The Study On Clinical Effect And The Impact Of MAPK Pathway And Related Cytokines With Busuishengxue Granule In Chronic Aplastic Anemia

Objective: To observe the clinical efficacy of Busui Shengxue Granule (BSSXG) in chronic aplastic anemia (CAA) and disscuss the differences in expression of signal transduction pathway MAPK before and after treatment. We observe the phosphorylation including ERK1/2, JNK, P38 and the expression of mRNA in bFGF and bFGFR.Methods: 124 cases of CAA were divided into two groups randomly.There are 61 cases who were used by BSSXG in experimental group,and 63 cases treatmented by Zaizaoshengxue Tablet in control group. The protein expression of enzymes P-ERK1/2, P-JNK, P-P38 of cultured bone marrow stromal cells were measured by Western blot and the mRNA expression of bFGF and bFGFR were measured by RT-PCR.Results: 1.The effects of BSSXG was superior to that of Zaizaoshengxue Tablet (p<0.05).2.The effect of Kidney-Yang deficiency type was superior to that of Kidney-Yin deficiency type(p<0.05). 3.The expression level of P-ERK1/2 in CAA patients were lower than that in normal group(P<0.05). P-JNK and P-P38 protein levels were higher than that of normal group (P<0.05), and the level of P-ERK1/2 in Kidney-yang deficient patients higher than that of Kidney-yin deficiency (P <0.05), P-JNK lower than the Kidney-yin deficiency (P <0.05), BSSXG can adjusted the abnormal expression of three protein. 4. The mRNA expression of bFGF and bFGFR of CAA lower than that of normal group (P<0.05). After treatment BSSXG made the mRNA expression of bFGF and bFGFR levels increased (P <0.05), and the effect of Kidney-Yin deficiency had a significant difference with Kidney -Yang dificiency (P <0.05).Conclusion: 1. BSSXG have better clinical efficacy, it is an effective drug for treatment of CAA. 2. The lower expression of P-ERK1/2 and the higher expression of P-JNK and P-P38 in CAA bone marrow stomal may be one of the mechanisms of bone marrow microenvironment environmental adhesion dysfunction. 3.BSSXG can significantly enhance the P-ERK1/2 expression and inhibite stromal cell apoptosis, improve the bone marrow micro-environment for cell proliferation, differentiation and survival returned to normal. Meanwhile, reduction of P-JNK, P-P38 protein levels can improve the hematopoietic stem cell / progenitor cell homing, migration, and enhance the adhesion of hematopoietic signal transduction. 4.P-ERK1/2 expression in the kidney-Yang deficiency was higher than that in patients with Kidney-Yin deficiency, P-JNK in the kidney-Yang type protein level in patients lower than kidney-Yin deficiency. These results may make references for the TCM treatments of CAA. 5.This study suggest that BSSXG can reulate the bFGF and bFGFR expression levels. This can proliferate and directionally differentiate and promote bone marrow angiogenesis, improve the hematopoietic microenvironment. It also can conclude that the mRNA of bFGF and bFGFR of kidney-Yang deficiency can be corrected better than that of in kidney-Yin deficiency.