Wang Jia, Zou Yang, Chang Dan, Hong Da-Qing, Zhang Jiong
General Practice Center, Sichuan Provincial People's Hospital & Sichuan Academy of Sciences, University of Electronic Science and Technology, Chengdu, China.
Division of Nephrology, Sichuan Provincial People's Hospital & Sichuan Academy of Sciences, University of Electronic Science and Technology, Chengdu, China.
Gland Surg. 2021 Oct;10(10):3030-3044. doi: 10.21037/gs-21-655.
Dachengqi decoction (DCQD), one of classic prescription of Chinese herbal medicine has been widely used in clinic to treat severe acute pancreatitis (SAP). The damage of pancreatic microcirculation plays key pathogenesis of SAP. However, little is known about the molecular pharmacological activity of DCQD on pancreatic microcirculation in SAP.
Sodium taurodeoxycholate and cerulein were used to establish model of SAP in vitro and , respectively. The pancreatic pathological morphology, wet weight ratio, myeloperoxidase (MPO) activity, cell viability and microcirculatory function of the pancreas, as well as serum lipase and amylase expressions were evaluated. The expression levels of SIRT1, acety-HMGB1, TLR-4, HMGB1, IL-23, IL-17A, neutrophil chemokines (KC, LIX, and MIP-2), and inflammation-related factors (IL-6, IL-1β, and TNF-α), the translocation of HMGB1 and the interaction of SIRT-HMGB1 in the pancreas and serum were determined by ELISA real-time PCR, western blotting and immunoprecipitation.
studies showed that DCQD or neutralizing antibody (anti-23p19 or anti-IL-17A) could all significantly decrease lipase, amylase activity, down-regulate the expression of CD68, Myeloperoxidase (MPO), wet/weight, IL-1β, IL-6, TNF-α, and neutrophil chemokines (KC, LIX, MIP-2), alleviate pathological injury and improve pancreatic microcirculatory function in rats with SAP. Furthermore, DCQD remarkably increased SIRT1 expression, promoted SIRT1 and HMGB1 combination, reduced HMGB1 translocation from nuclear to cytoplasm, and alleviated the expression of acetyl-HMGB1, HMGB1, IL-17A, TLR-4, and IL-23 and with SAP. However, the intervention with EX527 (SIRT1 inhibitor) or r-HMGB1 (recombinant HMGB1) obliviously reverses the above mentioned influence mentioned above of DCQD in SAP. , we confirmed that DCQD could decrease HMGB1 acetylation, migration, and release, and improve the decline of cell viability, SIRT1 expression and SIRI-HMGB1 combination induced by cerulean with promoting macrophage to release IL-23 by relying on the HMGB1/TLR-4 way.
DCQD treatment improves SAP-induced pancreatic microcirculatory dysfunction by inhibiting neutrophil-mediated inflammation via inactivating HMGB1-TLR-4-IL-23-IL-17A signaling by targeting SIRT1.
大承气汤(DCQD)作为经典的中药方剂之一,已在临床上广泛用于治疗重症急性胰腺炎(SAP)。胰腺微循环损伤是SAP的关键发病机制。然而,关于DCQD对SAP胰腺微循环的分子药理活性知之甚少。
分别采用牛磺脱氧胆酸钠和雨蛙素建立体外SAP模型。评估胰腺病理形态、湿重比、髓过氧化物酶(MPO)活性、细胞活力和胰腺微循环功能,以及血清脂肪酶和淀粉酶表达。通过ELISA、实时PCR、蛋白质免疫印迹和免疫沉淀法检测胰腺和血清中SIRT1、乙酰化HMGB1、TLR-4、HMGB1、IL-23、IL-17A、中性粒细胞趋化因子(KC、LIX和MIP-2)以及炎症相关因子(IL-6、IL-1β和TNF-α)的表达水平,HMGB1的转位以及SIRT-HMGB1的相互作用。
研究表明,DCQD或中和抗体(抗-IL-23或抗-IL-17A)均可显著降低脂肪酶、淀粉酶活性,下调CD68、髓过氧化物酶(MPO)、湿/重、IL-1β、IL-6、TNF-α和中性粒细胞趋化因子(KC、LIX、MIP-2)的表达,减轻病理损伤,改善SAP大鼠的胰腺微循环功能。此外,DCQD显著增加SIRT1表达,促进SIRT1与HMGB1结合,减少HMGB1从细胞核向细胞质的转位,并减轻乙酰化HMGB1、HMGB1、IL-17A、TLR-4和IL-23在SAP中的表达。然而,用EX527(SIRT1抑制剂)或r-HMGB1(重组HMGB1)干预可明显逆转DCQD对SAP的上述影响。因此,我们证实DCQD可通过依赖HMGB1/TLR-4途径促进巨噬细胞释放IL-23,减少HMGB1的乙酰化、迁移和释放,并改善由雨蛙素诱导的细胞活力下降、SIRT1表达以及SIRT-HMGB1结合。
DCQD治疗通过靶向SIRT1失活HMGB1-TLR-4-IL-23-IL-17A信号通路,抑制中性粒细胞介导的炎症,改善SAP诱导的胰腺微循环功能障碍。