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目的探讨中药芪加真武汤联合糖皮质激素对系统性红斑狼疮(SLE)患者外周血淋巴细胞(PBL)凋亡及Fas、FasL表达的影响。方法采用血清药理学方法,制取芪加真武汤含药兔血清。运用流式细胞仪检测19例SLE患者外周血淋巴细胞在不同浓度的芪加真武汤的含药血清(20%、10%、5%)、地塞米松(0.001 mol/L)及两者联合刺激下细胞凋亡和Fas、FasL表达的变化。结果①SLE患者PBL凋亡率明显高于正常组(P<0.001),Fas表达明显多于正常组(P<0.01),FasL表达与正常组差异不明显(P> 0.05)。②10%、20%含药血清显著减少SLE患者PBL的凋亡率(P<0.01),显著降低Fas表达(P<0.01), 升高FasL的阳性细胞率(P<0.05);③地塞米松可增高SLE患者PBL的凋亡率(P<0.05),但对Fas、FasL的表达无影响(P>0.05);④含药血清联合地塞米松显著减少PBL凋亡率(P<0.01),降低Fas表达(P<0.05),明显升高FasL的阳性细胞率(P<0.01)。结论SLE患者PBL存在凋亡及凋亡相关蛋白表达的紊乱,中药芪加真武汤在体外可纠正其紊乱,缓解由地塞米松引起的PBL过度凋亡。
Objective To investigate the effect of Qijia Zhenwu Decoction combined with glucocorticoids on the apoptosis of peripheral blood lymphocytes (PBL) and the expression of Fas and FasL in patients with systemic lupus erythematosus (SLE). Methods Serum pharmacological methods, preparation of Qi plus Zhenwu Tang containing rabbit serum. Flow cytometry was used to detect the serum levels of peripheral blood lymphocytes in 19 patients with SLE at different concentrations (20%, 10%, 5%), dexamethasone (0.001 mol / L) Stimulation of apoptosis and Fas, FasL expression changes. Results ① The apoptosis rate of PBL in patients with SLE was significantly higher than that in the normal group (P <0.001), and the expression of Fas was significantly higher than that in the normal group (P <0.01). The expression of FasL was not significantly different from that in the normal group (P> 0.05). ②10%, 20% drug-containing serum significantly decreased the apoptosis rate of PBL in SLE patients (P <0.01), significantly decreased the expression of Fas (P <0.01), and increased the positive rate of FasL (P <0.05) (P <0.05), but had no effect on the expression of Fas and FasL (P> 0.05); ④The serum containing PBMC combined with dexamethasone significantly reduced the apoptosis rate of PBL (P <0.01) Reduce Fas expression (P <0.05), and significantly increase the FasL positive cell rate (P <0.01). Conclusion The apoptosis of PBL in SLE patients and the expression of apoptosis-related proteins are disturbed. The traditional Chinese medicine Qijia Zhenwu Decoction can correct its disorder in vitro and relieve the excessive apoptosis of PBL caused by dexamethasone.