Effect Of Wuwei Wentong Chubi Capsule Combined With Fumigation Of Traditional Chinese Medicine On BMP/Smads Signal Pathway Expression In AS Patients

1.Objective To detect the expression of BMP-2(bone morphogenetic protein-2),TGF-β(transforming growth factor-β)and Smads series proteins in patients with ankylosing spondylitis(AS)through clinical experiments.The results of the study were as follows The effects of the combination of Wu Wei Wen Tong Paralysis Removal Capsules and Chinese herbal fumigation on the BMP/Smads signaling pathway related indexes in AS patients were investigated.We also investigated the therapeutic mechanisms of Ankylosing Spondylitis based on the BMP/Smads signaling pathway.2.Methods A randomized numerical table method was used to randomly divide the 60 AS patients who met the inclusion criteria into the treatment group(Wu Wei Wen Tong Removal of Palsy Capsule combined with Chinese medicine fumigation)and the control group(Liuzesulfonamide Pyridine)in the study of 60 patients with AS identified as Kidney Deficiency and Governor Cold in the Department of Rheumatology and Immunology,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from September 2019 to December 2020.Thirty cases each.The treatment group was given 3 capsules of Wu Wei Wen Tong Paralysis Removal Capsule 3 times a day and combined with herbal fumigation for 20 min each time,5 times a week;the control group was given 4 tablets of Sulfasalazine(SASP)twice a day;both groups were treated for 8 weeks.Another 20 healthy volunteers were established as the healthy control group.TGF-β levels in serum were quantified by ELISA(enzyme-linked immunosorbent method)before and after treatment,and BMP-2,Smad1,Smad2,Smad3,Smad5,Smad6,Smad7 and Smad8 were measured by PCR before and after treatment.The expression of Smad7 and Smad8 was measured,and the inflammation-related indexes of AS patients: erythrocyte sedimentation rate(ESR)was measured by the Weiss method,and high sensitivity C-reactive Protein(hs-CRP)was detected by ful y automated biochemical instrument.SPSS21.0 statistical software was used to analyze the data between the two groups and before and after treatment.3.Results 3.1 Changes in cytokines and inflammatory indexes in patients with active AS Compared with the healthy control group,the peripheral blood TGF-β level of active AS patients was significantly higher,and the levels of inflammatory indexes ESR and hsCRP were significantly higher(P<0.01).3.2 Expression of BMP/Smads signaling pathway-related genes in patients with active AS Compared with the healthy group,the expression of BMP-2,Smad1,Smad2,Smad3,Smad5,Smad8 in patients with active AS was Smad6 and Smad7 were decreased in patients with AS activity(P<0.01).3.3 The effect of Wu Wei Wen Tong De Palsy Capsule combined with Chinese medicine fumigation on cytokines and laboratory indexes of AS patients Compared with before treatment,the peripheral blood TGF-β level was reduced in both groups(P<0.01),and the levels of ESR and hs-CRP,the indexes of inflammation,were reduced(P<0.01).Compared with the SASP group after treatment,the WWC+Chinese medicine fumigation group had more significant reduction in TGF-β level(P<0.05),ESR and hs-CRP level(P<0.05).3.4 Effect of WWC+Chinese medicine fumigation on the expression level of serum cytokines and experimental indexes in AS patients Compared with before treatment,the levels of BMP-2,Smad1,Smad5 and Smad8 were reduced in the WWC+fumigation group(P<0.01),and the levels of Smad2 and Smad3 were also reduced(P<0.05);the levels of BMP-2,Smad1 and Smad5 were reduced in the SASP group after treatment(P<0.01),compared with those before treatment.Smad2,Smad3,and Smad8 levels also decreased(P<0.05);BMP-2,Smad1,Smad5,and Smad8 levels decreased more significantly in the WWC+fumigation group compared with the SASP group after treatment(P<0.01).The levels of Smad6 and Smad7 were increased in both groups compared with those before treatment(P<0.01);the levels of Smad6 and Smad7 were increased more significantly in the WWC+fumigation group compared with the SASP group after treatment(P<0.05).4.Conclusion 4.1 AS patients have elevated serum inflammation levels,elevated TGF-β levels,elevated monocyte BMP-2,Smad1,Smad2,Smad3,Smad5,Smad8 expression levels,and reduced Smad6,Smad7 expression levels,and active BMP/Smads active transduction signaling pathways may exist in AS patients in active phase.4.2 The therapeutic effect of Wu Wei Wen Tong Removal of Paralysis capsule combined with herbal fumigation could inhibit the levels of BMP-2,Smad1,Smad2,Smad3,Smad5 and Smad8,promote the expression of Smad6 and Smad7 genes and decrease the expression level of TGF-β in AS patients,and its therapeutic effect on AS may be related to the inhibition of BMP/Smads signaling pathway expression.