1.贵州中医药大学,贵州省贵阳市花溪区栋青路4号,550025
2.贵州中医药大学第二附属医院
通信作者:walker55@163. com
收稿:2025-06-19,
修回:2025-09-07,
纸质出版:2026-01-02
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任妮娜,马武开,凌益等.脊蛇祛湿胶囊对胶原诱导性关节炎模型大鼠血清NETs水平和巨噬细胞极化的影响[J].中医杂志,2026,67(01):60-68.
REN Nina,MA Wukai,LING Yi,et al.Effects of Jishe Qushi Capsule (脊蛇祛湿胶囊) on Serum NETs Levels and Macrophage Polarization in Collagen-Induced Arthritis Model Rats[J].Journal of Traditional Chinese Medicine,2026,67(01):60-68.
任妮娜,马武开,凌益等.脊蛇祛湿胶囊对胶原诱导性关节炎模型大鼠血清NETs水平和巨噬细胞极化的影响[J].中医杂志,2026,67(01):60-68. DOI: 10.13288/j.11-2166/r.2026.01.010.
REN Nina,MA Wukai,LING Yi,et al.Effects of Jishe Qushi Capsule (脊蛇祛湿胶囊) on Serum NETs Levels and Macrophage Polarization in Collagen-Induced Arthritis Model Rats[J].Journal of Traditional Chinese Medicine,2026,67(01):60-68. DOI: 10.13288/j.11-2166/r.2026.01.010.
目的
2
从中性粒细胞胞外诱捕网(NETs)介导的巨噬细胞极化角度探讨脊蛇祛湿胶囊治疗类风湿关节炎的可能作用机制。
方法
2
将24只雌性SD大鼠随机分为空白对照组、模型组、脊蛇祛湿胶囊组、肽基精氨酸脱亚胺酶4(PAD4)抑制剂组,每组6只。除空白对照组外,其他各组制备胶原诱导性关节炎大鼠模型。造模成功后,脊蛇祛湿胶囊组大鼠每日灌胃脊蛇祛湿胶囊1.47 g/kg,PAD4抑制剂组每周腹腔注射PAD4抑制剂4 mg/kg,空白对照组、模型组、PAD4抑制剂组每日灌胃2 ml纯水,均持续4周。分别于造模后第7、14、21、28、35天时观察各组大鼠四肢关节病变程度,进行关节炎指数(AI)评分;末次给药结束24 h后,HE染色、番红固绿染色、TRAP染色观察膝关节组织病理形态,流式细胞术检测大鼠外周血M1、M2型巨噬细胞计数,ELISA法检测大鼠血清酒石酸酸性磷酸酶(TRACP)、NETs、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、诱导型一氧化氮合酶(iNOS)含量,实时荧光定量PCR法和Western Blot法检测大鼠膝关节软骨组织髓过氧化物酶(MPO)、中性粒细胞弹性蛋白酶(NE)、核因子κB受体活化因子配体(RANKL)、骨保护素(OPG)、p65蛋白及mRNA表达。
结果
2
与空白组比较,模型组AI评分升高(
P
<0.05);膝关节病理显示滑膜炎性细胞浸润、血管新生及骨软骨破坏明显,TRAP染色破骨细胞计数、M1型巨噬细胞计数升高,M2型巨噬细胞计数减少;血清TRACP、NETs、TNF-α、IL-1β及iNOS含量升高(
P
<0.05);膝关节软骨组织MPO、NE、RANKL、p65蛋白及其mRNA表达升高,OPG蛋白及其mRNA表达降低(
P
<0.05)。与模型组比较,脊蛇祛湿胶囊组大鼠膝关节病理显示滑膜炎性细胞浸润、血管新生及骨软骨破坏改善;造模后第21、28、35天AI评分降低,TRAP染色破骨细胞计数减少,M1型巨噬细胞计数降低、M2型巨噬细胞计数升高,血清TRACP、NETs、TNF-α、IL-1β及iNOS含量降低(
P
<0.05);膝关节软骨组织MPO、NE、RANKL、p65蛋白及其mRNA表达降低,OPG蛋白及其mRNA表达升高(
P
<0.05)。与PAD4抑制剂组比较,脊蛇祛湿胶囊组大鼠AI评分降低,M1型巨噬细胞计数降低,M2型巨噬细胞计数升高(
P
<0.05);血清TRACP、TNF-α、IL-1β、iNOS含量降低,MPO、RANKL、p65蛋白及其mRNA表达降低,OPG蛋白水平升高(
P
<0.05)。
结论
2
脊蛇祛湿胶囊治疗类风湿关节炎机制可能是抑制NETs形成、下调RANKL/核因子κB(NF-κB)信号通路、调控巨噬细胞M1/M2极化失衡,从而抑制破骨细胞生成与活化并缓解炎性骨破坏。
Objective
2
To investigate the possible mechanism of
Jishe Qushi Capsule
(脊蛇祛湿胶囊, JQC) in treating rheumatoid arthritis (RA) from the perspective of macrophage polarization mediated by neutrophil extracellular traps (NETs).
Methods
2
Twenty-four female SD rats were randomly divided into four groups, blank control group, model group, JQC group, and peptidylarginine deiminase 4 (PAD4) inhibitor group with 6 rats in each group. All groups but the blank control group were subjected to the induction of collagen-induced arthritis (CIA). After successful model establishment, rats in the JQC group received intragastric administration of JQC 1.47 g/kg daily; rats in the PAD4 inhibitor group received intraperitoneal injections of the PAD4 inhibitor 4 mg/kg weekly. Rats in the blank, model, and PAD4 inhibitor groups received 2 ml of pure water daily by gavage. All treatments lasted 4 weeks. Joint lesions of each group were assessed on day 7, 14, 21, 28, and 35 after model establishment, and arthritis index (AI) scores were recorded. At 24 h after the final administration, histopathology of knee joints, including HE staining, safranin O-fast green staining, and TRAP staining, was performed. Flow cytometry was used to detect the counts of M1 and M2 macrophages in peripheral blood. ELISA was used to determine serum levels of TRACP, NETs, TNF-α, IL-1β, and iNOS. Western Blotting and qRT-PCR were used to measure MPO, NE, RANKL, OPG, and p65 protein and mRNA expression in knee cartilage tissue.
Results
2
Compared with the blank control group, the model group showed increased AI scores (
P
<0.05), marked synovial inflammatory infiltration, angiogenesis, and bone-cartilage destruction, increased TRAP-positive osteoclasts, increased M1 macrophages and decreased M2 macrophages, elevated serum TRACP, NETs, TNF-α, IL-1β, and iNOS (
P
<0.05), elevated MPO, NE, RANKL, and p65 protein/mRNA expression and decreased OPG protein/mRNA expression in knee cartilage tissue (
P
<0.05). Compared with the model group, the JQC group exhibited improved synovial inflammation, angiogenesis, and bone-cartilage damage, reduced AI scores on day 21, 28, and 35, decreased osteoclast counts, decreased M1 macrophages and increased M2 macrophages, reduced serum TRACP, NETs, TNF-α, IL-1β, and iNOS (
P
<0.05), decreased MPO, NE, RANKL, and p65 protein/mRNA expression and increased OPG expression (
P
<0.05). Compared with the PAD4 inhibitor group, the JQC group showed significantly lower AI scores, reduced M1 macrophages, increased M2 macrophages (
P
<0.05), reduced serum TRACP, TNF-α, IL-1β, and iNOS, decreased MPO, RANKL, and p65 expression, and increased OPG levels (
P
<0.05).
Conclusion
2
The therapeutic mechanism of JQC for RA may involve inhibition of NETs formation, downregulation of the RANKL/NF-κB signaling pathway, and regulation of macrophage M1/M2 polarization imbalance, thereby suppressing osteoclastogenesis and inflammatory bone destruction.
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