Research Progress on Chinese Medicine Immunomodulatory Intervention for Chronic Primary Immune Thrombocytopenia: Targeting Cellular Immunity

Chronic primary immune thrombocytopenia(CITP) is the most common acquired autoimmune disease that seriously threaten the physical and mental health of patients. Compared with Western medicine treatment, the intervention and treatment of Chinese medicine(CM) has shown certain therapeutic advantages. This paper reviewed the new pathogenesis progress on T cell immune abnormality in CITP, and CM studies on interferes effects of cellular immune regulation of CITP in recent years. Qi deficiency failing to control blood and internal obstruction of blood stasis are the two common types of CM syndromes in CITP patients, the corresponding treatments include invigorating Pi(Spleen), supplementing qi, activating blood, as well as tonifying qi and activating yang, regulating Gan(Liver) to invigorate Pi. The authors also mentioned the problems in the research field of CM for CTIP treatment, and put forward new ideas for the research in the future.

Panaxdiol Saponins Component Promotes Hematopoiesis and Modulates T Lymphocyte Dysregulation in Aplastic Anemia Model Mice

Objective: To investigate the potential efficacy of panaxadiol saponins component(PDS-C) in the treatment of aplastic anemia(AA) model mice. Methods: Totally 70 mice were divided into 7 groups as follows: normal, model, low-, medium-, high-dose PDS-C(20, 40, 80 mg/kg, namely L-, M-, H-PDS-C), cyclosporine(40 mg/kg), and andriol(25 mg/kg) groups, respectively. An immune-mediated AA mouse model was established in BALB/c mice by exposing to 5.0 Gy total body irradiation at 1.0 Gy/min, and injecting with lymphocytes from DBA mice. On day 4 after establishment of AA model, all drugs were intragastrically administered daily for 15 days, respectively, while the mice in the normal and model groups were administered with saline solution. After treatment, the peripheral blood counts, bone marrow pathological examination, colony forming assay of bone marrow culture, T lymphocyte subpopulation analysis, as well as T-bet, GATA-3 and Fox P3 proteins were detected by flow cytometry and Western blot. Results: The peripheral blood of white blood cell(WBC), platelet, neutrophil counts and hemoglobin(Hb) concentration were significantly decreased in the model group compared with the normal group(all P<0.01). In response to 3 dose PDS-C treatment, the WBC, platelet, neutrophil counts were significantly increased at a dose-dependent manner compared with the model group(all P<0.01). The myelosuppression status of AA was significantly reduced in M-, H-PDS-C groups, and hematopoietic cell quantity of bone marrow was more abundant than the model group. The colony numbers of myeloid, erythroid and megakaryocytic progenitor cells in the model group were less than those of the normal mice in bone marrow culture, while, PDS-C therapy enhanced proliferation of hematopoietic progenitor cells by significantly increasing colony numbers(all P<0.01). Furthermore,PDS-C therapy increased peripheral blood CD3^+ and CD3^+CD4^+ cells and reduced CD3^+CD8^+ cells(P<0.05 or P<0.01). Meanwhile, PDS-C treatment at medium-and high doses groups also increased CD4^+CD25^+Fox P3^+ cells, downregulated T-bet protein expression, and upregulated GATA-3 and Fox P3 protein expressions in spleen cells(P<0.05). Conclusion: PDS-C possesses dual activities, promoting proliferation hematopoietic progenitor cells and modulating T lymphocyte immune functions in the treatment of AA model mice.

Effect Evaluation of Strychnos nux-vomica L.with Integrative Methods for Bortezomib-Induced Peripheral Neuropathy in Multiple Myeloma Patients:A Self-Controlled Clinical Trial

Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule(NVC,0.4 g,thrice daily)were orally administrated for 30 days.Comparative analysis on parameters between pre-and post-therapy,including peripheral neuropathy(PN)grade,neurotoxicity score,Chinese medicine(CM)syndrome score,total neuropathy score(TNS),coagulation function,and serum nerve growth factor(NGF)levels were conducted.The adverse events were monitored.Results:In BIPN of MM patients who received NVC,PN grade was lowered,neurotoxicity score was obviously decreased(P 0.01),and both CM syndrome score and TNS were remarkably decreased(P<0.01).After the therapy,activated partial thromboplastin time was prolonged(P<0.01)and fibrinogen was declined(P<0.05),showing improvement in the hypercoagulable state of patients.No significant difference of NGF recovery degrees was detected between pre-and post-therapy(P>0.05).No evident adverse reactions were observed during the course of treatment.Conclusion:Strychnos nux-vomica L.has significantly effect with a good safety in treatment of BIPN in MM patients.

Pure Total Flavonoids from Citrus paradisi Macfad InduceLeukemia Cell Apoptosis In Vitro

Objective： To investigate the potential effect of pure total flavonoids from Citrus paradisi Macfad peel（PTFC） on the proliferation and apoptosis of human myeloid leukemia cells Kasumi-1, HL-60 and K562, and the underlying mechanisms. Methods： PTFC was extracted from Citrus paradisi Macfad peel and was identified by high performance liquid chromatography. The effect of PTFC on the proliferation and apoptosis of leukemia cells were determined by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide, fluorescent microscopy and flow cytometry, respectively. The effect of PTFC on the expression levels of apoptosis-related regulators was determined by Western blot assay. Results： Treatment with PTFC inhibited leukemia cell proliferation in a dose-and time-dependent manner and triggered Kasumi-1 cell apoptosis. Treatment with PTFC significantly increased the levels of activated poly adenosine diphosphate-ribosepolymerase and caspase-3/-9, but reduced the levels of Mcl-1 expression in Kasumi-1 cells. However, PTFC did not obviously induce HL-60 cell apoptosis. Conclusion： PTFC inhibited leukemia cell proliferation and induced their apoptosis by modulating apoptosisrelated regulator expression in leukemia cells in vitro.

Chinese Medicine Treatment on Graft-Versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation

Graft-versus-host disease(GVHD)is the most common complication after allogeneic hematopoietic stem cell transplantation,and also an important factor affecting the survival and quality of life in patients after transplantation.Currently,immunosuppressive therapy is commonly used for GVHD,but the curative effect is not ideal.How to effectively prevent and treat GVHD is one of the difficulties to be solved urgently in the field of transplantation.In this paper,we summarize the latest progress in pathogenesis,prevention and treatment of GVHD with Chinese medicine(CM).We hope it will provide ideas and methods for exploring the mechanism and establishing a new comprehensive therapy for GVHD with CM.