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郑京,林敏芳,王振飞,刘加林.加味四君子汤对阿霉素肾病大鼠骨代谢的影响[J].,2013,33(10):1376-1381
加味四君子汤对阿霉素肾病大鼠骨代谢的影响
Effect of Modified Sijunzi Decoction on the Bone Metabolism of Adriamycin Induced Nephropathy Rats
  
DOI:10.7661/CJIM.2013.10.1376
中文关键词:  阿霉素肾病  骨质疏松  加味四君子汤  骨保护素  核因子κB受体活化因子配体
英文关键词:adriamycin-induced nephropathy  osteoporosis  Modified Sijunzi Decoction  osteoprotegerin  receptor activator of nuclear factor-κB ligand (RANKL)
基金项目:福建省自然科学基金资助项目(No2012J01378)
Author NameAffiliationE-mail
郑京,林敏芳,王振飞   
刘加林 贵州省人民医院肾内科(贵阳550000) ljjl@medmail.com.cn 
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中文摘要:
      目的 探讨加味四君子汤对泼尼松干预的阿霉素肾病大鼠骨代谢的影响。方法 制作大鼠阿霉素肾病模型, 将50只SD大鼠随机分为5组,即模型组、激素组、中药组、中药加激素组及正常组。各组于造模后7、21、35天收集24 h尿标本,以双缩脲比色法测定大鼠24 h尿蛋白,以ELISA法测定各组血清骨保护素(osteoprotegerin,OPG)、核因子κB受体活化因子配体(receptor activator for NF-κB ligand,RANKL)、骨钙素(osteocalcin,BGP)以及抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatase,TRACP)水平,采用实时定量PCR和Western blot检测胫骨组织中OPG、RANKL的表达。结果(1)与正常组比较,模型组第7、21、35天24 h尿蛋白均有不同程度增高(P<0.05, P<0.01);与模型组同期比较,激素组及中药加激素组24 h尿蛋白均有不同程度下降,差异有统计学意义(P<0.05, P<0.01);并随着治疗时间的延长,降低更明显(P<0.05, P<0.01);中药组治疗35天,与模型组比较,差异亦有统计学意义(P<0.05)。(2)与本组21天比较,激素组TRACP、RANKL均明显升高(P<0.05, P<0.01);与模型组比较,第21、35天,激素组TRACP、RANKL均升高(P<0.05, P<0.01), OPG、BGP均降低(P<0.05, P<0.01);与中药组同期比较, 激素组、中药加激素组OPG均降低, RANKL均升高(P<0.05, P<0.01);且激素组TRACP升高,BGP降低(P<0.05, P<0.01);与激素组同期比较,中药加激素组OPG、BGP升高(P<0.05, P<0.01),RANKL降低(P<0.01);第35天,TRACP降低(P<0.01)。(3)与正常组比较,模型组第21天OPG、RANKL mRNA升高(P<0.05, P<0.01),第35天OPG、RANKL mRNA降低(P<0.01)。与中药组同期比较,激素组OPG mRNA降低(P<0.01),RANKL mRNA升高(P<0.05);中药加激素组OPG mRNA降低(P<0.05)。(4)与本组21天比较,激素组OPG降低(P<0.05),RANKL升高(P<0.05),中药加激素组RANKL降低(P<0.05)。 与模型组同期比较,激素组OPG降低(P<0.01),RANKL升高(P<0.01)。 与中药组同期比较,激素组、中药加激素组OPG均降低(P<0.01),RANKL均升高(P<0.01);与激素组同期比较, 中药加激素组OPG均升高(P<0.01),RANKL均降低(P<0.01)。结论 泼尼松能通过OPG/RANKL/RANK通路诱导骨质疏松。加味四君子汤在降蛋白尿的同时,可通过上述通路促进成骨细胞分化,抑制破骨细胞生成,从而减缓泼尼松诱导的骨质疏松的形成。
英文摘要:
      Objective To explore the effect of Modified Sijunzi Decoction (MSD) on the bone metabolism of prednisone intervened adriamycin-induced nephropathy rats. Methods The adriamycin-induced nephropathy rat model was prepared. Totally 50 SD rats were randomly divide into five groups, i.e., the model group, the hormone group, the Chinese medicine (CM) group, the CM+hormone group, and the normal control group. The 24-h urine samples were collected on the 7th,21st, and 35th day after modeling. The 24-h urine protein was measured by biuret colorimetry. Serum levels of osteoprotegerin (OPG), receptor activator of nuclear factor-κB ligand (RANKL), osteocalcin (BGP), and tartrate-resistant acid phosphatase (TRACP) were determined by ELISA. Expressions of OPG and RANKL in the tibia tissue were detected using real-time quantitative PCR and Western blot. Results(1) Compared with the normal control group, the 24-h urine protein increased in each group on the 7th, 21st, and 35th day (P<0.05, P<0.01). Compared with the model group, the 24-h urinary protein decreased in the hormone group and the CM+hormone group (P<0.05, P<0.01). The decrement was more obvious along with the treatment time went by (P<0.05, P<0.01). There was statistical difference in the reduction of urine protein on the 35th day between the CM group and the model group (P<0.05). (2) Compared with the 21st-day of the same group, the serum levels of TRACP and RANKL increased (P<0.05, P<0.01). Compared with the model group, the serum levels of the TRACP and RANKL increased (P<0.05, P<0.01), OPG and BGP decreased (P<0.05, P<0.01) in the hormone group. Compared with the CM group at the same period, serum OPG level decreased and the RANKL level increased in the hormone group and the CM+hormone group (P<0.05, P<0.01). Besides, the serum level of TRACP increased and BGP decreased (P<0.05, P<0.01). Compared with the hormone group at the same period, OPG and BGP increased (P<0.05, P<0.01), RANKL decreased (P<0.01) in the CM+hormone group. On the 35th day TRACP decreased (P<0.01). (3) Compared with the normal group, mRNA expressions of OPG and RANKL on the 21st day increased (P<0.05, P<0.01), mRNA expressions of OPG and RANKL on the 35th day decreased in the model group (P<0.01). Compared with the CM group at the same period, OPG mRNA expression decreased (P<0.01) and RANKL mRNA expression increased in the hormone group (P<0.05). OPG mRNA expression decreased in the CM+hormone group (P<0.05). (4) Compared with the hormone group on the 21st day, the OPG level decreased and the RANKL protein increased (both P<0.05). RANKL decreased in the CM+hormone group (P<0.05). Compared with the model group at the same period, OPG decreased and RANKL increased in the hormone group (P<0.01). Compared with the CM group at the same period, OPG decreased (P<0.01), RANKL increased (P<0.01) in the hormone group and the CM+hormone group. Compared with the hormone group at the same period, OPG increased and RANKL decreased in the CM+hormone group (both P<0.01). Conclusions Prednisone could induce osteoporosis through the OPG/RANKL/RANK pathway. MSZ could slow down the formation of prednisone-induced osteoporosis through promoting osteoblast differentiation, and inhibiting osteoclastogenesis.
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