中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (1): 95-102.doi: 10.12307/2024.727

• 细胞相关实验/试验研究Cell related experimental/trial studies • 上一篇    下一篇

黄芩汤调控肠道菌群治疗小鼠肠道急性移植物抗宿主病的机制

夏梦婷1,孙润洁2,付佳琪2,李素贞1,于漫亚2,崔  兴3   

  1. 1山东中医药大学第一临床医学院,山东中医药大学千佛山校区,山东省济南市   250014;2山东中医药大学中医学院,山东省济南市   250014;3山东中医药大学第二附属医院肿瘤中心,山东省济南市   250000
  • 收稿日期:2023-09-27 接受日期:2023-11-04 出版日期:2025-01-08 发布日期:2024-05-18
  • 通讯作者: 崔兴,主任医师,博士生导师,山东中医药大学第二附属医院肿瘤中心,山东省济南市 250000
  • 作者简介:夏梦婷,女,1996年生,山东中医药大学在读硕士,主要从事中医治疗血液和肿瘤疾病的临床及实验研究。
  • 基金资助:
    国家自然科学基金(81774080),项目负责人:崔兴;泰山学者计划(tsqn201812145),项目负责人:崔兴

Mechanism by which Huangqintang regulates intestinal flora for treatment of intestinal acute graft-versus-host disease in mice

Xia Mengting1, Sun Runjie2, Fu Jiaqi2, Li Suzhen1, Yu Manya2, Cui Xing3   

  1. 1First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Qianfoshan Campus of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China; 2School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China; 3Oncology Center, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, Shandong Province, China
  • Received:2023-09-27 Accepted:2023-11-04 Online:2025-01-08 Published:2024-05-18
  • Contact: Cui Xing, Chief physician, Doctoral supervisor, Oncology Center, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, Shandong Province, China
  • About author:Xia Mengting, Master candidate, First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Qianfoshan Campus of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 81774080 (to CX); Taishan Scholars Program, No. tsqn201812145 (to CX)

摘要:

文题释义:
黄芩汤:出自于《伤寒论》辨太阳病脉证并治第172条,为治疗热泻热痢的经典方剂,具有清肠止痢、和中止痛之功效,被后世誉为治痢之先方。现代临床上黄芩汤主要用于治疗溃疡性结肠炎等疾病。黄芩汤适应证与胃肠道急性移植物抗宿主病症状有很大的重叠,因此选用黄芩汤进行研究。
自噬:是一种进化上较为保守的细胞自我降解机制,胞质内的物质被包裹进囊泡中结合溶酶体形成自噬溶酶体,并被其中的溶解酶降解,借此实现细胞本身的代谢需要和某些细胞器的更新。


背景:肠道急性移植物抗宿主病是异基因造血干细胞移植后最凶险的并发症之一,具有较高的致死率,如何通过应用中药改善肠道炎症、调节自噬以治疗肠道急性移植物抗宿主病是当下值得研究的问题。
目的:探讨黄芩汤调控肠道菌群治疗肠道急性移植物抗宿主病的机制。 
方法:CB6F1小鼠经总剂量8 Gy的60Co X射线照射后通过尾静脉输入Balb/c H-2d小鼠的单个核细胞悬液(骨髓+脾)制备急性移植物抗宿主病模型,随机分为模型组及黄芩汤高、中、低剂量组。造模后分别给予不同剂量黄芩汤或等体积生理盐水连续灌胃14 d,进行临床急性移植物抗宿主病评分并记录生存时间,取小肠组织做苏木精-伊红染色行小肠黏膜病理分级评分。使用16S rDNA测序检测各组小鼠肠道菌群,行免疫荧光、免疫组化染色、PCR等检测自噬相关标志物的表达。
结果与结论:①与模型组相比,黄芩汤中、高剂量组小鼠存活时间显著延长(P < 0.01),临床急性移植物抗宿主病评分显著降低(P < 0.01),小肠黏膜病理分级评分显著降低(P < 0.01),小肠组织炎症因子肿瘤坏死因子α、白细胞介素1β、白细胞介素6水平显著下降(P < 0.01),小鼠小肠黏膜上皮结构完整性部分恢复;②肠道菌群研究发现,与模型组相比,黄芩汤中剂量组促炎菌株肠球菌显著减少(P < 0.05),而有益菌如梭状芽孢杆菌及促自噬的红球菌显著增多(P < 0.05);③与模型组相比,黄芩汤中剂量组的自噬标志物显著升高(P < 0.05);透射电镜下,黄芩汤中剂量组自噬泡数量显著增多;④结果表明:黄芩汤显著降低条件性致病菌丰度和小肠组织炎症因子水平,并提高有益菌相对丰度,同时促进小肠黏膜自噬的表达,从而明显改善急性移植物抗宿主病小鼠肠道症状。

https://orcid.org/0000-0002-8771-5898 (崔兴)

中国组织工程研究杂志出版内容重点:干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程

关键词: 肠道急性移植物抗宿主病, 黄芩汤, 造血干细胞移植, 肠道菌群, 梭状芽孢杆菌, 肠球菌, 抗炎, 自噬

Abstract: BACKGROUND: Intestinal acute graft-versus-host disease is one of the most aggressive complications after allogeneic hematopoietic stem cell transplantation with high lethality. How to improve intestinal inflammation and regulate autophagy by applying traditional Chinese medicine in order to treat intestinal acute graft-versus-host disease is a worthwhile research issue nowadays. 
OBJECTIVE: To investigate the mechanism of Huangqintang modulating intestinal flora for the treatment of intestinal acute graft-versus-host disease.  
METHODS: CB6F1 mice were irradiated with 60Co X radiation at a total dose of 8 Gy, and then single nucleated cell suspensions (bone marrow cells + splenocytes) from Balb/c H-2d mice were injected into the tail vein in order to prepare a model of intestinal acute graft-versus-host disease. These samples were randomly divided into the model group and the high-, moderate-, and low-dose Huangqintang groups. After modeling, the model, high-, moderate-, and low-dose groups received different doses of Huangqintang or an equal volume of saline by continuous gavage for 14 days. Clinical acute graft-versus-host disease grading, and survival time was recorded. Small intestinal tissues from each group were stained with hematoxylin and eosin for small intestinal mucosal pathology scoring. The intestinal flora of mice in each group was detected using 16S rDNA sequencing. Autophagy-related markers were detected using immunofluorescence, immunohistochemistry, and PCR. 
RESULTS AND CONCLUSION: (1) Compared with the model group, the survival time of mice was significantly prolonged (P < 0.01); the clinical acute graft-versus-host disease scores were significantly reduced (P < 0.01); the pathological grading scores of the small intestinal mucosa were significantly diminished (P < 0.01); the levels of the small intestinal tissue inflammatory factors tumor necrosis factor-α, interleukin-1β, and interleukin-6, were significantly decreased (P < 0.01); the structural integrity of the small intestinal mucosal epithelium was partially restored in mice after the intervention of moderate and high-dose Huangqintang. (2) The study of intestinal flora found that compared with the model group, the pro-inflammatory strain Enterococcus was significantly reduced (P < 0.05), while beneficial bacteria such as Clostridium_innocuum and Rhodococcus, a pro-autophagy bacterium, were significantly elevated (P < 0.05) in the moderate-dose Huangqintang group. (3) Compared with the model group, the autophagy markers were significantly elevated in the moderate-dose Huangqintang group (P < 0.05); under transmission electron microscopy, the number of autophagic vacuoles of moderate-dose Huangqintang group increased significantly. (4) The results showed that Huangqintang significantly reduced the abundance of conditionally pathogenic bacteria and the level of inflammatory factors in small intestinal tissues, and increased the relative abundance of beneficial bacteria and promoted the expression of autophagy in the small intestinal mucosa, which resulted in a significant improvement of intestinal symptoms in mice with acute graft-versus-host disease. 

Key words: intestinal acute graft-versus-host disease, Huangqintang, hematopoietic stem cell transplantation, intestinal microbiota, clostridium, enterococcus, antiinflammation, autophagy

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