CAJ | 학술논문

目的：通过观察风湿宁胶囊（FSN）对类风湿关节炎大鼠外周血Th17/Treg平衡和对关节腔滑液中炎性细胞因子的影响，进一步探讨其治疗类风湿关节炎（RA）的作用机制。方法：制备II型胶原诱导性关节炎（CIA）大鼠模型，采用流式细胞学检测方法观察风湿宁胶囊对CIA模型大鼠外周血辅助性T细胞亚群中Th17（IL-17+CD4+）细胞水平和调节性T细胞（CD4+CD25+Treg细胞）平衡状态的影响，并采用流式多重液相芯片技术检测CIA模型大鼠关节腔滑液中炎性细胞因子（TNF-α、IL-6、IL-17A、IL-4、IL-10）的含量，同时与正常大鼠、CIA模型大鼠和雷公藤多苷片（TPT）治疗大鼠比较。结果：与模型组比较， FSN中、高剂量组大鼠Th17细胞比率明显降低（P<0.05），各治疗组调节性T细胞比率有上调趋势，但差异不显著（P>0.05），各治疗组对Th17细胞和Treg细胞的影响与TPT组比较，均无显著性差异（P>0.05）；与模型组比较，FSN中、高剂量可明显降低大鼠关节滑液炎症因子TNF-α、IL-6、IL-17A水平（P<0.05），FSN各组对关节滑液IL-4、IL-10水平未见明显的上调作用（P>0.05），与TPT组比较，各治疗组对局部细胞因子IL-6、TNF-α、IL-17A、IL-4、IL-10的影响均无显著性差异（P>0.05）。结论：FSN能够明显降低外周Th17细胞比率，减少关节滑液炎症因子IL-6、TNF-α、IL-17A的分泌，但对外周Treg细胞比率和关节滑液中抗炎相关因子IL-4、IL-10的分泌无明显影响。风湿宁胶囊调节Th17细胞、改善机体免疫失衡状态、抑制滑膜细胞炎症介质过度分泌等作用可能是其治疗RA的重要机制。
목적：통과관찰풍습저효낭（FSN）대류풍습관절염대서외주혈Th17/Treg평형화대관절강활액중염성세포인자적영향，진일보탐토기치료류풍습관절염（RA）적작용궤제。방법：제비II형효원유도성관절염（CIA）대서모형，채용류식세포학검측방법관찰풍습저효낭대CIA모형대서외주혈보조성T세포아군중Th17（IL-17+CD4+）세포수평화조절성T세포（CD4+CD25+Treg세포）평형상태적영향，병채용류식다중액상심편기술검측CIA모형대서관절강활액중염성세포인자（TNF-α、IL-6、IL-17A、IL-4、IL-10）적함량，동시여정상대서、CIA모형대서화뢰공등다감편（TPT）치료대서비교。결과：여모형조비교， FSN중、고제량조대서Th17세포비솔명현강저（P<0.05），각치료조조절성T세포비솔유상조추세，단차이불현저（P>0.05），각치료조대Th17세포화Treg세포적영향여TPT조비교，균무현저성차이（P>0.05）；여모형조비교，FSN중、고제량가명현강저대서관절활액염증인자TNF-α、IL-6、IL-17A수평（P<0.05），FSN각조대관절활액IL-4、IL-10수평미견명현적상조작용（P>0.05），여TPT조비교，각치료조대국부세포인자IL-6、TNF-α、IL-17A、IL-4、IL-10적영향균무현저성차이（P>0.05）。결론：FSN능구명현강저외주Th17세포비솔，감소관절활액염증인자IL-6、TNF-α、IL-17A적분비，단대외주Treg세포비솔화관절활액중항염상관인자IL-4、IL-10적분비무명현영향。풍습저효낭조절Th17세포、개선궤체면역실형상태、억제활막세포염증개질과도분비등작용가능시기치료RA적중요궤제。
This study was aimed to observe the effects ofFeng-Shi-Ning (FSN) capsule on the balance of IL-17+CD4+T (Th17) / Foxp3+CD4+CD25+regulatory T (Treg) cells in peripheral blood and the inflammatory media in synovial fluid of rats with rheumatoid arthritis (RA), in order to further study the mechanism of FSN capsule in RA treatment. The collagen-induced arthritisⅡ (CIA) was used in the RA rat model establishment. The balance of Th17 and Treg cells in peripheral blood was analyzed by the flow cytometry method for effects of FSN capsule treatment. The levels of TNF-α, IL-6, IL-17A, IL-4 and IL-10 in synovial fluid were measured by cytometric bead array (CBA) method. The effects of the normal rats, CIA model rats and the rats treated by tripterygium wilfordii polyglycoside tablet (TPT) were compared. The results showed that compared with the model group, the percentage of Th17 cells in both the FSN capsule group and high-dose CIA group were obviously decreased (P < 0.05). The percentage of Treg cells had the tendency of increasing in all treatment groups with no significant difference (P > 0.05). There was no significant difference on Th17 and Treg cells among each treatment group and TPT group (P > 0.05). Compared with the model group, the high-dose and middle dose FSN can obviously reduce the levels of TNF-α, IL-6 and IL-17A in synovial fluid of rats in each FSN group (P < 0.05). There was no obvious upregulating effect on IL-4 and IL-10 in synovial fluid of each FSN group (P > 0.05). Compared with the TPT group, there were no significant differences on IL-6, TNF-α, IL-17A, IL-4 and IL-10 in each treatment group (P > 0.05). It was concluded that FSN can obviously reduce the percentage of Th17, decrease the secretion of IL-6, TNF-α and IL-17A in synovial fluid. However, it had no obvious effects on the percentage of Treg cells, or the secretion of IL-4 and IL-10 in synovial fluid. The mechanism of FSN capsule in RA treatment may be through regulating Th17 cells, adjusting body immune imbalance, and inhibiting the excessive secretion of inflammatory media in synovial fluid.