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河北中医学院 中西医结合学院,河北省中西医结合肝肾病证重点实验室,石家庄 050091
贲莹,博士,副教授,从事中西医结合神经病学研究工作,Tel:0311-89926777,E-mail:2941103568@qq.com
张志红,博士,副教授,从事糖尿病并发症防治研究工作,Tel:0311-89926289,E-mail:1053823012@qq.com
收稿日期:2021-08-03,
网络出版日期:2021-10-25,
纸质出版日期:2022-01-20
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贲莹,张天雅,田佳鑫等.基于SIRT1/p53介导的细胞凋亡途径探讨补阳还五汤对糖尿病周围神经病变的治疗作用及方中黄芪用量[J].中国实验方剂学杂志,2022,28(02):1-10.
BEN Ying,ZHANG Tian-ya,TIAN Jia-xin,et al.Therapeutic Effect of Buyang Huanwutang on Diabetic Peripheral Neuropathy and Dosage of Astragalus in Prescription: Based on SIRT1/p53-mediated Apoptosis[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(02):1-10.
贲莹,张天雅,田佳鑫等.基于SIRT1/p53介导的细胞凋亡途径探讨补阳还五汤对糖尿病周围神经病变的治疗作用及方中黄芪用量[J].中国实验方剂学杂志,2022,28(02):1-10. DOI: 10.13422/j.cnki.syfjx.20212401.
BEN Ying,ZHANG Tian-ya,TIAN Jia-xin,et al.Therapeutic Effect of Buyang Huanwutang on Diabetic Peripheral Neuropathy and Dosage of Astragalus in Prescription: Based on SIRT1/p53-mediated Apoptosis[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(02):1-10. DOI: 10.13422/j.cnki.syfjx.20212401.
目的
2
通过观察补阳还五汤调节沉默信息调节因子2相关酶1(SIRT1)/p53通路发挥对糖尿病周围神经病变(DPN)大鼠的神经保护作用,探讨其治疗DPN的机制和方中黄芪用量。
方法
2
90只SD大鼠随机分为正常组,模型组,DPN加含120 g黄芪的补阳还五汤组(BYHW120组),DPN加含60 g黄芪的补阳还五汤组(BYHW60组),DPN加含30 g黄芪的补阳还五汤组(BYHW30组),DPN加
α
-硫辛酸组(ALA组)。除正常组外,其余各组大鼠均用高糖高脂饲料和腹腔注射链脲佐菌素诱导糖尿病。各用药干预组分别给与相应药物持续干预12周,剂量依次为含120 g黄芪的补阳还五汤15g·kg
-1
·d
-1
,含60 g黄芪的补阳还五汤8.75 g·kg
-1
·d
-1
,含30 g黄芪的补阳还五汤 5.625 g·kg
-1
·d
-1
;
α
-硫辛酸 60 mg·kg
-1
·d
-1
。正常组给予标准饮食。干预结束后检测机械性痛阈和神经传导速度;取L4-5背根神经节,苏木素-伊红(HE)染色、甲苯胺蓝染色观察病理形态改变,原位末端标记法(TUNEL)染色观察神经细胞凋亡情况;免疫组化和蛋白免疫印迹法(Western blot)检测剪切的半胱氨酸天冬氨酸蛋白水解酶-3(cleaved Caspase-3),SIRT1/p53通路中主要蛋白SIRT1,乙酰化的p53(acetyl-p53),线粒体相关动力蛋白1(Drp1),B细胞淋巴瘤-2(Bcl-2)和Bcl-2相关X蛋白(Bax)的表达。
结果
2
与正常组比较,模型组血糖显著升高(
P
<
0.01),神经传导速度、机械性痛阈均显著降低(
P
<
0.01),TUNEL染色阳性细胞百分比,cleaved Caspase-3表达显著升高(
P
<
0.01),SIRT1表达显著降低(
P
<
0.01),acetyl-p53,Drp1,Bax/Bcl-2均显著升高(
P
<
0.01)。与模型组比较,各用药干预组cleaved Caspase-3,acetyl-p53,Drp1,Bax/Bcl-2均显著降低(
P
<
0.01);除BYHW30组外,其余用药干预组神经传导速度、机械性痛阈明显升高(
P
<
0.05,
P
<
0.01),TUNEL染色阳性细胞百分比明显升高(
P
<
0.05,
P
<
0.01);BYHW120组,ALA组SIRT1表达明显升高(
P
<
0.05,
P
<
0.01)。与BYHW120组比较,BYHW60组,BYHW30组的感觉神经传导速度、机械性痛阈及SIRT1表达明显降低(
P
<
0.05,
P
<
0.01),cleaved Caspase-3表达显著升高(
P
<
0.01);BYHW30组TUNEL染色阳性细胞百分比,acetyl-p53表达显著升高(
P
<
0.01)。
结论
2
补阳还五汤通过调节SIRT1/p53抑制细胞凋亡,治疗DPN。其治疗作用与方中黄芪的用量有一定关系,120 g黄芪剂量的补阳还五汤抑制p53依赖的细胞凋亡的作用较60 g和30 g黄芪剂量补阳还五汤更明显。
Objective
2
To explore the neuroprotective effect of Buyang Huanwutang (BYHW) on diabetic peripheral neuropathy (DPN) rats by regulating SIRT1/p53 pathway and to clarify the mechanism and the dosage of astragalus in the prescription.
Method
2
A total of 90 SD rats were randomized into control group, DPN group, DPN + BYHW containing 120 g Astragalus (at 15 g·kg
-1
·d
-1
) (BYHW120 group), DPN + BYHW containing 60 g Astragalus (at 8.75 g·kg
-1
·d
-1
) (BYHW60 group), DPN + BYHW containing 30 g Astragalus (at 5.625 g·kg
-1
·d
-1
) (BYHW30 group), and DPN +
α
-lipoic acid (at 60 mg·kg
-1
·d
-1
) (ALA group). Standard diet was given to rats in the control group and high-carbohydrate/high-fat diet and streptozotocin (ip) were used to induce diabetes in rats in other groups. The administration lasted 12 weeks. After the intervention, mechanical pain threshold and nerve conduction velocity were detected. The L4-5 dorsal root ganglions were stained with haematoxylin-eosin (HE) and toluidine blue to observe the pathological changes, and the apoptosis of nerve cells was detected by terminal deoxynucleotidal transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay. Cleaved cysteinyl aspartate-specific proteinase-3 (Caspase-3), and the main proteins in the SIRT1/p53 pathway, such as silencing information regulator 2 related enzyme 1 (SIRT1), acetyl-p53, dynamin-related protein 1 (Drp1), Bcl-2 associated X protein (Bax), and B-cell lymphoma-2 (Bcl-2), were detected by immunohistochemistry and Western blot.
Result
2
Compared with the control group, the DPN group presented increase in blood glucose (
P
<
0.01), decrease in nerve conduction velocity and mechanical pain threshold (
P
<
0.01), rise of the percentage of positive cells (TUNEL assay, the same below) and the expression of cleaved Caspase-3 (
P
<
0.01), drop in the expression of SIRT1 (
P
<
0.01), and elevation of acetyl-p53, Drp1, and Bax/Bcl-2 ratio (
P
<
0.01). Cleaved Caspase-3, acetyl-p53, Drp1, and Bax/Bcl-2 ratio in each administration group decreased as compared with those in the DPN group (
P
<
0.01). Nerve conduction velocity, mechanical pain threshold (
P
<
0.05,
P
<
0.01), and the percentage of positive cells (
P
<
0.05,
P
<
0.01) increased in the administration groups as compared with those in the DPN group except for the BYHW30 group, and BYHW120 group and ALA group showed the increase in SIRT1 (
P
<
0.05,
P
<
0.01). Nerve conduction velocity, mechanical pain threshold, and SIRT1 expression were lower (
P
<
0.05,
P
<
0.01) and expression of cleaved Caspase-3 was higher (
P
<
0.01) in the BYHW60 and BYHW30 groups than in the BYHW120 group. The percentage of positive cells and the expression of acetyl-p53 were higher in the BYHW30 group than in the BYHW120 group (
P
<
0.01).
Conclusion
2
BYHW inhibits apoptosis and exerts therapeutic effect on DPN by regulating the SIRT1/p53 pathway. The therapeutic effect is related to the dosage of Astragalus in the prescription. BYHW containing 120 g Astragalus suppresses p53-dependent apoptosis more significantly than Buyang Huanwutang containing 60 g and 30 g of Astragalus.
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