Department of Graduate School, Shanxi University of Chinese Medicine, Taiyuan, 030619, China.
Department of Traditional Chinese Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
Appl Biochem Biotechnol. 2023 Nov;195(11):6737-6751. doi: 10.1007/s12010-023-04417-w. Epub 2023 Mar 14.
The pathogenesis of recurrent oral ulcers (ROU) is complex, with a long duration of illness and challenging to cure. According to traditional Chinese medicine (TCM),"heat accumulation in the heart-spleen" is one of the main causative factors. Jiaweidaochi powder (JWDCP) is based on the ancient Chinese medicine formula JWDCS, with the addition of Tongcao and gypsum and the removal of Mu Tong. It is generally used to treat "heat accumulation in the heart-spleen." Previous studies have demonstrated that it effectively reduces recurrence rates and is anti-inflammatory in modulating immunity. The ROU rats' model for JWDCP intervention treatment had been established, and histological tests revealed that JWDCP has a therapeutic effect on the pathological changes in the oral mucosa. In addition, the methylation levels of peripheral blood IFNG gene were detected by bisulfite sequencing PCR (BSP), and the methylation levels of the IFNG promoter region in the model group and each dose group were lower than those in the control group. However, no significant methylation differences were observed. Furthermore, the results of enzyme-linked immunosorbent assay (ELISA) and RNA quantitative polymerase chain reaction showed that JWDCP could reduce IFN-γ and IL-4 protein concentrations, with high GATA-3 mRNA production, T-bet mRNAproduction was upgraded, elevated IL-4 mRNA levels, and reduced IFN-γ mRNA levels after treatment (P < 0.001). The expression of transcription factor T-betmRNA and GATA-3 gene mRNA was accompanied by changes in IFN-γmRNA and IL-4mRNA, demonstrating that Th2 type differentiation in RAS suppresses the body's immunity and that the imbalance of transcription factor expression further leads to Th1/Th2 drift. JWDCP is likely to reduce the protein concentration by regulating the imbalance of transcription factors and enhancing antioxidant capacity, thus achieving therapeutic effects. Treatment of recurrent oral ulcer models is not sufficient to reset IFNG methylation levels, correlating with the refractoriness of ROU, further confirming the complexity of epigenetic mechanisms and that epigenetic alterations in specific mediators may persist locally.
复发性口腔溃疡(ROU)的发病机制复杂,病程长,难以治愈。根据中医理论,“心脾积热”是主要致病因素之一。加味导赤散(JWDCP)是在古方导赤散的基础上加减而成,加用了甘草和石膏,去掉了木通。它通常用于治疗“心脾积热”。既往研究表明,它能有效降低复发率,并具有调节免疫的抗炎作用。已建立 JWDCP 干预治疗 ROU 大鼠模型,组织学检查表明 JWDCP 对口腔黏膜的病理变化有治疗作用。此外,采用亚硫酸氢盐测序 PCR(BSP)检测外周血 IFNG 基因的甲基化水平,模型组和各剂量组 IFNG 启动子区域的甲基化水平均低于对照组,但无显著的甲基化差异。进一步通过酶联免疫吸附试验(ELISA)和 RNA 定量聚合酶链反应发现,JWDCP 可降低 IFN-γ和 IL-4 蛋白浓度,高表达 GATA-3mRNA,上调 T-betmRNA 表达,降低 IL-4mRNA 水平,升高 IFN-γmRNA 水平(P < 0.001)。转录因子 T-betmRNA 和 GATA-3 基因 mRNA 的表达伴随着 IFN-γmRNA 和 IL-4mRNA 的变化,表明 RAS 中的 Th2 型分化抑制了机体的免疫力,转录因子表达的失衡进一步导致 Th1/Th2 漂移。JWDCP 可能通过调节转录因子的失衡和增强抗氧化能力来降低蛋白浓度,从而达到治疗效果。治疗复发性口腔溃疡模型不足以重置 IFNG 甲基化水平,与 ROU 的难治性有关,进一步证实了表观遗传机制的复杂性,特定介质的表观遗传改变可能在局部持续存在。