Tang Yijun, Xu Yongjian, Xiong Shengdao, Ni Wang, Chen Shixin, Gao Baoan, Ye Tao, Cao Yong, Du Chunling
The Department of Respiratory Disease, Taihe Hospital of Yunyang Medical College, Shiyan 442000, Hubei Province, China.
J Huazhong Univ Sci Technolog Med Sci. 2007 Aug;27(4):375-80. doi: 10.1007/s11596-007-0407-4.
To investigate the effect of the Ginkgo Biloba Extract (GBE) on the asthma and examine its possible mechanisms, 75 asthma patients were divided into 4 groups and the patients were respectively treated with fluticasone propionate for 2 weeks or 4 weeks, or treated with fluticasone propionate plus GBE for 2 weeks or 4 weeks. Fifteen healthy volunteers served as healthy controls. Sputum inhalation with inhaling hypertonic saline (4%-5%) was performed. Lung ventilatory function and forced expiratory volume in one second (FEV1) were measured. The numbers of different cells in induced sputum were calculated. The expression of PKCalpha in the cells was immunocytochemically detected and the percentages of positive cells in different cells were counted. Interleukin-5 (IL-5) in sputum supernatants was detected with enzyme-linked immunosorbent assay. The percentage of eosinophils, lymphocytes, PKCalpha positive inflammatory cells and the concentration of IL-5 in asthmatic patients were higher than those in the controls (P<0.05), and the eosinophils, lymphocytes, positive expression of PKCalpha and the level of IL-5 were significantly decreased in asthmatic patients after they were treated with fluticasone propionate or fluticasone propionate plus GBE. However, they were still significantly higher than those of the controls. Compared to the group treated with glucocorticosteroid for 2 weeks, no significant decrease was found in the percentage of eosinophils, lymphocytes, PKCalpha positive inflammatory cells and the IL-5 in the supernatant of induced sputum. Compared with the group treated with glucocorticosteroid for 2 or 4 weeks, significant decrease in the same parameters was observed in the group treated with fluticasone propionate and GBE for 4 weeks. The IL-5 level in the supernatant of induced sputum was positively correlated with the percentage of PKCalpha-positive inflammatory cells and the percentage of eosinophils in the induced sputum in asthma patient groups respectively (n=150, r= 0.83, P<0.01; n=150, r=0.76, P<0.01). The FEV1 was negatively correlated with the percentage of PKCalpha-positive inflammatory cells and the IL-5 levels in supernatant of induced sputum in asthma patients respectively (n=150, r=-0.77, P<0.01; n=150, r= -0.64, P<0.01). It is concluded that GBE could significantly decrease the infiltration of inflammatory cells such as eosinophils and lymphocytes in the asthmatic airway and relieve the airway inflammation. GBE may decrease the activation of the PKCalpha in the inflammatory cells and thereby decrease the IL-5 level in induced sputum. GBE may be used as a complement to the glucocorticosteroid therapy for asthma.
为研究银杏叶提取物(GBE)对哮喘的影响并探讨其可能机制,将75例哮喘患者分为4组,分别给予丙酸氟替卡松治疗2周或4周,或给予丙酸氟替卡松加GBE治疗2周或4周。15名健康志愿者作为健康对照。进行吸入高渗盐水(4%-5%)诱导痰液。测量肺通气功能和一秒用力呼气容积(FEV1)。计算诱导痰液中不同细胞的数量。免疫细胞化学检测细胞中PKCalpha的表达并计数不同细胞中阳性细胞的百分比。用酶联免疫吸附测定法检测痰液上清液中的白细胞介素-5(IL-5)。哮喘患者中嗜酸性粒细胞、淋巴细胞、PKCalpha阳性炎症细胞的百分比及IL-5浓度高于对照组(P<0.05),哮喘患者经丙酸氟替卡松或丙酸氟替卡松加GBE治疗后,嗜酸性粒细胞、淋巴细胞、PKCalpha阳性表达及IL-5水平显著降低,但仍显著高于对照组。与糖皮质激素治疗2周组相比,诱导痰液上清液中嗜酸性粒细胞、淋巴细胞、PKCalpha阳性炎症细胞百分比及IL-5无显著降低。与糖皮质激素治疗2周或4周组相比,丙酸氟替卡松和GBE治疗4周组相同参数显著降低。哮喘患者组诱导痰液上清液中IL-5水平分别与诱导痰液中PKCalpha阳性炎症细胞百分比及嗜酸性粒细胞百分比呈正相关(n=150,r=0.83,P<0.01;n=150,r=0.76,P<0.01)。哮喘患者FEV1分别与诱导痰液中PKCalpha阳性炎症细胞百分比及IL-5水平呈负相关(n=150,r=-0.77,P<0.01;n=150,r=-0.64,P<0.01)。结论:GBE可显著减少哮喘气道中嗜酸性粒细胞和淋巴细胞等炎症细胞浸润,减轻气道炎症。GBE可能降低炎症细胞中PKCalpha的活化,从而降低诱导痰液中IL-5水平。GBE可作为哮喘糖皮质激素治疗的补充。