Clinical And Experimental Study On The Immune Regulation Effect Of Chuankezhi Injection In Asthma

ObjectiveAim to investigate the immune regulation mechanism of Chuankezhi injection(CKZ) which is a Chinese medical model formula of reinforcing kidney and warming yang in the managment of bronchial asthma.Methods1.Animal Experiment:Mice were sensitized and challenged with ovalbumin (OVA) to establish allergic asthma-like model. To determine the contribution of Chuankezhi injection on airway allergic inflammation and immune regulation, we examined the BALF cell differentiated count, And lung histopathology, proportion of spleen Foxp3+CD4+CD25+Treg cells/CD4+T cells were measured by flowcytometry. Cytokines IL-4,IL-10 and TNF-βlevels in the cultured splenocytes supernatant were examined with ELISA. Foxp3 expression in lung was analyzed with immunohistochemistry.2. Clinical study:50 mild or moderate asthmatic patients collected from the department of Respiratory Medicine, Guangdong Provincial hospital of TCM were randomized into control group and Chuankezhi (CKZ) group. The control group received conventional treatment. CKZ group received the intramuscular injection (4ml qd x 7days) and the conventional treatment as well. The changes of the primary symptoms,PEF values,IgE level, blood T cell subsets were recorded before and after the treatment.Results1. Animal Experiment Administration of Chuankezhi injection prevented the eosinophil accumulation in BALF in the lungs of asthma. CKZ group mice have a lower spleen Foxp3+CD4+CD25+Treg cells/CD4+T cells proportion compared with control group. Asthma group mice had higher IL-4 and lower IL-10,TNF-βlevels in the cultured splenocytes supernatant than control group. And Chuankezhi injection corrected the polarization respectively. Foxp3 expression in asthma mice lung was significantly lower than that in control group. And there was a higher level of Foxp3 due to the treatment with Chuankezhi injection.2. Clinical study:The curative effects in 2 groups were significant (p<0.05) by statistical analysis, the effect in CKZ group was better than that in control group.Except for the major symptoms, CKZ group can lower EOS and IgE lever, correct the imbalance of CD4+ and CD8+ when compared with control group.2 groups can improve the peak expiratory flow rates. The comparison of PEFR after treatment were significant (p<0.05) by statistical analysis in the two group.Conclusions1. Insufficiency and dysfunction of Foxp3+CD4+CD25+Treg cell, as well as the imbalance between Thl and Th2 lymphocytes may play an important role in the pathogenesis of asthma.2. Chuankezhi injection can alleviate allergic inflammation in the airway in asthma patients.3. Chuankezhi injection inhibit the proliferation of Th2, and promote the activation of the Foxp3+CD4+CD25+ Treg cell and up-regulate the expression of the master transcription factor foxp3 to conduct immunotolerance.4. Regulatory cytokines IL-10, TNF-βmay be involved in the regulatory mechanisms of Foxp3+CD4+CD25+Treg cells induced by Chuankezhi injection.