Sun Linjuan
Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian, Beijing 100091, P.R. China.
Exp Ther Med. 2018 Jan;15(1):131-138. doi: 10.3892/etm.2017.5387. Epub 2017 Oct 27.
Mitochondrial factor and cell cytokines play important roles in the incidence of vascular dementia (VD), but their correlations with inflammatory and mitochondrial factors and the role of both in the kidney essence deficiency pattern and phlegm turbidity blocking orifice pattern are not clear. This study was aimed at studying the correlations between the serum mitochondrial factor and cell cytokines with TCM Syndrome Scale in vascular dementia. According to the inclusion criteria we collected 108 vascular dementia patients which were divided into the kidney essence deficiency pattern and phlegm turbidity blocking orifice pattern based on the TCM Syndrome Scale. We measured serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-18 (IL-18) concentration using an enzyme-linked immunosorbent assay (ELISA) and serum malondialdelyde (MDA) and superoxide dismutase (SOD) was quantified according to instructions of kits from the 108 patients (45 in kidney essence deficiency pattern, 63 in phlegm turbidity blocking orifice pattern). The scale scores were assessed using TCM Syndrome Scale, MMSE, Hachinski, Barthel, BBS, CDR. There was a significant difference on the scores of CDR and the factors of the memory, judgment, social affairs, personal care, family and hobbies among the two groups, The means of kidney essence deficiency group was higher than that of phlegm turbidity blocking orifice pattern group. IL-18 and SOD in the phlegm turbidity blocking orifice group was higher than those in the kidney essence deficiency pattern; IL-6 in phlegm turbidity blocking orifice pattern group was lower than that in the kidney essence deficiency pattern. By logistic regression analysis, we demonstrated that high concentration of IL-6, TNF-α, and MDA were associated with increased TCM syndrome scores in two groups, while IL-6, IL-18, TNF-α, SOD were associated with decreased MMSE, Barthel. Our study support the notion that IL-6 plays a more important role in the integral of kidney essence deficiency pattern, IL-18 is a more important factor in phlegm turbidity blocking orifice pattern. The results can be used as the theoretical basis of traditional Chinese Medicine prescription and pharmacological research in future, through decrease in IL-6 lever and increase in SOD in integral kidney essence deficiency pattern, and IL-18 as the main anti inflammation index in phlegm turbidity blocking orifice pattern.
线粒体因子和细胞因子在血管性痴呆(VD)的发病机制中发挥着重要作用,但其与炎症和线粒体因子的相关性以及二者在肾精亏虚证和痰浊阻窍证中的作用尚不清楚。本研究旨在探讨血管性痴呆患者血清线粒体因子和细胞因子与中医证候量表之间的相关性。根据纳入标准,收集108例血管性痴呆患者,依据中医证候量表将其分为肾精亏虚证和痰浊阻窍证。采用酶联免疫吸附测定(ELISA)法检测108例患者(肾精亏虚证45例,痰浊阻窍证63例)血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-18(IL-18)浓度,并按照试剂盒说明书对血清丙二醛(MDA)和超氧化物歧化酶(SOD)进行定量分析。采用中医证候量表、简易精神状态检查表(MMSE)、哈金斯基缺血指数量表、巴氏指数、平衡量表(BBS)、临床痴呆评定量表(CDR)评估量表评分。两组患者CDR评分以及记忆、判断、社交事务、个人生活自理、家庭及兴趣爱好等方面的评分存在显著差异,肾精亏虚组的平均分高于痰浊阻窍组。痰浊阻窍组的IL-18和SOD高于肾精亏虚证组;痰浊阻窍证组的IL-6低于肾精亏虚证组。通过逻辑回归分析,我们发现高浓度的IL-6、TNF-α和MDA与两组中医证候评分增加相关,而IL-6、IL-18、TNF-α、SOD与MMSE、巴氏指数降低相关。我们的研究支持以下观点:IL-6在肾精亏虚证整体中发挥更重要作用,IL-18是痰浊阻窍证中更重要的因素。研究结果可为今后中医方剂及药理研究提供理论依据,通过降低肾精亏虚证整体中IL-6水平、提高SOD水平,以及将IL-18作为痰浊阻窍证主要抗炎指标。