针药结合对阿尔茨海默病大鼠海马区Bcl-2和Bax蛋白表达的影响

Effect of acupuncture plus medication on expression of Bcl-2 and Bax in hippocampus in rats with Alzheimer's disease

目的:探讨针药结合治疗阿尔茨海默病(Alzheimer’sdisease,AD)的机制。方法:将成年SD大鼠60只随机分为正常组、假手术组、模型组、电针组、天麻素组和针药结合组,每组10只。腹腔注射D-半乳糖并联合双侧海马注射Aβ1-40建立AD模型大鼠。造模2周后,电针组和针药结合组大鼠选取"百会""大椎"与双侧"足三里"进行电针治疗,每天1次,每次30 min,连续4周;天麻素组和针药结合组以天麻素注射液进行腹腔注射治疗,每天1次,连续4周;正常组、模型组和假手术组大鼠不予干预。采用HE染色观察各组大鼠海马神经元形态;免疫组化法检测各组大鼠海马CA1区B淋巴细胞瘤-2基因(Bcl-2)、B淋巴细胞瘤因子相关X蛋白(Bax)的表达;Western blot法检测各组大鼠海马区Bcl-2、Bax蛋白的表达。结果:HE染色结果显示,正常组与假手术组海马CA1区神经元排列规则,胞质与胞核清晰可见;模型组神经元出现严重损伤,细胞排列不紧密,细胞形态不完整;各干预组细胞形态较模型组有显著改善。免疫组化法结果显示,与正常组和假手术组比较,模型组大鼠海马CA1区Bcl-2的表达减弱,Bax的表达增强(均P<0.05);与模型组比较,各干预组Bcl-2的表达增强,Bax的表达减弱(均P<0.05);与电针组或天麻素组比较,针药结合组Bcl-2的表达增强,Bax的表达减弱(均P<0.05)。Western blot法检测结果与免疫组化结果趋于一致。结论:电针与天麻素可明显抑制Bax的表达,上调Bcl-2的表达,以针药结合作用最为显著,表明电针结合天麻素对抑制AD大鼠海马区神经元的凋亡具有协同促进作用,这可能是针药结合治疗AD病变的机制之一。

Objective To explore the mechanism of acupuncture plus medication on treatment of Alzheimer’s disease(AD). Methods Sixty adult SD rats were randomly divided into a normal group, a sham operation group, a model group, an electroacupuncture(EA) group, a gastrodin group and an EA+gastrodin group, 10 rats in each one. The rat model of AD was established by intraperitoneal injection of D-galactose and bilateral hippocampal injection of Aβ1-40. Two weeks after modeling, the rats in the EA group and EA+gastrodin group were treated with EA at "Baihui"(GV 20)"Dazhui"(GV 14) and bilateral "Zusanli"(ST 36), 30 min per treatment, once a day for consecutive 4 weeks. The rats in the gastrodin group and EA+gastrodin group were treated with intraperitoneal injection of gastrodin, once a day for consecutive 4 weeks. The rats in the normal group, model group and sham operation group were not treated. The morphology of hippocampal neurons was observed by using HE staining. The expression of Bcl-2 and Bax in the hippocampal CA1 area was detected by using immunohistochemical method. The expression of Bcl-2 and Bax protein in hippocampus was detected by using Western blot.Results The HE staining results showed the arrangement of neurons in the hippocampal CA1 area was regular in the normal group and the sham operation group, and the cytoplasm and nucleus were clearly visible. The neurons in the model group were severely damaged;the cell arrangement was not close, and the cell morphology was incomplete. Compared with the model group, the cell morphology of each intervention group was significantly improved. The immunohistochemistry results showed that, compared with the normal group and the sham operation group, the expression of Bcl-2 in the hippocampal CA1 region in the model group was decreased(P<0.05), but the expression of Bax was enhanced(P<0.05);compared with the model group, the expression of Bcl-2 was increased(all P<0.05) and the expression of Bax was decreased(all P<0.05) in all intervention group;compared with the EA group or the gastrodin group, the expression of Bcl-2 was enhanced(P<0.05) and the expression of Bax was decreased(P<0.05) in the EA+gastrodin group. The result of Western blot method was consistent with that of immunohistochemistry method. Conclusion EA and gastrodin could significantly inhibit the expression of Bax and up-regulate the expression of Bcl-2, and the combination of EA and gastrodin has the most significant effect. This indicates that EA combined with gastrodin has synergistic effect on inhibiting the apoptosis of neurons in hippocampus in AD rats, which may be one of the mechanisms of EA plus medication on AD lesions.