Objective: To explore the inhibitory effect of Sidaxue, a traditional Miao herbal medicine formula, on articular bone and cartilage destruction and synovial neovascularization in rats with collagen-induced arthritis (CIA).
Methods: In a SD rat model of CIA, we tested the effects of daily gavage of Sidaxue at low, moderate and high doses (10, 20, and 40 g/kg, respectively) for 21 days, with Tripterygium glycosides (GTW) as the positive control, on swelling in the hind limb plantar regions by arthritis index scoring. Pathologies in joint synovial membrane of the rats were observed with HE staining, and serum TNF-α and IL-1β levels were detected with ELISA. The expressions of NF-κB p65, matrix metalloproteinase 1 (MMP1), MMP2 and MMP9 at the mRNA and protein levels in the synovial tissues were detected using real-time PCR and Western blotting. Network pharmacology analysis was conducted to identify the important target proteins in the pathways correlated with the therapeutic effects of topical Sidaxue treatment for RA, and the core target proteins were screened by topological analysis.
Results: Treatment with GTW and Sidaxue at the 3 doses all significantly alleviated plantar swelling, lowered arthritis index scores, improved cartilage and bone damage and reduced neovascularization in CIA rats (P<0.05), and the effects of Sidaxue showed a dose dependence. Both GTW and Sidaxue treatments significantly lowered TNF-α, IL-1β, NF-κB p65, MMP1, MMP2, and MMP9 mRNA and protein expressions in the synovial tissues of CIA rats (P<0.05). Network pharmacological analysis identified MMPs as the core proteins associated with topical Sidaxue treatment of RA.
Conclusion: Sidaxue alleviates articular bone and cartilage damages and reduces synovial neovascularization in CIA rats possibly by downregulating MMPs via the TNF-α/IL-1β/NF-κB-MMP1, 2, 9 signaling pathway, and MMPs probably plays a key role in mediating the effect of Sidaxue though the therapeutic pathways other than oral administration.
目的: 探究贵州苗医验方“四大血”（SX）对胶原诱导型关节炎（CIA）大鼠关节骨、软骨破坏及滑膜血管新生的作用机制。
方法: 将42只SD大鼠均分为空白组（Nor）、模型组（Mod）、雷公藤多苷片阳性对照组（GTW，40 g/kg）和SX高、中、低剂量组（SX 40、20、10 g/kg），7只/组。通过皮下注射牛型Ⅱ胶原来建立CIA大鼠模型，并且通过每天经口灌胃的方式给予治疗，持续3周。采用AI评分分别于造模前，灌胃前1周，灌胃后1周，灌胃2周，灌胃3周观察大鼠后足关节病变情况。HE染色法观察大鼠关节滑膜病理变化，ELISA法检测TNF-α、IL-1β，Real-time PCR检测滑膜组织中NF-κB p65、MMP1、MMP2、MMP9 mRNA表达水平，Western blot检测滑膜组织中NF-κB p65、基质金属蛋白1（MMP1）、MMP2、MMP9蛋白表达水平。网络药理学获取SX外用途径治疗类风湿性关节炎（RA）中的重要靶蛋白，经拓扑分析后筛选出核心靶蛋白。
结果: GTW组和SX高、中、低剂量组足跖肿胀度及关节炎指数评分均小于Mod组（P<0.05）。光镜下观察大鼠关节滑膜病理组织切片，Mod组可见较多软骨细胞坏死，软骨下层骨组织受侵蚀，并有新生毛细血管形成；而GTW组和SX高、中、低剂量组中，软骨及骨损伤均有不同程度地降低，新生血管数量减少，随SX剂量增高，治疗效果呈逐渐增强的趋势。与Mod组相比，GTW组和SX高、中、低剂量组滑膜组织TNF-α、IL-1β、NF-κB p65、MMP1、MMP2、MMP9 mRNA和蛋白表达量有不同程度地降低（P<0.05）。经网络药理学分析得到外用SX治疗RA中的核心靶蛋白—MMPs。
结论: SX可以改善CIA大鼠关节骨和软骨的破坏、减缓滑膜血管新生，其机制可能为调节MMP基因表达的TNF-α/IL-1β/NF-κB-MMP1、2、9信号转导途径，下调MMPs表达水平，此外可初步推断MMPs在除口服治疗途径以外仍发挥关键作用。
Keywords: Miao medicine Sidaxue formula; cartilage and bone destruction; matrix metalloproteinase; matrix metalloproteinases; network pharmacology; rheumatoid arthritis.