Zhang Shuang, Zhou Hui-Fang, Liu Yu-Nan, Liu Bei, Yuan Yi-Zhen, Shan Jin-Jun, Ji Jian-Jian
Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210029, China Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine Suzhou 215600, China.
Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210029, China.
Zhongguo Zhong Yao Za Zhi. 2021 Dec;46(24):6493-6501. doi: 10.19540/j.cnki.cjcmm.20210823.401.
The present study investigated the effect of Modified Dihuang Decoction in improving ovarian reserve in mice through the Bcl-2-related mitochondrial apoptosis pathway. Forty-eight adult female BALB/c mice were randomly divided into the following six groups with eight mice in each group: a blank group, a model group, a femoston group(three cycles of treatment with 0.13 mg·kg(-1) estradiol tablets for 2 days and 1.43 mg·kg(-1) estradiol and dydrogesterone tablets for 3 days), and high(64.74 g·kg(-1))-, medium(43.16 g·kg(-1))-, and low-dose(21.58 g·kg(-1)) Modified Dihuang Decoction groups. Mice in other groups except the blank group received a single intraperitoneal injection of 12 mg·kg(-1) cyclophosphamide and 1.2 mg·kg~(-1) busulfan to induce a model of diminished ovarian reserve(DOR), while those in the blank group received an equal volume of normal saline. Mice were treated with corresponding drugs for 15 d from the 36 th day, once per day, and the mice in the blank group and the model group were treated with an equal volume of normal saline. The general condition and oestrous cycle were observed. The serum hormone levels were detected with the enzyme-linked immunosorbent assay(ELISA). The morphological changes of ovaries were observed by HE staining. Western blot was used to detect the protein expression of cysteinyl aspartate specific proteinase-9(caspase-9), cleaved caspase-3, Bcl-2 associated X protein(Bax), Bcl-2, superoxide dismutase-2(SOD-2), and glutathione peroxidase-1(GPx-1). The mRNA expression of Bax and Bcl-2 was detected by real-time fluorescence-based quantitative polymerase chain reaction(real-time PCR). The results showed that compared with the blank group, the model group showed body weight loss, disordered oestrous cycle, elevated serum levels of follicle-stimulating hormone(FSH) and luteinizing hormone(LH), reduced serum levels of estradiol(E_2), anti-mullerian hormone(AMH), and inhibin B(INHB), the declining number of ovarian follicles and granulosa layers, increased number of atretic follicles, up-regulated protein expression of caspase-9, cleaved caspase-3, and Bax and Bax mRNA expression in ovaries, and down-regulated protein expression of Bcl-2, SOD-2 and GPx-1, and Bcl-2 mRNA expression. Compared with the model group, the Modified Dihuang Decoction groups displayed restored body weight and oestrous cycle, decreased serum levels of FSH and LH, elevated serum levels of E_2, AMH, and INHB, increased number of ovarian follicles, thickened granulosa layers, and declining number of atretic follicles. Additionally, the protein expression of caspase-9, cleaved caspase-3, and Bax, and Bax mRNA expression was down-regulated, and the protein expression of Bcl-2, SOD-2, and GPx-1, and Bcl-2 mRNA expression was up-regulated. The results suggest that Modified Dihuang Decoction can regulate endocrine hormone, promote follicle growth and improve ovarian reserve by enhancing ovarian anti-oxidant capacity, inhibiting the Bcl-2-related mitochondrial apoptosis pathway, and further inhibiting cell apoptosis.
本研究通过Bcl-2相关的线粒体凋亡途径,探讨了加味地黄汤对改善小鼠卵巢储备功能的作用。将48只成年雌性BALB/c小鼠随机分为6组,每组8只:空白组、模型组、补佳乐组(用0.13mg·kg⁻¹雌二醇片治疗2天,1.43mg·kg⁻¹雌二醇和地屈孕酮片治疗3天,共三个周期),以及高剂量(64.74g·kg⁻¹)、中剂量(43.16g·kg⁻¹)和低剂量(21.58g·kg⁻¹)加味地黄汤组。除空白组外,其他组小鼠单次腹腔注射12mg·kg⁻¹环磷酰胺和1.2mg·kg⁻¹白消安以诱导卵巢储备功能减退(DOR)模型,而空白组小鼠注射等体积的生理盐水。从第36天起,小鼠每天接受相应药物治疗15天,空白组和模型组小鼠则接受等体积的生理盐水。观察小鼠的一般状况和发情周期。采用酶联免疫吸附测定(ELISA)检测血清激素水平。通过HE染色观察卵巢的形态变化。采用蛋白质免疫印迹法检测半胱天冬酶-9(caspase-9)、裂解的半胱天冬酶-3、Bcl-2相关X蛋白(Bax)、Bcl-2、超氧化物歧化酶-2(SOD-2)和谷胱甘肽过氧化物酶-1(GPx-1)的蛋白表达。采用实时荧光定量聚合酶链反应(实时PCR)检测Bax和Bcl-2的mRNA表达。结果显示,与空白组相比,模型组小鼠体重减轻、发情周期紊乱、血清促卵泡生成素(FSH)和促黄体生成素(LH)水平升高、血清雌二醇(E₂)、抗苗勒管激素(AMH)和抑制素B(INHB)水平降低、卵巢卵泡和颗粒层数量减少、闭锁卵泡数量增加、卵巢中caspase-9、裂解的半胱天冬酶-3和Bax的蛋白表达及Bax mRNA表达上调,Bcl-2、SOD-2和GPx-1的蛋白表达及Bcl-2 mRNA表达下调。与模型组相比,加味地黄汤组小鼠体重和发情周期恢复、血清FSH和LH水平降低、血清E₂、AMH和INHB水平升高、卵巢卵泡数量增加、颗粒层增厚、闭锁卵泡数量减少。此外,caspase-9、裂解的半胱天冬酶-3和Bax的蛋白表达及Bax mRNA表达下调,Bcl-2、SOD-2和GPx-1的蛋白表达及Bcl-2 mRNA表达上调。结果表明,加味地黄汤可通过增强卵巢抗氧化能力、抑制Bcl-2相关的线粒体凋亡途径进而抑制细胞凋亡,调节内分泌激素,促进卵泡生长并改善卵巢储备功能。