加减补阳还五汤对膜性肾病大鼠Podocin、Nephrin 的影响
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R692

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浙江省中医药重大研究项目(2018ZY011);温州市中医药科研项目(2018ZA004)


Modified Buyang Huanwu Tang Has Effect on Podocin and Nephrin in Rats with Membranous Nephropathy
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    摘要:

    目的:探讨加减补阳还五汤对膜性肾病(MN) 大鼠的治疗效果及可能的作用机制。方法:将雄性SD大鼠36只随机分为正常组、模型组、盐酸贝那普利组、加减补阳还五汤高、中、低剂量组(中药高、中、低剂量组),每组6只。正常组大鼠按6 mL/kg的剂量尾静脉注射生理盐水,其余5组按等剂量注射抗近端小管刷状缘抗原(Anti-Fx1A) 构建MN模型。模型制备成功后,正常组、模型组每天给予10 mL/kg 0.9%的氯化钠注射液灌胃,盐酸贝那普利组每天按1.60 mg/kg的剂量给予0.16 mg/mL的盐酸贝那普利药液,中药高、中、低剂量组分别予以7.04、3.52、1.76 g/mL 的中药浓缩液灌胃。分别于模型制备前、模型制备成功后、给药后第7、14、28天留取各组大鼠24 h尿液,检测24 h尿蛋白(24 hUP)。给药28天后处死大鼠,心脏取血,检测血中白蛋白(Alb)、胆固醇(TC)、甘油三酯(TG)、血肌酐(SCr) 和尿素氮(BUN) 水平,取肾脏组织行苏木精-伊红染色(HE染色)、马松三色染色(Masson染色)、过碘酸六胺银染色(PASM染色),光学显微镜下观察肾脏组织病理改变;免疫荧光检测免疫球蛋白G(IgG) 和补体C3在肾小球的阳性表达;免疫组织化学法观察足细胞裂孔膜蛋白Podocin 在肾小球的阳性表达情况;RT-PCR 检测足细胞裂孔膜蛋白Podocin、Nephrin mRNA 表达量。结果:与正常组比较,模型组大鼠24 hUP 增多(P<0.05),肾小球基底膜上皮下免疫复合物形成,IgG、C3表达增多,肾组织Podocin蛋白及Podocin、Nephrin mRNA表达下降(P<0.01)。与模型组比较,4 个给药组大鼠治疗28 d 后24 hUP 降低(P<0.05);上皮下免疫复合物形成减少,IgG、C3 表达下降;肾组织Podocin、Nephrin mRNA表达升高(P<0.01);Podocin蛋白表达升高,但仅中药高剂量组差异有统计学意义(P<0.05)。与盐酸贝那普利组比较,中药低、中剂量组大鼠给药28 d后24 hUP及肾组织Podocin 蛋白表达差异均无统计学意义;中药低剂量组Podocin、Nephrin mRNA 表达较低(P<0.01);中剂量组Nephrin mRNA 的表达较低(P<0.05),Podocin mRNA 的表达下降,但差异无统计学意义;中药高剂量组大鼠给药28 d 后24 hUP 降低,上皮下免疫复合物形成减少,IgG、C3 表达下降,Podocin 蛋白及Podocin、Nephrin mRNA 表达增多,差异均有统计学意义(P<0.05,P<0.01)。各组大鼠血Alb、TG、TC、SCr、BUN差异均无统计学意义。结论:加减补阳还五汤能够降低MN大鼠的24 hUP,且高剂量效果最佳,其治疗MN的作用机制可能是上调Podocin、Nephrin mRNA的表达,减少免疫复合物的形成。

    Abstract:

    Abstract: Objective: To discuss the curative effect of modified Buyang Huanwu tang on rats with membranous nephropathy(MN) and its possible mechanism. Methods:A total of 36 male SD rats were randomly divided into the normal group, the model group, the benazepril hydrochloride group, the modified Buyang Huanwu tang groups of high- dose, medium- dose and low- dose(the Chinese herbal medicine groups of high- dose,medium- dose and low- dose),6 rats in each group. The normal group was injected with 6 mL/kg of saline through tail vein,and the other five groups were injected with 6 mL/kg of Anti- Fx1A to establish MN models. After successful modeling,the normal group and the model group were given 10 mL/kg of 0.9% sodium chloride injection by gavage daily,and the benazepril hydrochloride group was given 0.16 mg/mL of benazepril hydrochloride solution at a dose of 1.60 mg/kg;the Chinese herbal medicine groups of high-dose, medium- dose and low- dose were respectively given 7.04, 3.52 and 1.76 g/mL concentrated solution of Chinese herbal medicine by gavage. Before establish models,after models were successfully established and on the 7th,14th and 28th day after gastric perfusion respectively,the 24-hour urine in each group was used to detect the 24-hour urine protein(24 hUP). After 28-day administration,the rats were sacrificed;their blood was taken from the heart to detect the levels of albumin (Alb),total cholesterol(TC),triglyceride(TG),serum creatinine(SCr) and blood urea nitrogen(BUN);their kidney tissues were given hematoxylin- eosin staining(HE staining) , Masson trichrome staining(Masson staining) and Periodic Schiff- Methenamine staining(PASM staining), and the pathological changes in the kidney tissues were observed under optical microscope; the positive expression of immunoglobulin G(IgG) and complement C3 in the glomerulus was detected by immunofluorescence;the positive expression of podocin of podocyte slit diaphragm protein in the glomerulus was observed by immunohistochemistry;the mRNA expression of podocin and nephrin of podocyte slit diaphragm protein was detected by RT- PCR. Results: Compared with those in the normal group, in the model group, the 24 hUP was increased(P<0.05); subcutaneous immune complexes were formed on the basement of glomerulus;the expression of IgG and C3 increased,as well as the protein expression of podocin and the mRNA expression of podocin and nephrin in the kidney tissues were decreased(P<0.01). Compared with those in the model group,in the four administration groups,the 24 hUP after 28-day treatment was decreased(P<0.05);the formation of epithelial immune complexes and the expression of IgG and C3 were decreased; the mRNA expression of podocin and nephrin in the kidney tissues was increased(P<0.01); the protein expression of podocin was increased, but only the difference in the Chinese herbal medicine group of high- dose was significant(P<0.05). After 28-day administration,there was no significant difference being found in the comparison of the 24 hUP and the protein expression of podocin in the kidney tissues in the Chinese herbal medicine groups of low- dose and medium-dose. Compared with those in the benazepril hydrochloride group,the mRNA expression of podocin and nephrin in the Chinese herbal medicine group of low-dose was lower(P<0.01);the mRNA expression of nephrin in the Chinese herbal medicine group of medium-dose was lower(P<0.05),and the mRNA expression of podocin was decreased,but there being no significance in the difference. After 28- day administration,in the Chinese herbal medicine group of high- dose,the 24 hUP, the formation of epithelial immune complexes and the expression of IgG and C3 were decreased; the protein expression of podocin and the mRNA expression of podocin and nephrin were increased; differences being significant(P< 0.05, P<0.01). Compared the levels of Alb, TG, TC, SCr and BUN in blood between each two groups, there being no significance in the difference. Conclusion:The modified Buyang Huanwu tang can reduce the 24 hUP of MN rats,and the high-dose one has the best effect. Its mechanism may be up-regulating the mRNA expression of prodocin and nephrin and reducing the formation of immune complexes,so that it can treat MN.

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张良,黄蔚霞,程锦国,冯源,陈玲玲,木林洁.加减补阳还五汤对膜性肾病大鼠Podocin、Nephrin 的影响[J].新中医,2020,52(9):24-29

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  • 在线发布日期: 2020-05-09
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