Department of Renal and Pulmonary Diseases, Qingdao Huangdao District Hospital of Traditional Chinese Medicine, Qingdao, Shandong, China.
Emergency Department, Qingdao Huangdao District Hospital of Traditional Chinese Medicine, Qingdao, Shandong, China.
Cell Mol Biol (Noisy-le-grand). 2021 Nov 25;67(3):178-183. doi: 10.14715/cmb/2021.67.3.28.
Acute respiratory distress syndrome (ARDS) is a life-threatening condition in which the lungs become severely inflamed, causing the alveoli to constrict or fill with fluid, which prevents the lungs from functioning properly. This disease becomes more dangerous when it occurs in patients with diabetes. Because of the clinical condition of these patients, it is not possible to treat them with usual medicines. One of the best options for treating these people is to use herbs. Borage (Borago officinalis) is a medicinal herb that, in addition to its anti-inflammatory properties, is also able to control blood sugar. Therefore, in the current study, the effect of borage oil was considered on the signaling pathway of the NLRP3 inflammasome complex, TLR4, and serum levels of inflammatory cytokines (IL-1? and IL-18) in type II diabetic patients with ARDS. For this purpose, 25 diabetic type II patients with ARDS were divided into three groups by ARDS Berlin Definition. Then, after providing the demographic and clinical characteristics of the patients, they were treated with 30 mg/day borage oil for seven days. The expression of NLRP3 and TLR4 genes (by Real-time PCR technique) and serum levels of IL-1? and IL-18 (by ELISA test) were evaluated before and after treatment with borage oil through blood samples taken from patients. The results showed that serum levels of inflammatory cytokines (IL-1? and IL-18), NLRP3 gene, and TLR4 gene were significantly decreased in diabetic type II patients with mild ARDS by treating with borage oil. IL-1? serum level and TLR4 were significantly decreased in diabetic type II patients with moderate ARDS. But there was not any significant decrease or increase in IL-1?, IL-18, NLRP3 gene, and TLR4 gene in diabetic type II patients with severe ARDS after 7 days of treatment with borage oil. According to the obtained results, borage oil can act as a double-edged blade. Thus, in the early and middle stages of ARDS, borage oil can be effective in reducing the inflammasome pathway of inflammation and also reduce blood sugar levels in these diabetic patients. But in the severe stage of ARDS, it not only does not help to treat the ARDS; it also increases systolic and diastolic blood pressure in diabetic patients.
急性呼吸窘迫综合征（ARDS）是一种危及生命的疾病，其肺部严重发炎，导致肺泡收缩或充满液体，从而使肺部无法正常运作。当糖尿病患者发生这种疾病时，情况会变得更加危险。由于这些患者的临床状况，无法用通常的药物治疗他们。治疗这些人的最佳选择之一是使用草药。琉璃苣（Borago officinalis）是一种药用植物，除了具有抗炎特性外，还能够控制血糖。因此，在当前的研究中，考虑了琉璃苣油对 NLRP3 炎性小体复合物、TLR4 以及 II 型糖尿病合并 ARDS 患者血清中炎症细胞因子（IL-1β和 IL-18）信号通路的影响。为此，根据 ARDS 柏林定义，将 25 例 II 型糖尿病合并 ARDS 患者分为三组。然后，在提供患者的人口统计学和临床特征后，他们每天用 30 毫克的琉璃苣油治疗七天。通过从患者身上采集的血液样本，使用 Real-time PCR 技术评估 NLRP3 和 TLR4 基因的表达（通过实时 PCR 技术）和血清中白细胞介素-1β和白细胞介素-18（通过 ELISA 试验）的水平在使用琉璃苣油治疗前后。结果表明，轻度 ARDS 的 II 型糖尿病患者在使用琉璃苣油治疗后，炎症细胞因子（IL-1β和 IL-18）、NLRP3 基因和 TLR4 基因的血清水平显著降低。中度 ARDS 的 II 型糖尿病患者的血清白细胞介素-1β和 TLR4 水平显著降低。但在接受琉璃苣油治疗 7 天后，II 型糖尿病合并重度 ARDS 的患者的白细胞介素-1β、白细胞介素-18、NLRP3 基因和 TLR4 基因均未出现明显的降低或升高。根据获得的结果，琉璃苣油可以发挥双刃剑的作用。因此，在 ARDS 的早期和中期，琉璃苣油可以有效降低炎症小体通路的炎症反应，还可以降低这些糖尿病患者的血糖水平。但在 ARDS 的严重阶段，它不仅无助于治疗 ARDS，还会增加糖尿病患者的收缩压和舒张压。
