The Regulating Effect Of Erzhi Tiangui Particles In Maternal Fetal Tolerance In Embryo Implantation Based On The Role Of NF-κB Signaling Pathway

Objective: The author intends to investigate the regulating effect of the key factors NF-κB and MCP-1 in Erzhi Tiangui granules on patients of repeated implantation failure who have the syndrome of kidney qi deficiency and who have clinical pregnancy rate in the peripheral blood and NF-κB signal transduction pathway. The author also aims to analyze the mechanism of repeated implantation failures on patients who is kidney qi deficiency in the NF-kB signal transduction pathway and the moderating effect of traditional Chinese medicine on tonifying the kidney in embryo implantation immune tolerance.Methods: This study extract dialectical diagnostic criteria of in vitro fertilization and embryo transplantation in the treatment of kidney qi deficiency repeated implantation failure patients 70 cases, according to the time of the out-patient clinic patients sequence number, the odd number of points into two to day Tiangui granule group, the even number of points in the placebo group, and also the author select 35 cases due to male factors of IVF normal control group. The treatment group in taking Erzhi Tianguigranules after three cycles of combined with conventional IVF treatment. But the placebo group and non kidney deficiency group placebo for 3 cycles and combined with conventional IVF treatment, observing kidney qi deficiency and infertility patients with deficiency of the kidney and the changes in symptom scores; fertilization rate; good quality embryo rate; biochemical pregnancy rate; clinical pregnancy rate. Adopting enzyme-linked immunosorbent assay(ELISA) in three groups which detected anti-hCG antibody(AHCGAb) and anti-cardiolipin antibody-IgG(ACA-IgG) and anti-sperm antibody(AsAb),anti-endometrial(AEMAb), anti-ovarian antibody(AOVAb) level, using real-time fluorescence quantitative PCR(RT-PCR) technique to detect the main signaling molecules in peripheral blood of NF-κB signal transduction pathway of NF-κBmRNA, MCP-1mRNA content; Western blot method for the determination of NF-κB protein and MCP-1 protein. Three groups of patients after seven days of serum MCP-1 concentration was detected by ELISA transplantation.Results: 1. After the treatment of kidney qi deficiency symptoms the Erzhi Tiangui granules treatment group improved significantly, the syndrome score had significant statistical difference(P<0.01). Before and after the treatment in the two groups of kidney qi deficiency syndrome integral of the difference is statistically significant differences(P<0.01).2. Compared with the placebo group, the treatment group non kidney deficiency group fertilization rate, good quality embryo rate, biochemical pregnancy rate and clinical pregnancy rate were higher, there existed statistically significant difference(P<0.05). The treatment group and non kidney deficiency group have no significant difference(P>0.05). 3. Non kidney deficiency group compared,placebo group and treatment group AHCGAb, ACA-IgG, AsAb, AEMAb, AOVAb positive rate is higher, there exists an significant difference(P<0.05); the placebo group and treatment group have no significant difference(P>0.05). 4. To analyze the expression of peripheral blood of NF-κB signal transduction pathway key effectors of NF-κB and its downstream factors MCP-1 from threegroups of patients, we found that compared with the placebo group and non kidney deficiency group and treatment group transplantation, NF-κB, MCP-1protein content decreased, the NF-κB mRNA and MCP-1 mRNA expression were downregulated, 7 days of serum MCP-1 concentration decreased after transplantation, there was statistically significant difference(P<0.05);treatment group and non kidney deficiency group compared to NF-κB, MCP-1protein content, NF-κB, MCP-1mRNA expression level, serum level of MCP-1in no statistical difference(P>0.05). 5. The patients were further divided into pregnant group and non pregnant group, Comparing the two groups we found that the pregnancy group AHCGAb, ACA-IgG, AsAb, AEMAb, AOVAb had positive rate and serum MCP-1 concentration were lower than the non pregnant group, with significant statistical difference(P<0.01).Conclusions:1. The Erzhi Tiangui granules can significantly perfect the syndrome of recurrent implantation failure in patients with kidney deficiency,improving the fertilization rate, making the patients with good quality embryo rate, and can also improve the clinical pregnancy rate. 2. The reproductive antibodies may be an important immune factor affecting the embryo implantation,which is related to the implantation of the embryo. 3. NF-κB and MCP-1mRNA are associated with the pathogenesis of planting failure repeatedly. The elevating of serum MCP-1 has great significance in the early diagnosis of embryo implantation failure. 4. Erzhi Tiangui granules restrain the NF-κB signal transduction pathway and lower the expression of the MCP-1, reducing the impact of maternal fetal interface of immune rejection, so as to improve the implantation rate and the deficiency of kidney qi repeated implantation failure in IVF outcomes for patients.