CN117357613A - 一种中药复方组合物在制备抗肺纤维化药物中的用途 - Google Patents
一种中药复方组合物在制备抗肺纤维化药物中的用途 Download PDFInfo
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Abstract
本发明属于医药技术领域,具体涉及一种中药复方组合物在制备抗急性肺损伤和肺纤维化药物中的用途。本发明的中药复方组合物具有显著的抗急性肺损伤和肺纤维化的作用,能够用于改善和治疗急性肺损伤和肺纤维化疾病,该中药复方组合物是通过保护血管内皮屏障功能、抑制中性粒细胞的致炎作用来抗急性肺损伤,通过抑制转化生长因子β1/信号转导分子2信号通路、减少上皮间质转化、降低氧化应激水平改善肺纤维化程度。为急性肺损伤和肺纤维化患者提供一种疗效显著,不良反应小的新药物,以减轻患者的痛苦。
Description
技术领域
本发明属于医药技术领域,具体涉及一种中药复方组合物在制备抗急性肺损伤和肺纤维化药物中的新用途。
背景技术
唐草片是一种纯中药制剂,由老鹳草、金银花、柴胡、香薷、瓜蒌皮、石榴皮、黄芪、甘草、木棉花等二十味中药组成。具有清热解毒、活血益气的功效。目前临床用于治疗艾滋病毒感染者及艾滋病患者,有提高CD4淋巴细胞计数作用,可改善乏力、脱发、食欲减退和腹泻等症状。
唐草片中多种中药成分均被证实具有显著的抗炎作用。老鹳草是牻牛儿苗科的多年生草本植物,主要用于祛风通络;活血;清热利湿等。近年来,老鹳草中黄酮类、有机酸和挥发油等90多种化学成分被分离并证明具有抗炎、抗菌、抗病毒、抗氧化及免疫调节等作用。现有研究表明,老鹳草对炎症性疾病具有显著的治疗作用。如老鹳草的乙醇提取物显著降低了二甲苯或角叉菜胶诱导的大鼠耳朵和足部肿胀,并降低了毛细血管通透性。另外,在大鼠佐剂性关节炎模型中,老鹳草软膏可显著缓解由弗氏完全佐剂引起的过敏性炎症,并减少关节肿胀。金银花具有多种药理作用,涉及对炎症、发热、病毒、细菌、免疫反应、肝脏、神经系统和心脏的影响。研究发现,在脂多糖诱导的小鼠急性肺部模型中,金银花对脂多糖诱导的肺部炎症和炎症介质具有治疗作用。金银花通过下调促炎细胞因子的表达,减少气道中活化的多形核中性粒细胞的浸润,减轻肺水肿,减少亚硝化应激,改善肺形态。另外有研究采用网络药理学来确定金银花的潜在活性成分和靶点,其中活性成分金黄菊醇、木犀草素、山柰酚和槲皮素在肺部炎症中具有公认的作用。金银花对脂多糖诱导的大鼠肺纤维化具有显著的抗炎作用,金银花预处理降低了支气管肺泡灌洗液中细胞因子肿瘤坏死因子α、白细胞介素6和白细胞介素1β的水平。柴胡中的有效成分柴胡皂苷A和柴胡皂苷D具有抗病毒、抗炎、抗肿瘤及保肝护肾等多种药理作用。在鼻腔滴注脂多糖诱导小鼠急性肺损伤模型中,柴胡皂苷A显著抑制了小鼠的肺湿干比、髓过氧化物酶活性和支气管肺泡灌洗液中的炎性细胞因子肿瘤坏死因子α和白细胞介素1β的水平。此外,柴胡皂苷A通过抑制核因子κB的活化和NLRP3炎性小体的表达发挥关键的抗炎作用,并减轻脂多糖诱导的肺纤维化。在葡聚糖硫酸钠诱导的溃疡性结肠炎模型中,柴胡皂苷D用药能够有效降低疾病活动指数、增加结肠长度和改善病理特征,显著抑制肿瘤坏死因子α、白细胞介素6和白细胞介素1β等促炎细胞因子mRNA的水平,增加抗炎细胞因子白细胞介素10mRNA的水平。除此之外,唐草片中的黄芪、香薷、甘草等成分也具有显著的抗菌抗炎的药理作用,唐草片中的黄酮类、酚酸类等化合物具有提高免疫、抗病毒、抗氧化及抑菌消炎等作用。唐草片对以炎症反应为主要特征的急性肺损伤及其后期发展阶段肺纤维化具有防治作用。
动物实验证明唐草片能够有效调节免疫低下肺部感染小鼠的炎性细胞因子的分泌,提高免疫力,控制炎症反应。
急性肺损伤及其更严重的形式急性呼吸窘迫综合征是由多种因素引起的肺部急性炎症,主要表现为弥漫性肺泡损伤及上皮细胞功能障碍。近年来,急性肺损伤的发病率不断增加,死亡率达到30~40%,尽管当前糖皮质激素如地塞米松、泼尼松龙和泼尼松等、抗生素如大环内酯类和他汀类如辛伐他汀等多种药物被广泛用于临床治疗急性肺损伤,但由于这些药物的多种不良反应,如骨质疏松、消化性溃疡和凝血功能障碍等,以及细菌对抗生素产生的耐药性等原因,极大地限制了它们的应用,且并不能显著提高急性肺损伤患者的生活质量或降低死亡率。
若急性肺损伤的炎症不受控制,肺组织发生反复的损伤和修复,长期可发展为肺纤维化。肺纤维化是由肺泡上皮细胞反复发生损伤、成纤维细胞增殖、胶原蛋白和其他细胞外基质过度沉积而引起的间质性肺部疾病,患者5年生存率仅为20%。目前用于特发性肺纤维化的药物吡非尼酮和尼达尼布仅能延缓肺纤维化的进展,且因其作用机制尚不完全清晰,价格昂贵和腹泻、恶心、鼻咽炎、皮肤相关症状的不良反应等原因,并未受到广泛使用。
因此,研究和开发出一种可以用于治疗急性肺损伤和肺纤维化的新药物,有效的解决急性肺损伤和肺纤维化患者的痛苦仍是目前研究的重点和难点。
发明内容
为了更好的治疗急性肺损伤和肺纤维化疾病,减轻急性肺损伤和肺纤维化患者的痛苦。本发明提供了一种中药复方组合物的新用途,具体地,是在制备抗急性肺损伤和肺纤维化药物中的新用途。该中药复方组合物是由上海百岁行药业有限公司生产,产品名为唐草片,批准文号为国药准字Z20050291的纯中药制剂。本发明是对该现有产品进行二次研发,意外地发现,该唐草片具有一定的抗急性肺损伤和肺纤维化的作用。
本发明的具体技术方案为:
本发明提供了一种中药复方组合物在制备抗急性肺损伤和肺纤维化药物中的用途,所述中药复方组合物由以下重量份数的成分组成:老鹳草120~150份、黄芪120~150份、龙葵120~200份、金银花120~200份、木棉花60~100份、诃子40~60份、白花蛇舌草80~150份、石榴皮40~60份、糯稻根150~200份、菱角80~150份、瓜蒌皮40~60份、柴胡60~100份、香薷40~60份、甘草60~80份、鸡血藤120~150份、红花40~60份、银杏叶40~60份、马齿苋60~120份、胡黄连40~60份、全蝎28~40份。
进一步地,所述中药复方组合物制成包括片剂、胶囊剂、散剂和颗粒剂常规口服剂型。
进一步地,所述中药复方组合物制成薄膜衣片。
进一步地,所述中药复方组合物给药剂量根据患病程度、有无既往病史因素综合考虑进行调整。
本发明的唐草片具有显著的抗急性肺损伤作用,能够通过保护血管内皮屏障功能、抑制中性粒细胞的致炎作用显著减轻脂多糖诱导的小鼠急性肺损伤,延长小鼠的生存时间、增加小鼠体重、改善生存状况。
本发明的唐草片具有显著的抗肺纤维化作用,能够通过抑制转化生长因子β1/信号转导分子2信号通路、减少上皮间质转化、降低氧化应激水平显著减轻脂多糖诱导的小鼠肺纤维化。
附图说明
图1为急性肺损伤小鼠肺组织病理切片HE染色结果图,其中:A为正常组小鼠肺组织病理形态,B为假手术组小鼠肺组织病理形态,C为模型组小鼠肺组织病理形态,D为唐草片(1g/kg)组小鼠肺组织病理形态。
图2为急性肺损伤小鼠肺组织中促炎细胞因子的水平图,其中:A为小鼠肺组织中白细胞介素6、白细胞1β和肿瘤坏死因子α的蛋白质免疫印迹法图谱,B为小鼠肺组织中自细胞介素6表达水平的比较图,C为小鼠肺组织中白细胞介素1β表达水平的比较图,D为小鼠肺组织中肿瘤坏死因子α表达水平的比较图。
图3为急性肺损伤小鼠肺组织伊文思蓝渗出量水平的比较图。
图4为急性肺损伤小鼠肺组织血管内皮细胞钙黏蛋白水平的比较图。
图5为急性肺损伤小鼠肺组织中髓过氧化物酶水平的比较图。
图6为急性肺损伤小鼠消皮素D表达的水平图,其中:A为小鼠肺组织消皮素D表达水平比较图,B为小鼠外周血中性粒细胞中消皮素D的N端活化表达水平比较图。
图7为急性肺损伤小鼠外周血中性粒细胞趋化因子受体2和中性粒细胞弹性蛋白酶的表达水平图,其中:A为小鼠外周血中性粒细胞趋化因子受体2蛋白表达水平的比较图,B为小鼠外周血中性粒细胞弹性蛋白酶表达水平的比较图。
图8为急性肺损伤小鼠的Kaplan-Meier生存曲线图。
图9为急性肺损伤小鼠的体重变化图。
图10为肺纤维化模型筛各组小鼠肺组织病理切片以Masson染色评估胶原沉积水平图。其中A为正常组小鼠肺组织病理切片Masson染色图,B为模型1组小鼠肺组织病理切片Masson染色图,C为模型2组小鼠肺组织病理切片Masson染色图,D为模型3组小鼠肺组织病理切片Masson染色图,E为各组小鼠肺组织胶原沉积水平的比较图。
图11为肺纤维化小鼠肺组织病理切片HE染色结果图,其中A为正常对照组小鼠肺组织病理切片HE染色图,B为模型组小鼠肺组织病理切片HE染色图,C为唐草片组(0.5g/kg)小鼠肺组织病理切片HE染色图,D为唐草片组(1g/kg)小鼠肺组织病理切片HE染色图。
图12为为肺纤维化小鼠肺组织病理切片以Masson染色评估胶原沉积水平图。其中A为正常组小鼠肺组织病理切片Masson染色图,B为模型组小鼠肺组织病理切片Masson染色图,C为唐草片组(0.5g/kg)小鼠肺组织病理切片Masson染色图,D为唐草片组(1g/kg)组小鼠肺组织病理切片Masson染色图
图13为肺纤维化小鼠肺组织胶原沉积水平的比较图。
图14为肺纤维化小鼠肺组织中上皮细胞标志物钙黏蛋白E和间充质细胞标志物α平滑肌肌动蛋白的表达水平比较图。其中,A为肺纤维化小鼠肺组织中钙黏蛋白E和α平滑肌肌动蛋白的蛋白质免疫印迹法图谱,B为各组小鼠钙黏蛋白E表达水平的比较图,C为各组小鼠α平滑肌肌动蛋白表达水平的比较图。
图15为肺纤维化小鼠肺组织中转化生长因子β1/信号转导分子2的信号通路蛋白表达水平图。其中,A为肺纤维化小鼠肺组织中转化生长因子β1和信号转导分子2的蛋白质免疫印迹法图谱,B为转化生长因子β1表达水平比较图,C为信号转导分子2表达水平的比较图。
具体实施方式
以下通过具体实施方式的描述对本发明作进一步说明,但这并非是对本发明的限制,本领域技术人员根据本发明的基本思想,可以做出各种修改或改进,但是只要不脱离本发明的基本思想,均在本发明的范围之内。
实施例1、唐草片对脂多糖诱导的小鼠急性肺损伤的防治作用
1主要实验材料
SPF级的雄性BALB/c小鼠,约6周龄,体重18~20g,购买于河南省动物实验中心(动物合格证号:No.410975221100022365)。唐草片,批号:201108,批准文号:国药准字Z20050291,上海百岁行药业有限公司。脂多糖(L8880),北京索莱宝科技有限公司;高效RIPA裂解液(组织/细胞),北京索莱宝科技有限公司;BCA蛋白浓度测定试剂盒,GLPBIO;PVDF膜(孔径为0.45μm),德国MerckMillipore公司;预染蛋白分子量标准(marker),CISTRO;APS,西格玛奥德里上海有限公司;SDS-PAGE凝胶制备试剂盒,北京索莱宝科技有限公司;超灵敏ECL化学发光检测试剂盒,上海雅酶生物医药科技有限公司;小鼠IL-1βELISA试剂盒,杭州联科生物技术股份有限公司;小鼠IL-6ELISA试剂盒,杭州联科生物技术股份有限公司;小鼠TNF-αELISA试剂盒,杭州联科生物技术股份有限公司;小鼠外周血中性粒细胞分离试剂盒,北京索莱宝科技有限公司;免疫组化一抗:MPO,武汉塞维尔生物技术有限公司;免疫组化二抗:HRP标记的山羊抗兔,武汉塞维尔生物技术有限公司;GAPDH抗体,武汉塞维尔生物技术有限公司;山羊抗兔IgG-HRP,SAB上海萨博生物技术有限公司;山羊抗鼠IgG-HRP,SAB上海萨博生物技术有限公司;GSDMD抗体,艾博抗(上海)贸易有限公司;VE-cadherin抗体,Affinity Biosciences;CXCR2抗体,南京巴傲得生物科技有限公司;Neutrophil elastase抗体,北京博奥森生物技术有限公司;IL-6抗体,SAB上海萨博生物技术有限公司;IL-1β抗体,SAB上海萨博生物技术有限公司;TNF-抗体,SAB上海萨博生物技术有限公司。动物房IVC饲养系统,北京众实科技有限公司;-80℃低温冰箱,苏州安泰空气技术有限公司;水平离心机,赛默飞世尔科技公司;Milli-Q超纯水制造系统,Millipore公司(美国);分析天平Quintix型,赛多利斯集团(德国);移液器,德国Eppendorf生命科技公司;低温高速离心机,德国Eppendorf公司;全波长酶标仪Multiskan GO型,赛默飞世尔科技公司;水平摇床,赛多利斯集团(德国);高通量组织研磨机,宁波新芝生物科技股份有限公司;Western Blot装置,美国Bio-Rad公司;WB化学发光成像仪,上海培清科技有限公司。
2实验方法
2.1药品配制:唐草片分为0.25g/kg,0.5g/kg,1g/kg和2g/kg四个剂量组,分别以0.5%羧甲基纤维素钠溶液配制成浓度为0.025g/ml,0.05g/ml,0.1g/ml和0.2g/ml的唐草片混悬液。脂多糖的配制:将脂多糖用无菌生理盐水配制成浓度10mg/ml的储存液,用于急性肺损伤生存期实验;再将储存液稀释5倍至2mg/ml,用于急性肺损伤实验。
2.2急性肺损伤模型的建立及给药:将小鼠随机分为正常对照组、假手术组、模型组和唐草片各剂量组(四个剂量见2.1),每组10只。唐草片各剂量组在造模前5天每天各按0.1ml/10g体重灌胃给药,对照组、假手术组和模型组每天以0.1ml/10g体重的0.5%羧甲基纤维素钠水溶液灌胃。所有小鼠在第5天灌胃给药1小时后开始造模。除对照组外其余各组小鼠腹腔注射300mg/kg的5%水合氯醛进行麻醉。麻醉后将小鼠仰卧位固定于解剖板上,在颈部涂抹碘伏消毒后剪开皮层,钝性分离颈部肌肉,暴露气管。将模型组和唐草片用药组小鼠用微量进样器缓慢注入脂多糖(4mg/kg),直立解剖板缓慢水平旋转,以便脂多糖在肺部分布均匀,随后缝合伤口,消毒皮肤。假手术组小鼠以同样的造模方式气管滴注等体积生理盐水。
2.3标本采集:在建模后24小时,小鼠称重,眼眶采血后留取血清,储存于-80℃超低温冰箱待检测用,颈椎脱臼处死小鼠,摘取肺脏,左肺固定于4%的多聚甲醛,48h后取出做HE染色;右肺放于冻存管里,储存于-80℃超低温冰箱,用于促炎细胞因子的检测。
2.4HE染色观察肺组织病理变化:将方法2.3留存的肺组织脱水浸蜡,包埋,石蜡切片,脱蜡至水,HE染色,脱水封片,进行显微镜镜检和图像采集分析。
2.5酶联免疫吸附试验检测血清中促炎细胞因子的表达:将方法2.3留存的血清,采用联科生物ELISA试剂盒,检测血清中白细胞介素6,白细胞介素1β和肿瘤坏死因子α的水平。
2.6蛋白质免疫印迹法检测肺组织促炎细胞因子的表达:将方法2.3留存的肺组织剪碎,进行蛋白样品制备、蛋白定量及变性,利用SDS-PAGE凝胶电泳,对白细胞介素6,白细胞介素1β,肿瘤坏死因子α进行定量分析。
2.7免疫组化染色检测肺组织中血管内皮细胞钙黏蛋白,髓过氧化物酶和消皮素D的表达:取方法2.3留存的肺组织,脱水浸蜡,包埋,石蜡切片,脱蜡至水,抗原修复,阻断内源性过氧化物酶,血清封闭,孵育一抗二抗,DAB显色,复染细胞核,脱水封片,进行显微镜镜检和图像采集分析。
2.8伊文思蓝染色检测血管内皮通透性:将雄性BALB/c小鼠随机分为对照组、模型组和唐草片(1g/kg)组,每组10只。按2.2方法,以脂多糖4mg/kg的剂量气管滴注进行造模,造模后24h进行以下操作:将小鼠尾静脉注射200μL 0.5%伊文思蓝染液,观察1小时。小鼠颈椎脱臼处死,取肺称重,取50~100mg组织放入2mL EP管,加1mL甲酰胺,于55℃的水浴条件下孵育24h。室温2000rpm/min离心10min,取上清液待测。根据预实验结果,以甲酰胺为溶剂,配制合适浓度梯度的伊文思蓝溶液标准曲线。于620nm波长下用酶标仪检测吸光度。计算每毫克肺组织中渗出的伊文思蓝染液的含量。
2.9急性肺损伤小鼠湿/干重比值测定及给药剂量的筛选:将雄性BALB/c小鼠随机分为对照组、假手术组、模型组、唐草片各剂量组,每组8只。按2.2方法造模后24h对小鼠进行称重,眼眶采血留取抗凝全血,摘取肺脏,用生理盐水冲洗后称重,在70℃烘箱中烘烤48h直至肺组织中水分蒸发至恒重,称取肺干重并计算肺系数和湿/干重比。
2.10蛋白质免疫印迹法检测外周血中性粒细胞相关蛋白的表达:取方法2.9中留取的对照组、模型组和唐草片(1g/kg)组的新鲜抗凝全血,每3~4只小鼠的抗凝全血合为一例样本,使用Solbraio的小鼠外周血中性粒细胞分离试剂盒分离中性粒细胞。抽取提取的小鼠外周血中性粒细胞上清20μL,用1×PBS稀释5倍,测定中性粒细胞蛋白浓度。用蛋白质免疫印迹法检测中性粒细胞趋化因子受体2、中性粒细胞弹性蛋白酶和消皮素D的N端活化蛋白的表达。
2.11观察急性肺损伤小鼠生存期:将雄性BALB/c小鼠随机分为对照组、模型组、唐草片(0.5g/kg)组和唐草片(1g/kg)组,每组9只。按2.2方法,以脂多糖20mg/kg的剂量进行气管滴注造模,观察急性肺损伤小鼠14天的生存情况。实验期间每天给药一次,直至生存期观察结束。
2.12统计学分析:使用SPSS20.0软件对数据进行统计学处理,Graphpad Prism8.4.2对数据进行绘图,Image-Pro Plus软件对免疫组化染色阳性区域进行统计,正态分布数据采用Mean±SD表示,P<0.05具有统计学意义。
3实验结果
3.1唐草片对急性肺损伤小鼠一般状况和肺水肿的影响:
小鼠气管滴注脂多糖24h后,对照组动物精神状态良好,毛发顺滑有光泽,活动灵活;假手术组毛发较对照组略有疏松,光泽减少,但精神状态和活动保持良好。模型组小鼠术后精神萎靡,活动量明显减少,并伴有眼角分泌物增加、毛发竖立变湿等现象;唐草片(1g/kg)组小鼠较模型组毛发更光滑,活动较多。提示唐草片对急性肺损伤小鼠的一般状况具有改善作用。肺组织的湿/干重比反映了其含水量,即肺水肿的严重程度。唐草片对肺水肿的影响结果如表3所示,与对照组相比,假手术组由于术后体重下降致肺系数略有升高,但湿/干重比无明显差异,提示气管滴注生理盐水对小鼠肺部无明显影响;与对照组和假手术组相比,模型组肺系数及湿/干重比均显著升高(P<0.01),反映模型组小鼠肺部出现严重水肿,提示造模成功。与模型组相比,唐草片(0.5g/kg)组和唐草片(1g/kg)组的肺系数和湿/干重比均显著降低(P<0.05),唐草片(0.25g/kg)组和唐草片(2g/kg)组的湿/干重比与模型组相比略有减低但无统计学意义,表明唐草片可显著降低脂多糖诱发急性肺损伤小鼠的肺水肿,0.5g/kg和1g/kg适合作为急性肺损伤小鼠的治疗剂量。
表1唐草片不同剂量对脂多糖诱导的急性肺损伤小鼠肺水肿的影响
与对照组比较,*P<0.05,**P<0.01,***P<0.001;与假手术组比较,##P<0.01,###P<0.001;与模型组比较,&P<0.05,&&P<0.01,&&&P<0.001.(n=8).
3.2唐草片对急性肺损伤小鼠肺组织病理变化的影响
各组小鼠肺组织HE染色结果显示如图1。对照组小鼠肺脏组织无明显异常,肺泡结构清晰,未见明显的炎性改变;假手术组小鼠肺泡腔内出现少量的红细胞,支气管内有少量坏死的细胞碎片,未见明显的炎性改变;模型组小鼠出现较大面积的肺泡壁轻度增厚,并伴有大量的炎性细胞浸润,小面积的肺泡腔内可见多量的炎性细胞浸润,小面积出血,肺泡腔内还可见少量的红细胞,支气管内有少量坏死的细胞碎片;唐草片(1g/kg)组对比模型组表现出肺泡壁厚度变薄,炎性细胞浸润减少,肺水肿减轻。提示唐草片能够改善脂多糖诱导的小鼠急性肺损伤的肺组织病理改变。
3.3唐草片对血清和肺组织促炎细胞因子水平的影响
实验结果如表2和图2所示,与对照组相比,模型组的血清和肺组织中白细胞介素6,白细胞介素1β和肿瘤坏死因子α的表达均显著升高(P<0.01);与模型组相比,唐草片的白细胞介素6,白细胞介素1β和肿瘤坏死因子α的表达显著降低(P<0.05),提示唐草片可以抑制脂多糖诱导小鼠急性肺损伤引起的肺组织及全身的促炎细胞因子的表达。
表2唐草片对脂多糖诱导的急性肺损伤小鼠血清中促炎细胞因子水平的影响
组别 | 白细胞介素6(pg/mL) | 白细胞介素1β(pg/mL) | 肿瘤坏死因子α(pg/mL) |
对照组 | 14.8±9.4 | 49.0±2.3 | 346.6±13.0 |
模型组 | 347.8±229.5*** | 56.7±7.1** | 426.6±48.3*** |
唐草片组(1g/kg) | 162.9±68.7# | 49.4±4.5## | 365.1±9.6## |
与对照组比较,**P<0.01,***P<0.001;与模型组比较,#P<0.05,##P<0.01.(n=8~10).
3.4唐草片对血管内皮通透性的影响
本实验通过伊文思蓝液外渗实验,对内皮细胞通透性进行量化评估,结果如图3所示。当小鼠尾静脉注射0.5%的伊文思蓝染液后,对照组小鼠肺组织的颜色基本保持不变,模型组小鼠肺组织有大量伊文思蓝染液渗出(P<0.001),唐草片(1g/kg)组显著降低伊文思蓝染液渗出的程度(P<0.001)。提示唐草片对血管内皮屏障功能具有保护作用。
本实验通过免疫组化染色检测肺组织血管内皮细胞钙黏蛋白表达,结果如图4所示。与对照组相比,模型组的血管内皮细胞钙黏蛋白免疫组化染色阳性区域百分比显著降低(P<0.01);与模型组相比,唐草片(1g/kg)组阳性区域百分比显著升高(P<0.05)。提示唐草片可通过减少肺组织中血管内皮细胞钙黏蛋白的降解,抑制脂多糖刺激引起的血管内皮通透性增加。
3.5唐草片对肺组织中性粒细胞浸润的影响
髓过氧化物酶主要存在于中性粒细胞,其水平及活性变化代表着中性粒细胞的功能和活性状态。本实验采用免疫组化染色的方法评估小鼠肺组织中性粒细胞含量,实验结果见图5,对照组和假手术组间无明显差异,模型组小鼠肺组织髓过氧化物酶免疫染色阳性区域百分比显著升高(P<0.001);与模型组相比,唐草片组(1g/kg)组髓过氧化物酶免疫染色阳性区域百分比显著降低(P<0.05)。表明唐草片可减轻急性肺损伤引起的肺组织中性粒细胞浸润。
3.6唐草片对中性粒细胞焦亡的影响
本实验采用免疫组化染色的方法评估小鼠肺组织中消皮素D的水平,实验结果见图6-A。本实验采用蛋白质免疫印迹法检测小鼠外周血中性粒细胞中消皮素D的N端活化的表达,实验结果见图6-B。与对照组相比,模型组肺组织消皮素D水平及外周血中性粒细胞消皮素D的N端活化的表达水平显著升高(P<0.05),唐草片可以显著降低其表达(P<0.05)。提示急性肺损伤时,肺组织的焦亡水平升高,肺部处于急性炎症性损伤的状态,唐草片可抑制中性粒细胞焦亡引起的肺组织损伤。
3.7唐草片对外周血中性粒细胞趋化作用和脱颗粒的影响
本实验分离急性肺损伤小鼠的外周血中性粒细胞,通过蛋白质面印迹法检测细胞中趋化因子受体2和弹性蛋白酶的表达。结果表见图7。与对照组相比,模型组中性粒细胞的趋化因子受体2和弹性蛋白酶表达显著升高(P<0.01);唐草片(1g/kg)可显著降低其表达(P<0.05)。提示唐草片可以通过下调中性粒细胞表面的趋化因子受体2的表达抑制其趋化作用,并抑制中性粒细胞脱颗粒释放的弹性蛋白酶,减轻脂多糖诱导的急性肺损伤。
3.8唐草片对急性肺损伤小鼠生存期的影响
本实验采用死亡率大于65%致死剂量的脂多糖(20mg/kg)气管滴注构建严重急性肺损伤模型,观察小鼠14天的生存情况。模型组小鼠在14天内的平均生存时间为7.3天,唐草片0.5g/kg和1g/kg组平均生存时间可达10~12天。根据Kaplan-Meier生存曲线(图8)结果显示,模型组小鼠在脂多糖气管滴注后14天的存活率仅为33.3%,而唐草片0.5g/kg和1g/kg组小鼠生存率分别达到66.7%和77.8%,分别将存活率提高了33.4%和44.5%。唐草片1g/kg组与模型组生存率相比具有显著的统计学意义(P<0.05)。
在脂多糖气管滴注后,模型组小鼠的体重显著下降,从第4天开始逐渐恢复,而唐草片(1g/kg)组小鼠体重在下降至第2天后开始逐渐恢复,且在第4天至10天体重显著高于模型组(P<0.05),实验结果见图9。提示唐草片可降低大剂量脂多糖诱发的严重急性肺损伤小鼠的死亡率,延长其生存时间,增加体重,改善生存状态。
实施例2、唐草片对脂多糖诱导的小鼠急性肺损伤的防治作用
1主要实验材料
CAT测定试剂盒,南京建成生物工程研究所;GSH测定试剂盒,南京建成生物工程研究所;MDA测定试剂盒,南京建成生物工程研究所;HYP测定试剂盒,南京建成生物工程研究所;E-cadherin抗体,艾博抗(上海)贸易有限公司;α-SMA抗体,艾博抗(上海)贸易有限公司;TGF-β1抗体,SAB上海萨博生物技术有限公司;p-Smad2抗体,艾博抗(上海)贸易有限公司;Smad2抗体,艾博抗(上海)贸易有限公司。其余与实施例1的主要实验材料相同。
2实验方法
2.1药品配置:唐草片剂量组分为0.5g/kg和1g/kg。配置方式采用实施例1“2.1”项的方法。
2.2肺纤维化模型的建立与筛选:随机将雄性BALB/c小鼠分为对照组和以下三种模型组,每天以0.1mL/10g体重的0.5%羧甲基纤维素钠水溶液灌胃,直至动物处死。模型1:在第1天气管滴注脂多糖4mg/kg,第35天处死小鼠。模型2:在第1天气管滴注脂多糖4mg/kg,在第7,14,21天腹腔注射脂多糖4mg/kg,第35天处死小鼠。模型3:在第1和14天气管滴注脂多糖4mg/kg,第35天处死小鼠。气管滴注方式采用实施例1“2.2”项的方法。通过肺组织肺系数和Masson染色阳性区域百分比,评估三种模型小鼠肺纤维化的严重程度,筛选出最佳造模方式。
2.3动物分组及给药方式:随机将雄性BALB/c小鼠分为对照组、模型组、唐草片(0.5g/kg)组和唐草片(1g/kg)组。唐草片用药组在造模前5天开始按0.1mL/10g体重灌胃给药,对照组和模型组(模型3)每天以0.1mL/10g体重的0.5%羧甲基纤维素钠水溶液灌胃,直至动物处死。
2.4标本采集:在建模后35天,对各组小鼠称重,眼眶采血后留取血清,颈椎脱臼处死小鼠,摘取肺脏,称重,左肺固定于4%的多聚甲醛,48h后取出做HE染色和Masson染色;右肺放于冻存管里,储存于-80℃超低温冰箱,用于其他生化指标的检测。
2.5HE染色和Masson染色观察肺组织病理变化和胶原沉积:将方法2.4留存的肺组织进行脱水浸蜡,包埋,石蜡切片,脱蜡至水,HE染色,脱水封片,进行显微镜镜检和图像采集分析。将方法2.4留存的肺组织进行脱水浸蜡,包埋,石蜡切片,脱蜡至水,进行Masson染色,脱水封片,进行显微镜镜检和图像采集分析。
2.6测定肺组织中羟脯氨酸的含量:使用羟脯氨酸测定试剂盒(碱水解法)测定肺组织中羟脯氨酸的含量。操作方法如下:样本水解,调pH至6.0~6.8左右,取3~4mL水解液加活性混匀,离心,各管取1mL上清用于检测。按试剂盒说明书操作流程依次加样各检测试剂,混匀,水浴,冷却,离心取上清,于波长550nm处测定各孔OD值。
2.7蛋白质面印迹法检测上皮间质转化相关蛋白和转化生长因子β1/信号转导分子2信号通路蛋白的表达:将方法2.4留存的肺组织剪碎,进行蛋白样品制备,蛋白定量及变性,利用SDS-PAGE凝胶电泳,对小鼠肺组织中的α平滑肌肌动蛋白,黏钙蛋白E,转化生长因子β1,信号转导分子2,磷酸化信号转导分子2进行定量分析。
2.8测定肺组织氧化应激相关指标的含量:制备10%肺组织匀浆,用BCA试剂盒测定上清蛋白浓度后,分别采用硫代巴比妥酸法、钼酸铵法和微板法按照各试剂盒说明书的操作流程测定肺组织中丙二醛,过氧化氢酶和还原型谷胱甘肽的含量。
2.9统计学分析:使用SPSS20.0软件对数据进行统计学处理,Graphpad Prism8.4.2对数据进行绘图,Image-Pro Plus软件对Masson染色阳性区域进行统计,正态分布数据采用Mean±SD表示,P<0.05具有统计学意义。
3实验结果
3.1肺纤维化模型的筛选
肺系数实验结果见表3。与对照组相比,三种脂多糖诱导的肺纤维化模型肺系数均有不同程度的升高,其中模型3肺重和肺系数升高最显著(P<0.001);模型1和模型2的肺重和肺系数均明显低于模型3(P<0.05),表明模型3(即分别在第1天和14天气管滴注脂多糖4mg/kg的造模方式)引起的肺组织重量增加最多。
表3脂多糖诱导的不同肺纤维化模型对小鼠肺系数的影响
组别 | N | 体重(g) | 肺重(g) | 肺指数(mg/g) |
对照组 | 8 | 25.3±1.6 | 0.144±0.013 | 5.71±0.28 |
模型1 | 9 | 22.7±1.2 | 0.146±0.013 | 6.42±0.61### |
模型2 | 7 | 22.4±2.0 | 0.150±0.008 | 6.75±0.51**# |
模型3 | 8 | 23.5±1.7 | 0.178±0.015*** | 7.62±0.74*** |
与对照组比较,**P<0.01,***P<0.001;与模型3比较#P<0.05,###P<0.001.
本实验采用Masson染色的方法评估肺纤维化小鼠胶原沉积的含量。肺纤维化模型筛选的Masson染色结果见图10-A。胶原沉积比较结果图10-B。对照组小鼠肺组织仅有少量的胶原沉积,三种模型组胶原沉积均有不同程度的增加,其中模型3小鼠的肺组织胶原阳性区域百分比最大(P<0.01)。综合三种模型对肺纤维化小鼠的肺系数和胶原沉积的影响,选择模型3为后续实验的造模方式。
3.2唐草片对肺纤维化小鼠一般状况与肺系数的影响
在造模后35天,对照组小鼠精神状态良好,毛发顺滑有光泽,活动灵活;模型组小鼠精神较萎靡,毛发枯黄,活动减少;唐草片各组可改善上述症状。造模初期,模型组动物体重较对照组显著减低,唐草片各组体重较模型组显著增加,造模至35天时,四组动物的体重无明显差异。与对照组相比,模型组肺重显著升高,肺系数增加(P<0.001);唐草片各组可显著抑制肺纤维化引起的肺重和肺系数增加(P<0.05),两个用药剂量组间无明显差异。实验结果见表4。
表4唐草片对LPS诱导的肺纤维化小鼠肺系数的影响
组别 | N | 体重(g) | 肺重(g) | 肺系数(mg/g) |
对照组 | 8 | 25.3±1.6 | 0.144±0.013 | 5.71±0.28 |
模型组 | 13 | 23.7±1.4 | 0.182±0.028** | 7.69±1.02*** |
唐草片(0.5g/kg) | 11 | 23.4±1.2 | 0.155±0.013## | 6.66±0.61## |
唐草片(1g/kg) | 12 | 24.0±1.2 | 0.162±0.015# | 6.77±0.53# |
与对照组比较,***P<0.001;与模型组比较,#P<0.05,##P<0.01
3.3唐草片对肺纤维化小鼠病理组织变化的影响
HE染色实验结果见图11,对照组小鼠肺脏组织无明显异常,肺泡结构清晰,未见炎性细胞及间质渗出。模型组小鼠肺组织出现大量纤维化团块,细胞外基质增多,并伴有炎性细胞浸润;大量的血管、支气管周围可见淋巴细胞呈灶性浸润;支气管腔内可见坏死的细胞碎片。与模型组相比,唐草片组(1g/kg)肺组织肺泡壁厚度显著减轻,炎性细胞浸润和间质沉积明显减少。提示唐草片可显著改善脂多糖诱发的小鼠肺纤维化的病理组织变化。
3.4唐草片对肺纤维化小鼠胶原沉积的影响
Masson染色实验结果结果如图12和图13。对照组(图12-A)小鼠肺组织仅有少量的胶原沉积,与对照组相比,模型组(图12-B)成纤维细胞大量增生,胶原沉积显著增加(P<0.01);与模型组比较,唐草片各组(图12-C、图12-D)的胶原阳性区域百分比明显降低(P<0.05),两个剂量组间无明显差异,表明唐草片可抑制脂多糖诱导小鼠肺纤维化所致的胶原沉积。
3.5唐草片对肺纤维化小鼠肺组织中羟脯氨酸含量的影响
本实验采用碱水解法测定肺组织中羟脯氨酸的含量,实验结果见表5。与对照组相比,模型组小鼠肺组织中羟脯氨酸含量显著升高(P<0.01),唐草片(1g/kg)组可明显降低其含量(P<0.05)。提示唐草片可抑制肺纤维化引起的肺组织羟脯氨酸含量的增加,减少胶原纤维的含量。
表5唐草片对脂多糖诱导的肺纤维化小鼠肺组织中羟脯氨酸含量的影响
组别 | N | 羟脯氨酸含量(μg/g组织) |
对照组 | 5 | 156.2±36.0 |
模型组 | 5 | 276.2±76.4** |
唐草片组(1g/kg) | 5 | 183.4±30.6# |
与对照组比较**P<0.01;与模型组比较#P<0.05
3.6唐草片对肺纤维化小鼠上皮间质转化的影响
本实验采用蛋白质免疫印迹法检测各组小鼠肺组织中上皮细胞标志物钙黏蛋白E和间充质细胞标志物α平滑肌肌动蛋白的表达,实验结果见图14。与对照组相比,模型组小鼠肺组织中钙黏蛋白E的表达显著下调(P<0.05),唐草片(1g/kg)组与模型组相比小鼠肺组织中钙黏蛋白E的表达明显增加(P<0.05);与对照组相比,模型组小鼠肺组织中α平滑肌肌动蛋白的表达显著上调(P<0.001),唐草片(1g/kg)组与模型组相比小鼠肺组织中α平滑肌肌动蛋白的表达明显降低(P<0.05)。提示唐草片可通过抑制上皮间质转化改善脂多糖诱导的小鼠肺纤维化。
3.7唐草片对肺纤维化小鼠转化生长因子β1/信号转导分子2信号通路的影响
本实验采用蛋白质免疫印迹法检测各组小鼠肺组织中转化生长因子β1和磷酸化信号转导分子2的表达水平。实验结果见图15。与对照组相比,模型组小鼠肺组织的转化生长因子β1和磷酸化信号转导分子2蛋白表达显著增高(P<0.05),唐草片(1g/kg)组的转化生长因子β1和磷酸化信号转导分子2蛋白表达显著下降(P<0.05)。提示唐草片可以通过抑制转化生长因子β1/信号转导分子2信号通路的表达减轻脂多糖诱发的小鼠肺纤维化。
3.8唐草片对肺纤维化小鼠氧化应激水平的影响
本实验分别采用硫代巴比妥酸法、钼酸铵法和微板法测定肺组织匀浆中丙二醛,过氧化氢酶和还原型谷胱甘肽的含量,实验结果见表6。与对照组相比,模型组小鼠肺组织的脂质过氧化物丙二醛水平显著升高(P<0.05),抗氧化剂过氧化氢酶和还原型谷胱甘肽水平显著下降(P<0.01);与模型组相比,唐草片(1g/kg)组小鼠肺组织的丙二醛水平下降(P<0.05),过氧化氢酶和还原型谷胱甘肽水平升高(P<0.05)。提示唐草片可以抑制肺纤维化小鼠的氧化应激水平,调节体内氧化与抗氧化系统的平衡。
表6唐草片对脂多糖诱导肺纤维化小鼠肺组织氧化应激水平的影响
与对照组比较,*P<0.05,***P<0.001vs;与模型组比较,#P<0.05,##P<0.01。
Claims (4)
1.一种中药复方组合物在制备抗急性肺损伤和肺纤维化药物中的用途,所述中药复方组合物由以下重量份数的成分组成:老鹳草120~150份、黄芪120~150份、龙葵120~200份、金银花120~200份、木棉花60~100份、诃子40~60份、白花蛇舌草80~150份、石榴皮40~60份、糯稻根150~200份、菱角80~150份、瓜蒌皮40~60份、柴胡60~100份、香薷40~60份、甘草60~80份、鸡血藤120~150份、红花40~60份、银杏叶40~60份、马齿苋60~120份、胡黄连40~60份、全蝎28~40份。
2.如权利要求1所述的用途,其特征在于,所述中药复方组合物制成包括片剂、胶囊剂、散剂和颗粒剂常规口服剂型。
3.如权利要求1所述的用途,其特征在于,所述中药复方组合物制成薄膜衣片。
4.如权利要求1所述的用途,其特征在于,所述中药复方组合物给药剂量根据患病程度,有无既往病史因素综合考虑进行调整。
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