Certain skin disorders, such as contact dermatitis and chronic urticaria, are characterized by inflammation involving mast cells and worsen by stress. The underlying mechanism of this effect, however, is not known. Th...Certain skin disorders, such as contact dermatitis and chronic urticaria, are characterized by inflammation involving mast cells and worsen by stress. The underlying mechanism of this effect, however, is not known. The skin appears to have the equivalent of a hypothalamic-pituitary-adrenal (HPA) axis, including local expression of corticotropin-releasing hormone (CRH) and its receptors (CRH-R). We have reported that acute stress and intradermal administration of CRH stimulate skin mast cells and increase vascular permeability through CRH-R1 activation. In this study, we investigated the expression of CRH-R1, the main CRH-R subtype in human skin, and the mast cell related gene histidine decarboxylase (HDC), which regulates the production of histamine, in normal and pathological skin biopsies. Quantitative real time PCR revealed that chronic urticaria expresses high levels of CRH-R1 and HDC as compared to normal foreskin, breast skin and cultured human keratinocytes. The lichen simplex samples had high expression of CRH-R1,but low HDC. These results implicate CRH-R in chronic urticaria, which is often exacerbated by stress.展开更多
目的探讨疏肝运脾汤治疗肠癌癌因性疲乏(Cancer related fatigue,CRF)的临床疗效及作用机制。方法选取2020年3月—2022年3月期间南通市第三人民医院收治的住院或门诊肠癌患者110例作为研究对象,按随机数字表法分为对照组和治疗组,每组...目的探讨疏肝运脾汤治疗肠癌癌因性疲乏(Cancer related fatigue,CRF)的临床疗效及作用机制。方法选取2020年3月—2022年3月期间南通市第三人民医院收治的住院或门诊肠癌患者110例作为研究对象,按随机数字表法分为对照组和治疗组,每组各55例。两组患者均给予抗肿瘤治疗如手术、放化疗、介入、分子靶向、免疫等的基础上增加CRF相关干预措施。对照组进行非药物干预,治疗组在对照组基础上加用自拟疏肝运脾汤加减。治疗6个月后,观察比较两组患者临床疗效、不良反应情况,治疗前后中医临床症状等级评分、卡氏评分(Keypunch Performance System,KPS)、Piper疲乏评分、医院焦虑抑郁情绪测量表(Hospital Anxiety and Depression Scale,HAD)评分变化,血清指标[内分泌激素促肾上腺皮质激素(Adrenocorticotropic hormone,ACTH)、皮质醇(Cortisol,CORT)及T细胞亚群]水平。结果治疗后两组患者中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组明显低于对照组,差异有统计学意义(P<0.05)。治疗后对照组各维度的Piper疲乏评分及总分与治疗前比较,差异无统计学意义(P>0.05);治疗组各维度的Piper疲乏评分及总分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组各维度(行为维度、情感维度、感觉维度和认知维度)的Piper疲乏评分及总分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者KPS评分较治疗前升高,HAD焦虑、HAD抑郁评分较治疗前降低,差异有统计学意义(P<0.05);且治疗组KPS评分高于对照组,HAD焦虑及HAD抑郁评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清ACTH、NF-κB p65、TNF-α、sTNF-R1水平较治疗前明显降低,血清CORT水平较治疗前明显升高,差异有统计学意义(P<0.05);且治疗组血清ACTH、NF-κB p65、TNF-α、sTNF-R1水平明显低于对照组,血清CORT水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CD8+水平降低,CD3+、CD4+及CD4+/CD8+水平升高,差异有统计学意义(P<0.05);且治疗组CD8+水平低于对照组,CD3+、CD4+及CD4+/CD8+水平均高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组总有效率96.36%(53/55)明显高于对照组80.00%(44/55),差异有统计学意义(P<0.05)。治疗过程中,两组患者均未出现明显不良反应,用药前后的血尿常规、心电图及肝肾功能检查结果均未见异常。结论从基因层面探讨疏肝运脾汤治疗肠癌CRF的分子机制,找到抑制CRF的新靶点———细胞核因子NF-κB的中医组方,改善肿瘤微环境的免疫抑制和炎症状态,提高肠癌临床疗效,提升患者的生活质量,延长其生存时间。展开更多
文摘Certain skin disorders, such as contact dermatitis and chronic urticaria, are characterized by inflammation involving mast cells and worsen by stress. The underlying mechanism of this effect, however, is not known. The skin appears to have the equivalent of a hypothalamic-pituitary-adrenal (HPA) axis, including local expression of corticotropin-releasing hormone (CRH) and its receptors (CRH-R). We have reported that acute stress and intradermal administration of CRH stimulate skin mast cells and increase vascular permeability through CRH-R1 activation. In this study, we investigated the expression of CRH-R1, the main CRH-R subtype in human skin, and the mast cell related gene histidine decarboxylase (HDC), which regulates the production of histamine, in normal and pathological skin biopsies. Quantitative real time PCR revealed that chronic urticaria expresses high levels of CRH-R1 and HDC as compared to normal foreskin, breast skin and cultured human keratinocytes. The lichen simplex samples had high expression of CRH-R1,but low HDC. These results implicate CRH-R in chronic urticaria, which is often exacerbated by stress.
