补髓生血颗粒治疗慢性再障临床疗效及对骨髓细胞p-JNK mRNA及蛋白表达的影响

Clinical Efficacy of Busui Shengxue Granule Treating Chronic Aplastic Anemia and Its Effect on Expressions of p-JNK mRNA and Protein in Bone Marrow Cells

目的:观察中药补髓生血颗粒治疗慢性再生障碍性贫血(CAA)的临床疗效,并探讨对骨髓细胞p-JNK信号通路mRNA及蛋白表达的影响。方法:将符合纳入标准的60例CAA患者按照随机数表分为试验组、对照组各30例,正常组20例均为健康志愿者。试验组口服补髓生血颗粒,对照组口服再造生血片,两组连续治疗6个月。观察比较治疗前后两组临床疗效及中医证候疗效变化,检测两组CAA患者治疗前后骨髓单个核细胞中p-JNK的mRNA表达(采用RT-PCR法检测)、p-JNK的蛋白表达(采用Western-blot法检测)。结果:治疗后,试验组临床总有效率高于对照组(P<0.05);治疗前,两组p-JNK的mRNA及蛋白表达均高于正常组(均P<0.05);治疗后,两组p-JNK的mRNA及蛋白表达水平均有降低,与疗前相比均有显著性差异(均P<0.05),p-JNK mRNA表达试验组与对照组相比有显著性差异(P<0.05),与正常组相比无显著性差异(P>0.05),p-JNK蛋白表达试验组与对照组相比有显著性差异(P<0.05),与正常组相比有显著性差异(P<0.05)。结论:补髓生血颗粒治疗CAA可提高临床总有效率,改善患者临床症状与造血功能。CAA患者骨髓细胞中p-JNK的mRNA及蛋白表达水平异常升高,提示CAA发病机制可能与p-JNK表达异常相关,补髓生血颗粒可能通过下调p-JNK mRNA及蛋白表达水平,来抑制造血干细胞过凋亡效应,延长细胞生存时间,提高骨髓造血能力。

Objective:To observe the clinical efficacy of Chinese medicine Busui Shengxue Granule in the treatment of chronic aplastic anemia(CAA) and explore the effect of mRNA and protein expression on p-JNK signaling pathway in bone marrow cells. Method:Sixty patients with CAA who met the inclusion criteria were divided into the test group and the control group according to the random number table,and 30 cases in each group. Meanwhile, 20 cases in the normal control group were healthy volunteers. The test group took Busui Shengxue Granule, and the control group used Zaizao Shengxue Tablets. The two groups were treated continuously for 6 months. We observed the clinical efficacy and TCM syndrome changes before and after treatment, and detected the expressions of p-JNK mRNA(detected by RT-PCR) and p-JNK protein(detected by Western-blot) in bone marrow mononuclear cells before and after treatment in two groups. Result:After treatment, the total effective rate of the test group was higher than that of the control group(P<0.05). Before treatment, the mRNA and protein expression of p-JNK in the two groups were higher than those in the normal control group(P<0.05). After treatment, two groups’ mRNA and protein expression levels of p-JNK were decreased, and there were significant differences compared with those before treatment(P<0.05). In aspect of p-JNK mRNA expression, the test group had significant difference compared with the control group(P<0.05), and there was no significant difference compared with the normal control group(P>0.05). Furthermore, in aspect of p-JNK protein expression, there was a significant difference between the test group and the control group(P<0.05), and the same with the normal control group(P<0.05). Conclusion:The treatment of CAA with Busui Shengxue Granule can improve the total clinical efficiency and improve the clinical symptoms and hematopoietic function of patients. The expression of p-JNK mRNA and protein in bone marrow cells of CAA patients was abnormally elevated, suggesting that the pathogenesis of CAA may be associated with abnormal expression of p-JNK. Busui Shengxue Granule may inhibit the overapoptosis effect of hematopoiesis stem cells by down-regulating p-JNK mRNA and protein expression levels to prolong the stem cells’ survival time and improve bone marrow hematopoietic capacity.