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1.湖南中医药大学 中西医结合学院,长沙 410208
2.湖南中医药大学 中西医结合心脑疾病防治湖南省重点实验室,长沙 410208
3.湖南中医药大学 中医学院,长沙 410208
4.湖南中医药大学 第一附属医院,长沙 410007
Received:13 June 2025,
Revised:2025-10-23,
Accepted:23 October 2025,
Published Online:24 October 2025,
Published:20 February 2026
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刘武超男,李定祥,杨乐等.化瘀解毒方调控NETosis防治瘀毒互结型急性脑梗死后脑缺血损伤的机制[J].中国实验方剂学杂志,2026,32(04):50-59.
LIU Wuchaonan,LI Dingxiang,YANG Le,et al.Mechanism of Huayu Jiedu Prescription in Preventing and Treating Cerebral Ischemia Injury by Regulating NETosis After Acute Cerebral Infarction with Blood Stasis and Toxin Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(04):50-59.
刘武超男,李定祥,杨乐等.化瘀解毒方调控NETosis防治瘀毒互结型急性脑梗死后脑缺血损伤的机制[J].中国实验方剂学杂志,2026,32(04):50-59. DOI: 10.13422/j.cnki.syfjx.20252301.
LIU Wuchaonan,LI Dingxiang,YANG Le,et al.Mechanism of Huayu Jiedu Prescription in Preventing and Treating Cerebral Ischemia Injury by Regulating NETosis After Acute Cerebral Infarction with Blood Stasis and Toxin Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(04):50-59. DOI: 10.13422/j.cnki.syfjx.20252301.
目的
2
探讨脑缺血损伤“瘀毒互结”病机物质基础及化瘀解毒方对急性脑梗死后脑缺血损伤中性粒细胞胞外诱捕网形成相关的细胞死亡方式(NETosis)的保护作用。
方法
2
将72只SD大鼠随机分为:假手术(Sham)组,瘀毒互结型模型(Model)组,化瘀解毒方低、中、高剂量(HYJDP-L、M、H)组(9、18、36 g·kg
-1
),丁苯酞(NBP)组(0.06 g·kg
-1
),共6组,每组12只。除假手术组外,其余各组大鼠均采用角叉菜胶/干酵母联合改良线栓法制备大鼠瘀毒互结型大脑中动脉局灶性脑缺血模型。采用Zea-Longa's级神经功能评分对造模24 h的大鼠进行神经功能评分;2,3,5-氯化三苯基四氮唑(TTC)染色法评估脑梗死率;苏木素-伊红(HE)染色观察脑组织病理形态;酶联免疫吸附测定法(ELISA)检测血清中白细胞介素-8(IL-8)、髓过氧化物酶-DNA复合物(MPO-DNA)和瓜氨酸化组蛋白H3(CitH3)含量;蛋白免疫印迹法(Western blot)检测脑组织中磷酸化(p)-磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B(Akt)、哺乳动物雷帕霉素靶蛋白(mTO
R)及螯合体1(p62)、CitH3蛋白表达;免疫荧光法(IF)检测脑组织中中性粒细胞特异性标志物(Ly6G)、CitH3、神经元特异性核蛋白(NeuN)的表达。
结果
2
与Sham组比较,Model组神经功能缺损评分显著上升(
P
<
0.01)、脑梗死率显著上升(
P
<
0.01);HE染色显示神经元不同程度变性坏死,坏死神经元结构模糊,胞核固缩碎裂,胞质溶解成空网状,亦见少量胶质细胞增生;ELISA结果显示IL-8、MPO-DNA、CitH3含量显著上升(
P
<
0.01);Western blot结果显示p-PI3K、p-Akt、p-mTOR、p62蛋白表达降低、CitH3蛋白表达显著升高(
P
<
0.01);IF结果显示中性粒细胞外诱捕网(NETs
+
)细胞数量升高、NeuN
+
细胞数量显著降低(
P
<
0.01)。与Model组比较,HYJDP-H组神经功能评分明显下降(
P
<
0.05);HYJDP-H组和NBP组脑梗死率显著下降(
P
<
0.01);HE染色结果显示HYJDP-H组脑组织损伤明显减轻;ELISA结果显示HYJDP-M组、HYJDP-H和NBP组IL-8、MPO-DNA、CitH3含量显著下降(
P
<
0.01);Western blot结果显示HYJDP-H和NBP组p-PI3K、p-Akt、p-mTOR、p62蛋白表达显著升高、各药物干预组CitH3蛋白表达显著降低(
P
<
0.01);IF结果显示各药物干预组NETs
+
细胞数量显著降低、NeuN
+
细胞数量显著升高(
P
<
0.01)。
结论
2
NETs可能是脑缺血损伤“瘀毒互结”病机的物质基础;化瘀解毒方可以通过调控PI3K/Akt/mTOR通路,减少相关促炎、NETosis产物的释放,缓解了自噬依赖性NETosis导致的脑缺血损伤过程,进而发挥脑保护作用。
Objective
2
To investigate the material basis of the pathogenesis of cerebral ischemic injury with blood stasis and toxin syndrome and to explore the protective effects of Huayu Jiedu prescription (HYJDP) on neutrophil extracellular trap-related cell death (NETosis) in cerebral ischemic injury following acute cerebral infarction.
Methods
2
Seventy-two Sprague-Dawley (SD) rats were randomly divided into six groups (
n
=12 per group): sham operation (Sham) group, blood stasis and toxin model (Model) group, low-, medium-, and high-dose HYJDP groups (HYJDP-L, HYJDP-M, and HYJDP-H; 9, 18, and 36 g·kg
-1
, respectively), and butylphthalide (NBP) group (0.06 g·kg
-1
). Except for the Sham group, rats in all other groups were subjected to carrageenan/dry yeast combined with a modified intraluminal filament method to est
ablish a focal cerebral ischemia model of the middle cerebral artery with blood stasis and toxin syndrome. Neurological function was evaluated at 24 h after modeling using the Zea-Longa neurological deficit score. Cerebral infarction rate was assessed by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Pathological morphology of brain tissue was observed using hematoxylin-eosin (HE) staining. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of interleukin-8 (IL-8), myeloperoxidase-DNA complexes (MPO-DNA), and citrullinated histone H3 (CitH3). Protein expression of phosphorylated phosphatidylinositol 3-kinase (p-PI3K), protein kinase B (p-Akt), mammalian target of rapamycin (p-mTOR), sequestosome 1 (p62), and CitH3 in brain tissue was detected by Western blot. Immunofluorescence (IF) was used to detect the expression of neutrophil-specific marker Ly6G, CitH3, and neuron-specific nuclear protein (NeuN) in brain tissue.
Results
2
Compared with the Sham group, neurological deficit scores and cerebral infarction rates in the model group were significantly increased (
P
<
0.01 for both). HE staining showed varying degrees of neuronal degeneration and necrosis, characterized by blurred neuronal structures, nuclear pyknosis and fragmentation, cytoplasmic dissolution into a vacuolated reticular pattern, and mild glial cell proliferation. ELISA results showed that serum levels of IL-8, MPO-DNA, and CitH3 were significantly increased (
P
<
0.01). Western blot analysis demonstrated decreased expression of p-PI3K, p-Akt, p-mTOR, and p62, while CitH3 expression was significantly increased (
P
<
0.01). IF results showed an increased number of NETs
+
cells and a significant decrease in NeuN
+
cells (
P
<
0.01). Compared with the Model group, neurological deficit scores in the HYJDP-H group were significantly decreased (
P
<
0.05), and cerebral infarction rates in the
HYJDP-H and NBP groups were significantly reduced (
P
<
0.01). HE staining showed that brain tissue damage was markedly alleviated in the HYJDP-H group. ELISA results showed that levels of IL-8, MPO-DNA, and CitH3 were significantly decreased in the HYJDP-M, HYJDP-H, and NBP groups (
P
<
0.01). Western blot analysis showed that expression of p-PI3K, p-Akt, p-mTOR, and p62 was significantly increased in the HYJDP-H and NBP groups, while CitH3 expression was significantly reduced in all drug intervention groups (
P
<
0.01). IF results showed that the number of NETs
+
cells was significantly decreased and the number of NeuN⁺ cells was significantly increased in all drug intervention groups (
P
<
0.01).
Conclusion
2
NETs may be the material basis of the pathogenesis of cerebral ischemic injury characterized by blood stasis and toxin. HYJDP can regulate the PI3K/Akt/mTOR signaling pathway, reduce the release of pro-inflammatory mediators and NETosis-related products, alleviate cerebral ischemic injury caused by autophagy-dependent NETosis, and thereby exert a neuroprotective effect.
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