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益气养阴方对阿霉素肾病大鼠乙酰肝素酶和nephrin 的影响。

Effect of yiqiyangyin recipe on heparanase and nephrin in rats with adriamycin-induced nephropathy.

机构信息

Department of Traditional Chinese Medicine, Children's Hospital of Fudan University, Shanghai 201102, China.

出版信息

J Tradit Chin Med. 2013 Jun;33(3):334-42. doi: 10.1016/s0254-6272(13)60175-2.

Abstract

OBJECTIVE

To discuss the mechanism of Yiqiyangyin recipe in rats with adriamycin (ADR)-induced nephropathy.

METHODS

We randomly divided 30 Sprague-Dawley rats into 5 groups: control, model, glucocorticoid, Chinese herb, and Chinese herb plus glucocorticoid groups. The 24-h urine volume was collected on days 7, 14, 21, and 28 after ADR injection, and all rats were killed on day 28. We measured the 24-h levels of urinary protein, serum cholesterol, and serum triglycerides, and renal function of all rats by using routine biochemical methods. Pathological changes in the rat kidneys were observed under light and electron microscopes. Heparanase (HPA) mRNA expression levels were measured using real-time fluorescence-quantitative polymerase chain reaction. Urine levels of HPA in all groups were measured using enzyme-linked immunosorbent assay. The expression of nephrin was detected by immunohistochemical staining and quantitatively analyzed using Motic image analysis 3.2 software.

RESULTS

The levels of urinary protein and serum triglycerides and cholesterol in rats with ADR-induced nephropathy increased on day 14. The serum albumin levels simultaneously decreased. All the changes reached the peak on day 28. Examination under the light microscope showed inflammatory cells and slight fibroplasia in the renal interstitium in the model group, but fewer inflammatory cells were observed in the intervention groups than those in the model group. Examination under the electron microscope showed extensive fusion of foot processes in ADR rats. HPA mRNA expression was higher in the model group than that in the control group. The HPA mRNA levels in the intervention groups, especially in the Chinese herb group, and Chinese herb plus glucocorticoid group were significantly lower than the level in the model group. The HPA expression levels correlated significantly with the proteinuria level. No significant difference was found in the HPA level in urine between the intervention groups and the model group, whereas the model group had a higher urinary HPA level than the control group. Nephrin mRNA expression levels in the model group were higher than those in the control group. Nephrin mRNA expression levels were significantly lower in the intervention groups than that in the model group, especially the Chinese herb plus glucocorticoid group. Compared with the control group, the model group showed increased nephrin expression in the kidney. Nephrin levels in the other groups, especially in the Chinese herb plus glucocorticoid group, were significantly lower than that in the model group. The nephrin levels in the kidney were negatively correlated with the proteinuria level.

CONCLUSION

Yiqiyangyin recipe could attenuate foot process injury particularly in combination with a steroid reduce the development of proteinuria possibly by inhibition of HPA in the kidney, and regulate the expression of nephrin in rats with ADR-induced nephropathy. Our study showed that treatment with Yiqiyangyin recipe plus glucocorticoid was better than a singular intervention, and we explored the pharmacological mechanism of this combination by biochemical and molecular biological analysis to provide a basis for clinical application.

摘要

目的

探讨益气养阴方治疗阿霉素肾病大鼠的作用机制。

方法

将 30 只 Sprague-Dawley 大鼠随机分为 5 组:对照组、模型组、糖皮质激素组、中药组、中药加糖皮质激素组。在阿霉素注射后第 7、14、21 和 28 天收集 24 小时尿液,第 28 天处死所有大鼠。采用常规生化方法检测所有大鼠的 24 小时尿蛋白、血清胆固醇和血清甘油三酯水平及肾功能。光镜和电镜下观察大鼠肾脏的病理变化。采用实时荧光定量聚合酶链反应检测肝素酶(HPA)mRNA 表达水平。采用酶联免疫吸附试验检测各组大鼠尿液中 HPA 水平。采用免疫组织化学染色法检测肾组织中nephrin 的表达,并采用 Motic 图像分析 3.2 软件进行定量分析。

结果

阿霉素肾病大鼠第 14 天开始出现尿蛋白和血清甘油三酯、胆固醇水平升高,同时血清白蛋白水平降低,所有变化在第 28 天达到高峰。光镜下模型组大鼠肾间质可见炎性细胞浸润和轻度纤维增生,而干预组炎性细胞较模型组减少。电镜下阿霉素大鼠足突广泛融合。模型组 HPA mRNA 表达高于对照组。干预组,尤其是中药组和中药加糖皮质激素组的 HPA mRNA 水平明显低于模型组。HPA 表达水平与蛋白尿水平呈显著正相关。干预组与模型组大鼠尿液中 HPA 水平无显著差异,而模型组大鼠尿液中 HPA 水平高于对照组。模型组大鼠肾组织中 nephrin mRNA 表达水平高于对照组。干预组 nephrin mRNA 表达水平明显低于模型组,尤其是中药加糖皮质激素组。与对照组相比,模型组大鼠肾脏中 nephrin 的表达增加。其他组,尤其是中药加糖皮质激素组大鼠肾脏中 nephrin 水平明显低于模型组。肾组织中 nephrin 水平与蛋白尿水平呈显著负相关。

结论

益气养阴方可减轻足突融合,尤其与激素合用可减少蛋白尿的发生,可能通过抑制肾脏 HPA 来调节阿霉素肾病大鼠的 nephrin 表达。本研究通过生化和分子生物学分析探讨了该联合用药的药理机制,为临床应用提供了依据。

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