Liu Li, Ding Qian, Dai Xiao-Fang
Cancer Center, Union Hospital of Huazhong University of Science and Technology, Wuhan.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Dec;27(12):1082-5.
To investigate the effect of Shenqi Fuzheng Injection (SFI) in radiation pneumonitis and its influence on the levels of plasma transforming growth factor beta (TGF-beta), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) at various stages (pre-, mid- and post-radiation) of radiotherapy (RT).
Fifty-eight patients enrolled in this study were randomized into two groups, all received conventional radio therapy, but the treatment group was intravenously dripped with SFI additionally, once daily, starting 3 days before radiotherapy to 1 week after the end of it. Levels of TGF-beta, TNF-alpha and IL-10 in blood samples collected and frozen at different time point of RT, before radiotherapy (Pre-RT), after received 40-50 Gy radiation (Mid-RT) and in time of terminating RT (Post-RT), were measured with enzyme linked immunosorbent assay (ELISA). And the occurrence of radiation pneumonitis was analyzed according to RTOG acute radiation pneumonitis criteria.
Level of TGF-beta increased in both groups after RT, either Mid- or Post-RT, but in comparing with that at Pre-RT, statistical significant (P < 0.05) only showed in the control group at Post-RT time when it raised to peak, while in inter-group comparing insignificance was shown. Level of TNF-alpha also increased in both groups, but statistical significance only showed in the control groups as compared with that of Pre-RT, accordingly, it was lower in the treatment group than that in the control group at corresponding time points (P < 0.05). Level of IL-10 decreased gradually in the process of RT, as compared with that at Pre-RT, significant difference was shown in both groups at Post-RT but not at Mid-RT, as compared between groups, no significance (P < 0.05) was shown, though the treatment group showed a high tendency. As for the ratio of IL-10/TNF-alpha, significant difference of lowering in the control group after RT was shown as compared with that at Pre-RT (P < 0.05), and also as compared with that in the treatment group at corresponding time point (P < 0.05). The occurrence of radiation pneumonia > or = grade 2 in the treatment group was significantly lower than that in the control group (chi2 = 8.7133, P < 0.01).
Plasma level of TNF-alpha and ratio of IL-10/ TNF-a could be the practicable indexes for estimating the susceptibility of acute radiation pneumonia; SFI can regulate the network of cytokine, and thus be effective in preventing and treating radiation pneumonitis.
探讨参芪扶正注射液（SFI）对放射性肺炎的影响及其对放疗（RT）各阶段（放疗前、放疗中、放疗后）血浆转化生长因子β（TGF-β）、肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）水平的影响。
本研究纳入的58例患者随机分为两组，均接受常规放疗，但治疗组额外静脉滴注SFI，每日1次，从放疗前3天开始至放疗结束后1周。在放疗的不同时间点，即放疗前（Pre-RT）、接受40-50 Gy放疗后（Mid-RT）和放疗结束时（Post-RT）采集并冻存血样，采用酶联免疫吸附测定（ELISA）法检测TGF-β、TNF-α和IL-10水平。并根据RTOG急性放射性肺炎标准分析放射性肺炎的发生情况。
放疗后两组的TGF-β水平均升高，无论是放疗中还是放疗后，但与放疗前相比，仅对照组在放疗后达到峰值时有统计学意义（P < 0.05），而组间比较无显著性差异。两组的TNF-α水平也升高，但仅对照组与放疗前相比有统计学意义，因此，治疗组在相应时间点低于对照组（P < 0.05）。放疗过程中IL-10水平逐渐降低，与放疗前相比，两组在放疗后有显著差异，但在放疗中无显著差异，组间比较无显著性差异（P < 0.05），尽管治疗组有升高趋势。至于IL-10/TNF-α比值，放疗后对照组与放疗前相比有显著降低（P < 0.05），与治疗组在相应时间点相比也有显著降低（P < 0.05）。治疗组2级及以上放射性肺炎的发生率显著低于对照组（χ2 = 8.7133，P < 0.01）。
血浆TNF-α水平和IL-10/TNF-α比值可能是评估急性放射性肺炎易感性的实用指标；SFI可调节细胞因子网络，从而有效防治放射性肺炎。
