来源：风湿病与关节炎,2019,8（1）:15-20,27.

新风胶囊通过调控凋亡相关蛋白促进类风湿关节炎患者外周血CD4⁺T细胞凋亡（临床研究）

刘　健¹，章平衡²，曹永贺³

　　【摘　要】目的：探讨新风胶囊（XFC）对类风湿关节炎患者外周血CD4⁺T细胞凋亡的影响。方法：采用随机、双盲法将28例活动期类风湿关节炎患者分为XFC组15例和来氟米特组（LEF组）13例，采用流式细胞术分析CD4⁺ T细胞凋亡水平，Western blot法和实时定量PCR检测凋亡相关蛋白及mRNA相对表达水平。结果：与治疗前比较，治疗后XFC组外周血红细胞沉降率（ESR）、C-反应蛋白（CRP）、抗环瓜氨酸肽（CCP）抗体、DAS28、B淋巴细胞瘤-2（Bcl-2）mRNA水平明显降低（P < 0.01 ），而CD4⁺T细胞凋亡水平、Fas mRNA、FasL mRNA、Caspase-8 mRNA、Caspase-3 mRNA、Bax mRNA和Fas、FasL、Caspase-8、Caspase-3蛋白水平明显升高（P < 0.01）；与LEF组比较，XFC组ESR、CRP、Bcl-2 mRNA表达水平明显降低（P < 0.01），CD4⁺T细胞凋亡水平、Fas mRNA、FasL mRNA、Caspase-8 mRNA、Caspase-3 mRNA、Bax mRNA和Fas、FasL、Caspase-8、Caspase-3表达水平差异无统计学意义（P > 0.05）。结论：XFC通过上调Fas、FasL、Caspase-8、Caspase-3促凋亡蛋白表达，下调Bcl-2抑制凋亡蛋白表达，促进异常活化的CD4⁺T细胞凋亡，从而抑制类风湿关节炎患者机体的免疫炎症反应改善病情。

　　【关键词】　关节炎，类风湿；新风胶囊；凋亡；CD4⁺T细胞

Xinfeng Capsule（新风胶囊）Promotes the Apoptosis of CD4⁺T Cells in Peripheral Blood of Rhrumatoid Arthritis Patients by Regulating Apoptosis-related Proteins

LIU Jian,ZHANG Ping-heng,CAO Yong-he

　　【ABSTRACTt】Objective:To investigate the effect of Xinfeng Capsule（XFC,新风胶囊）on apoptosis of CD4⁺T cells in peripheral blood of patients with rheumatoid arthritis.Methods:Twenty-eight patients with RA were randomly and double-blind divided into XFC group（15 cases）and LEF group（13 cases）.The apoptosis level of CD4⁺ T cells was analyzed by flow cytometry.The expression of apoptosis-related proteins and mRNA were detected by Western blot and RT-PCR.Results:Compared with before treatment,the level of ESR,CRP,anti-CCP antibodies,DAS28 and Bcl-2mRNA were significantly decreased（P < 0.01）,the level of CD4⁺T cells apoptosis,（Fas,FasL,Caspase-8, Caspase-3,Bax）mRNA and the proteins expression of Fas,FasL,Caspase-8 and Caspase-3 were significantly increased after XFC treatment（P < 0.01）.Compared with LEFgroup,the level of ESR,CRP and Bcl-2 mRNA were significantly decreased in XFC group（P < 0.01）,while the level of CD4⁺T cells apoptosis（Fas, FasL, Caspase-8,Caspase-3,Bax）mRNA and the proteins expression of Fas,FasL,Caspase-8 and Caspase-3 were significantly increased after XFC treatment have no statistical differences（P > 0.05）.Conclusion:XFC can up-regulate the expression of Fas,FasL,Caspase-8 and Caspase-3, down-regulate the expression of Bcl-2, and promoting the apoptosis of CD4⁺T cells to inhibit the imm-une inflammatory response of rheumatoid arthritis patients and improving the disease.

　　【Keywords】 arthritis,rheumatoid;Xinfeng Capsule（新风胶囊）;apoptosis;CD4⁺T cells