Study on Curative Effect and Immune Regulation Mechanism of Liangxue Sanxue Decoction in Immune Thrombocytopenia with Yin Deficiency and Blood Heat Syndrome
|School||Hunan University of Traditional Chinese Medicine|
|Course||Traditional Chinese Medicine|
|Keywords||immune thrombocytopenia(ITP) Liangxue Sanxuedecoction (LSD) Curative effect observation mechanism CD4~+CD25~+regulatory T cells Foxp3 CD40L|
Objects:To investigate the clinical curative effect of Liangxue Sanxue decoction and it’s influence on CD4+CD25+regulatory T (Treg) cells and related factors expressions in immune thrombocytopenia patients with yin deficiency and blood heat syndrome, and study the mechanism of Liangxue Sanxue decoction on immune thrombocytopenia through animal experiments.Methods:1. Clinical Study:60patients with ITP of yin asthenia and blood heat syndrome were randomly divided into Liangxue Sanxue decoction group and prednisone group. The treatment lasted for3months, syndrome curative effect and symptoms integral of traditional Chinese medicine (TCM), clinical effect of western medicine, peripheral blood platelet count, the expressions of CD4+CD25+Treg cells and forkhead box protein3(FOXP3) were compared before and after treatment.2.Experimental Study:the rats were randomly divided into blank group, model group, prednisone group, Liangxue Sanxue decoction high, medium and low dose group. ITP rat model was made by intraperitoneal injection with rabbit anti-rat platelet serum (APS). The levels of CD4+CD25+Treg cells and Foxp3were measured by flow cytometry, the expression of Foxp3mRNA and Foxp3protein were determined by RT-PCR and Western-blotting method, the changes of cluster of differentiation40ligand(CD40L) in peripheral blood were determined by enzyme-linked immune sorbent assay (ELISA) to compare. Results:1.Clinical study:Liangxue Sanxue decoction increased syndrome curative effect of TCM, and each symptoms was improved (P<0.01). The improvements of western medicine, peripheral blood platelet count were compared before and after the treatment. There were no statistical significances between the two groups(P>0.05). Compared the expressions of CD4+CD25+Treg cells and FOXP3before and after the treatment, there were statistical significances in each group (P<0.05).2.Experimental study:Foxp3is mainly expressed in the nucleus. Compared with blank group, the expressions of CD4+CD25+Treg cells and Foxp3, Foxp3mRNA and Foxp3protein were significantly lower while the level of CD40L was significantly higher in model group. There were statistical significance in these indices between the two groups (P<0.01). Compared with the model group, the expressions of CD4+CD25+Treg cells and Foxp3, Foxp3mRNA and Foxp3protein were increased(P<0.01or P<O.05), and the levels of CD40L were decreased(P<0.01or P<0.05) in treatment groups. There were no statistical significance between Liangxue Sanxue decoction high dose group and prednisone group (P>0.05).Conclusion:1.Liangxue Sanxue decoction can enhance the quantity of platelet and improve the bleeding of ITP patients with yin asthenia and blood heat syndrome, which may be related to increasing the expression of FOXP3to increase the immune suppressive function of CD4+CD25+Treg cells to play a role in the treatment of ITP.2. Liangxue Sanxue decoction can decrease the destruction of peripheral platelet, which may be related to the down-regulation of CD40L overexpression, and up-regulation of Foxp3expressions, increasing the expression and immune suppressive function of CD4+CD25+Treg cells.