Clinical Evaluation Of Mai Dong Di Shao Decoction On Treating Sjogren’s Syndrome Patients & Experimental Study Of Ophiopogon Japonicus Polysaccharide On Affecting Sjogren’s Syndrome Mice

Objectives: Sjogren’s syndrome (SS) is an autoimmune disorder characterized bylymphocytic infiltration of salivary and lacrimal glands leading to xerostomia andkeratoconjunctivitis sicca. The aetiology and pathogenesis are largely unknown. Evidencehas accumulated suggesting that a Th1/Th2 cytokine imbalance has a role in thepathogenesis of SS. Currently, only palliative treatment is available. Ophiopogonjaponicus,a common Chinese herbal, has been used to treat siccaoassociated disorders in traditionalChinese medicine for centuries. According to the theory of traditional Chinese medicine,"diagnosis and treatment based on an overall analysis of the illness and the patient’scondition", we present the method of "relieve dryness and distribute the body fluid" to treatthe disease. Based on our clinical practices, we summarized the representative prescriptionof "Mai Dong Di Shao Decoction" to treat SS. And to find the active components ofOphiopogon japonicus in treating SS and elucidate its involved mechanism, we studied theeffects of Ophiopogon japonicus polysaccharide (OJP) on affecting SS mice.Methods: In the part of clinical study, we used the Mai Dong Di Shao Decoction totreat SS patients. 40 patients in two different hospitals were randomly divided into twogroups: Mai Dong Di Shao Decoction group and hydroxychloroquine (HCQ)group, whichwas served as positive control. The patients in Mai Dong Di Shao Decoction group were administered the decoction twice a day, and those in the HCQ group were administeredHCQ as 0.2 bid. Both of the two groups were observed for three treatment courses (onetreatment course equals to 30 days). Clinical symptoms, signs, security indexes and effectswere included in the observation. In the part of experimental study, we constructed a micemodel of SS by immunizing C57BL/6 mice with submandibular gland (SMG) antigen. Atthe same time, OJP were administered. During the four weeks’ experiment, salivary flowrates were determined every week, body weight, food and water intake were measuredevery two days. After death, serum were collected for IFN-γ, and IL-4 ELISA analysis andthe IFN-γ,/IL-4 was calculated, SMG and spleen were harvested for organ index calculation,and part of SMG was examined for histological changes.Results: The clinical study showed that the Mai Dong Di Shao Decoction could relievethe patients’ sensations of mouth dryness, mouth cauterization, eye dryness, eyewinker andnose dryness. Which were consistent with the clinical signs of tongue proper, tonguesurface, tongue coating and salivary accumulated under the tongue. The laboratory indexesindicated that the Mai Dong Di Shao Decoction could increase the salivary flow, lacrimalflow and improve the abnormities of RF, ESR and IgG. The total efficacy was better thanHCQ. Results of the experimental study showed that immunization with SMG antigeninduced decreased salivary flow and body weight, increased water intake, SMG index,spleen index, IFN-γ, level and IFN-γ/IL-4 ratio compared with the normal group. However,administration of the OJP could improve these data with respect to the model mice,especially the high-dose of OJP group.Conclusions: The clinical study approved that the Mai Dong Di Shao Decoction couldrelieve the patients’ symptoms, such as mouth dryness and eye dryness. And its totalefficacy was better than HCQ. The experimental study approved that OJP could protect theSS-like mice by regulating the Th1/Th2 cytokine imbalance. Thus, this study provided abasis for the use of Ophiopogon japonicus in SS.