Sun Yue, Cao Yonghe
Department of Rheumatism Immunity, The First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei 230031, China.
Department of Traditional Chinese Medicine, The First Affiliated Hospital, Xinxiang Medical University, Xinxiang 453100, China.
J Tradit Chin Med. 2018 Aug;38(4):601-609.
To observe the effects of Xinfeng capsule on the apoptosis of peripheral blood CD4+ T lymphocytes and changes in the Fas/FasL-mediated apoptotic pathway in patients with rheumatoid arthritis (RA).
A total of 28 RA patients were included in the study; they were randomly divided into the Xinfeng capsule (XFC) group (3 capsules, 3 per day) and the leflunomide (LEF) group (1 pellet, once per night). The treatment course in each groups was 12 weeks. The normal control (NC) group consisted of 10 healthy people. The apoptotic rate was examined using flow cytometry. Fas, FasL, caspase 8, caspase 3, bcl-2, and bax mRNA were examined using qRT-PCR. Apoptotic proteins Fas, FasL, caspase 8, and caspase 3 were examined using western blotting.
After treatment, patients in the two groups all showed some trend of improvement. Disease activity indexes, joint morning stiffness time, joint swelling/tenderness number, health assessment questionnaire (HAQ) score, RA quality of life (RAQOL) questionnaire, and self-rating anxiety scale (SAS), as well as all apoptotic related indicators were reduced in both groups after treatment with no significant difference between groups. But the improvement in terms of the self-rating depression scale (SDS) in the XFC group was better than in the LEF group. RA patients showed lower apoptotic rates in CD4+ T cells, lower bax, Fas, caspase 8, and caspase 3 mRNA, and less protein expression of Fas, caspase 8, and caspase 3 than in the NC group. These indicators increased after treatment. However, the level of Bcl-2 mRNA was higher in the XFC group than in the NC group before treatment, and it subsequently decreased. The XFC group expressed lower Bcl-2 mRNA than the LEF group. Negative correlations were found between ESR and the apoptotic rate in CD4+ T cells, Fas, and caspase 3; CRP and Fas; and, swollen joint count and Bax, while positive correlations were found between ESR and Bcl-2.
XFC can regulate the Fas/FasL system and promote CD4+ T cell apoptosis and thus reduce the abnormal immune response, which can improve symptoms in RA patients.
观察新风胶囊对类风湿关节炎（RA）患者外周血CD4+T淋巴细胞凋亡及Fas/FasL介导的凋亡途径变化的影响。
共纳入28例RA患者，随机分为新风胶囊（XFC）组（3粒，每日3次）和来氟米特（LEF）组（1片，每晚1次）。每组疗程均为12周。正常对照组（NC）由10名健康人组成。采用流式细胞术检测凋亡率。采用qRT-PCR检测Fas、FasL、半胱天冬酶8、半胱天冬酶3、bcl-2和bax mRNA。采用蛋白质印迹法检测凋亡蛋白Fas、FasL、半胱天冬酶8和半胱天冬酶3。
治疗后，两组患者均有一定改善趋势。两组治疗后疾病活动指数、关节晨僵时间、关节肿胀/压痛数、健康评估问卷（HAQ）评分、RA生活质量（RAQOL）问卷、自评焦虑量表（SAS）以及所有凋亡相关指标均降低，组间差异无统计学意义。但XFC组在自评抑郁量表（SDS）方面的改善优于LEF组。RA患者CD4+T细胞凋亡率、bax、Fas、半胱天冬酶8和半胱天冬酶3 mRNA水平低于NC组，Fas、半胱天冬酶8和半胱天冬酶3蛋白表达也较少。治疗后这些指标升高。然而，XFC组治疗前Bcl-2 mRNA水平高于NC组，随后降低。XFC组Bcl-2 mRNA表达低于LEF组。ESR与CD4+T细胞凋亡率、Fas和半胱天冬酶3；CRP与Fas；关节肿胀计数与Bax之间呈负相关，而ESR与Bcl-2之间呈正相关。
XFC可调节Fas/FasL系统，促进CD4+T细胞凋亡，从而减少异常免疫反应，改善RA患者症状。
