制首乌中顺式二苯乙烯苷转化量与特异质肝损伤的相关性研究

Study on idiosyncratic liver injury and content of cis-2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside in radix Polygoni multiflori Preparata

考察制首乌中易感物质顺式二苯乙烯苷(顺式-2,3,5,4'-四羟基二苯乙烯-2-O-β-D-葡萄糖苷,cis-SG)转化量与特异质肝损伤的相关性,并探讨其可能的安全限度。通过光照将制首乌50%乙醇提取液中反式二苯乙烯苷(反式-2,3,5,4'-四羟基二苯乙烯-2-O-β-D-葡萄糖苷,trans-SG)转化为cis-SG,得到不同转化量的样品,分别在正常大鼠和内毒素(2.8 mg·kg^(-1),iv)复制的易感性模型大鼠上给药(7.56 g·kg^(-1),ig),考察血浆生化指标、炎症因子及组织病理的改变等,比较大鼠肝损伤作用的差异。结果表明,所有制首乌样品在正常大鼠上均未引起肝损伤;在内毒素模型上,未光照、光转化cis-SG含量0.10%的制首乌样品均未见明显的肝损伤,而光转化cis-SG含量0.35%和0.70%的制首乌样品均引起明显肝脏病理改变,表现为肝细胞肿胀坏死、大量炎症细胞浸润,肝组织核转录因子-κB(NF-κB)p65表达量、细胞凋亡率均显著增加(P<0.05),同时血浆ALT、AST、TNF-α和IL-6含量均显著增加(P<0.05),过氧化物酶体增殖物激活受体-γ(PPAR-γ)含量显著降低(P<0.05)。同时,临床上制首乌引起肝损伤患者的余留药物含量分析发现,其cis-SG含量(>0.40%)均高于产地收集饮片(<0.10%)。综合实验评价和临床分析结果提示,易感物质cis-SG含量与制首乌特异质肝损伤存在一定的量-毒关系;为降低临床用药风险,初步建议可将cis-SG含量0.10%作为何首乌生产炮制过程的质控限度。

This study was designed to investigate the correlation between idiosyncratic liver injury and content of cis-2,3,5,4＇-tetrahydroxystilbene-2-O-β-D-glucoside（cis-SG） in radix Polygoni multiflori Preparata（RPMP）. In order to compare the effect of hepatotoxicity of different cis-SG contents in RPMP, rats were administered with 50% alcohol extracts of RPMP（7.56 g·kg^（-1）, via intragastric administration） alone or co-treated with lipopolysaccharide（LPS, 2.8 mg·kg^（-1）, via tail vein injection）. The results showed that no significant alterations of plasma ALT and AST activities were observed in the normal rats. In the LPS treated rats, the group without light treatment and the group with 0.10% cis-SG after light treatment did not exhibit obvious injury in liver. The group with 0.35% cis-SG after light treatment and the group with 0.70% cis-SG after light treatment showed significant increases in ALT, AST, TNF-α, IL-6, NF-κB p65 and apoptosis rate（P 0.05）, causing pathological changes in the liver tissue. Through the content analysis of drug in patients with liver injury, we found that the content of cis-SG（ 0.40%） was generally higher than that of pieces collected from different origins（ 0.10%）. The comparative analysis of experiments and clinical data showed that there was a relationship between the content of cis-SG and idiosyncratic liver injury. In order to reduce the risk of clinical medication, the content of cis-SG of 0.10% should be a limit of quality control in the production processing of Polygonum multiflorum.