清肠化瘀方对溃疡性结肠炎患者CDX2 mRNA、miR-22及Th17细胞的影响

Effects of Qingchang Huayu Recipe on CDX2 mRNA,miR-22 and Th17 Cells in patients with ulcerative colitis

目的探讨中药清肠化瘀方对溃疡性结肠炎(ulcerative colitis,UC)患者尾型同源盒转录因子2(caudal type homeobox transcription factor2,CDX2)、miR-22及辅助性T细胞17(the helper 17 cells,Th17)的影响。方法选择大肠湿热型UC患者96例,按照随机数字表法分为研究组(48例)和对照组(48例),研究组口服美沙拉嗪片和中药清肠化瘀方,对照组口服美沙拉嗪片和中药清肠化瘀方低剂量配方颗粒,疗程均为12周。比较两组治疗前后中医证候评分、Sutherland疾病活动指数(disease activity index,DAI)评分、Geboe指数评分;并包括两组血清CDX2 mRNA、miR-22、IL-17、IL-21水平和外周血Th17含量,比较炎症性肠病生活质量问卷(inflammatory bowel disease quality of life questionnaire,IBDQ)评分。结果治疗后研究组中医证候评分、DAI评分、Geboe指数评分均低于对照组(P<0.01);血清CDX2 mRNA水平高于对照组(P<0.01),miR-22水平低于对照组(P<0.01),外周血Th17细胞含量及血清IL-17、IL-21水平低于对照组(P<0.01);IBDQ各维度(肠道症状、全身症状、情感能力、社会能力)评分均高于对照组(P<0.01)。结论清肠化瘀方可有效改善中医证候,促进肠黏膜的修复和愈合,改善患者生活质量,治疗大肠湿热型UC效果显著,其机制可能与调控CDX2 mRNA、miR-22表达,抑制Th17细胞分化,减少IL-17、IL-21等Th17细胞相关因子合成有关。

Objective To investigate the effects of Qingchang Huayu Recipe on caudal type homeobox transcription factor 2(CDX2),miR-22 and helper T cell 17(Th17)in patients with ulcerative colitis(UC).Methods A total of 96 patients with UC of damp-heat of large intestine were randomly divided into study group(48 cases)and control group(48 cases).The study group took mesalazine tablets and Qingchang Huayu Recipe orally,and the control group took mesalazine tablets and Qingchang Huayu Recipe low-dose granules orally.The course of treatment took 12 weeks.The traditional Chinese medicine(TCM)syndrome score,Sutherland disease activity index(DAI)score and Geboe index score were compared between the two groups before and after treatment.The levels of serum CDX2 mRNA,miR-22,IL-17,IL-21 and Th17 in peripheral blood of the two groups were compared.The scores of inflammatory bowel disease quality of life questionnaire(IBDQ)were compared.Results The TCM syndrome score,DAI score and Geboe index score of the study group were lower than those of the control group(P<0.01);the level of serum CDX2 mRNA was higher than that of the control group(P<0.01);the level of miR-22 was lower than that of the control group(P<0.01);the content of peripheral blood Th17 cells and the levels of serum IL-17 and IL-21 were lower than those of the control group(P<0.01);the scores of IBDQ in all dimensions(intestinal symptoms,systemic symptoms,emotional ability and social ability)were higher than those of the control group(P<0.01).Conclusion Qingchang Huayu Recipe can effectively improve TCM syndromes,promote the repair and healing of intestinal mucosa,improve the quality of life of patients,and it has a significant effect on the treatment of UC of damp-heat of large intestine.Its mechanism may be related to regulating the expression of CDX2 mRNA and miR-22,inhibiting the differentiation of Th17 cells and reducing the synthesis of Th17 cell related factors such as IL-17 and IL-21.