的影响。方法选取2013年6月至2015年6月诊治的肥胖性高血压患者160例为病例组,另选取同期进行健康体检的正常人100例为正常组。采用Real time-PCR测定2组血管内皮细胞Toll样受体2(TLR2)、Toll样受体4(TLR4)mRNA表达。将160例肥胖性高血压患者随机分为观察A组和观察B组,每组80例。观察A组给予替米沙坦治疗,观察B组在观察A组基础上加用葛根素治疗,疗程1个月。采用Real time-PCR和Western-blot分别测定TLR2、TLR4、NF-κB及其抑制蛋白IκBa mRNA和蛋白表达。采用酶联免疫吸附实验(ELISA)测定血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、超敏C-反应蛋白(hs-CRP)水平变化。结果 (1)与对照组比较,肥胖性高血压患者组TLR2、TLR4 mRNA表达显著升高,差异有统计学意义(P<0.05);(2)经治疗后,观察A组和观察B组TLR2、TLR4、NF-κB mRNA和蛋白表达及TNF-α、IL-6、hs-CRP水平显著下降,IκBa mRNA和蛋白表达显著升高(P<0.05),但观察组以上指标改善程度优于对照组,差异有统计学意义(P<0.05)。结论肥胖性高血压患者存在明显的免疫炎性反应紊乱,葛根素联合替米沙坦能够明显下调TLR/NF-κB炎症信号通路的激活及炎性因子释放,进而对血管内皮损伤发挥保护作用。

Objective To investigate the effect of puerarin combined with telmisartan on Toll-like receptor/nuclear factor-κB （ TLR/NF-κB） inflammatory signal pathway in patients with obesity hypertension .Methods A total of 160 patients with obesity hypertension who were admitted and treated in our hospital from June 2013 to June 2015 were enrolled as case group,and the other 100 healthy subjects were served as normal control group .The expression levels of TLR2 ,TLR4 mRNA in vascular endothelial cells were detected by Real time-PCR.In addition, the patients in case group were randomly redivided into observation group （ n =80） and control group （ n =80）.The patients in control group were treated by telmisartan ,however, the patients in observation group ,on the basis of control group , were given puerarin ,with a treatment course of one month for both groups.After treatment, The expression levels of TLR2, TLR4, NF-κB and IκBa at mRNA and protein were detected by Real time-PCR and Western Blot , respectively .Furthermore the serum levels of TNF-α, IL-6 and hs-CRP were detected by ELISA.Results As compared with those in normal control group ,the expression levels of TLR2 and TLR4 mRNA in case group were significantly increased （ P 〈0.05）.After treatment ,the expression levels of TLR2, TLR4, NF-κB mRNA and protein and the serum levels of TNF-α, IL-6, hs-CRP in control group and observation group were significantly decreased , however , the expression levels of IκBa mRNA and protein in both groups were significantly increased ,as compared with those before treatment （ P 〈0.05）,but the improvement degree of these parameters in observation group was superior to that in control group （ P 〈0.05）.Conclusion The obvious immune inflammatory reaction disorder exists in patients with obesity hypertension .Puerarin combined with telmisartan can obviously down -regulate the activation of TLR/NF-κB inflammatory signal pathway and release of inflammatory factors so us to perform protective effects on vascular endothelial injury .