Publications (2)0 Total impact
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ABSTRACT: To observe the effects of Modified Liangge Powder (MLP) on the expressions of platelet toll like receptor 4 (TLR4) and the release of platelet-derived cytokines interleukin 8 (IL-8), beta platelet globulin (beta-TG), soluble CD40 ligand (sCD40L). The modulating effects on the release of cytokines from mice platelets by TLR4 ligand through monoclonal antibody blocking TLR4 on platelet were compared. The stimulated platelet by LPS was incubated with low (0.94 g/mL), medium (1.89 g/mL), and high (2.84 g/mL) dose of MLP contained serum. The changes of the platelet TLR4 expression and platelet-derived cytokines were observed. The positive expression rate of platelet TLR4 obviously decreased (P < 0.01) and the release of sCD40L and beta-TG from platelets significantly increased (P < 0.01) after stimulated by LPS. However, the release of sCD40L and beta-TG from platelets obviously decreased by TLR4 monoclonal antibody (P < 0.05, P < 0.01). There was no statistical difference in IL-8 between before and after LPS stimulation (P > 0.05). Platelet TLR4 positive expression rate was significantly higher after incubated by medium and high doses of MLP contained serum (P < 0.01), and the releasing of sCD40L and beta-TG was lower in the serum contained groups. The inhibitory effects were enhanced in a dose-dependent manner. LPS induced platelet activation by TLR4 and released sCD40L and beta-TG, while the release of platelet IL-8 was not dependent on platelet TLR4-LPS pathway. MLP could inhibit LPS-stimulated sCD40L and beta-TG, inhibit the binding of platelet TLR4 and LPS in a dose-dependent manner, thus reducing the release of platelet cytokines.Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine / Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban 05/2012; 32(5):681-4.
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ABSTRACT: To examine the efficacy of a treatment regimen combining modern (Western) medication and a traditional Chinese medicinal recipe Modified Liang-Ge San on sepsis, and its effect on platelet parameters/activation, platelet TLR4 expression and the intensity of inflammatory response in the patients. 64 patients with sepsis were randomly assigned to two groups (32 each) to receive Western therapy only (group X) and Western therapy + Modified Liang-Ge San (group L). The values of: platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), the expression of TLR4 and procaspase activating compound-1 (PAC-1) in platelets, plasma concentration of soluble CD40 ligand (sCD40L) and tumor necrosis factor-α (TNF-α) were collected on the day of admission, and 3, 5, 9 days after treatment. Acute physiology and chronic health evaluation II (APACHE II) score, length of stay in intensive care unit (ICU), bleeding events and 28 day mortality in these patients were also analyzed. A group of 15 healthy volunteers (group C) were used as control. Compared to group C, the patients with sepsis have significantly: lower PLT (×10 9/L: 211.37±77.84 vs. 272.33±34.23, P< 0.01 ), increased MPV (fL: 10.24±0.81 vs. 9.64±0.66, P< 0.05) and PDW (fL: 17.79±1.68 vs. 15.61±1.54, P< 0.01), up-regulated platelet TLR4 [(39.93±9.07)% vs. (23.50±4.68)%] and PAC-1 expression [(42.21±8.74)% vs. (21.02±3.49)%], both P < 0.01, and higher level of sCD40L (μg/L: 6.94±1.05 vs. 3.27±0.41)and TNF-α(ng/L: 60.10±9.77 vs. 4.08±3.08), both P< 0.01. Compared to group X, group L had significantly (P< 0.05 or P< 0.01, respectively) lower value in: creatinine (μmol/L: 106.2±34.4 vs. 127.5±43.7); alanine aminotransferase (U/L: 31.7±12.5 vs. 41.9±19.9);aspartate aminotransferase (U/L: 54.1±21.6 vs. 68.5±24.1); TLR4 [(27.14±6.08)% vs. (30.92±5.47)%]; PAC-1 [(27.52±6.51)% vs. (31.24±5.77)%]; sCD40L (3.86±0.69 vs. 4.38±0.73); TNF-α (22.06±7.19 vs. 28.25±8.99), and higher PLT (261.93±55.32 vs. 231.37±63.58, P< 0.05), in the 9 days after treatment. In patients with sepsis, platelet PAC-1 expression correlated significantly to PLT ( r = - 0.409, P< 0.01 ) negatively, and MPV, PDW, platelet TLR4 expression, plasma sCD40L ( r (1) = 0.262, r (2) = 0.318, r (3) = 0.341, r(3) = 0.519, all P< 0.01) positively; sCD40L and TNF-α was positively correlated ( r = 0.542, P < 0.01 ) in these patients. In comparison with group X, the length of stay in ICU (day: 8.06±2.86 vs. 9.31±2.48), the incidence of bleeding (12.5% vs. 21.9%) and APACHE II score (12.75± 4.56 vs. 14.59± 3.97) were significantly lower (all P< 0.05) in group L on the 9 days after treatment. No significant difference was found in 28 day mortality between group L and X (15.63% vs. 18.75%, P> 0.05). In patients with sepsis, platelet TLR4 expression is elevated together with platelet activation. The joint application of Western medicine and Modified Liang-Ge San may suppress such up-regulation in TLR4/other inflammatory mediators, and alleviate platelet activation/thrombocytopenia in these patients.Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue 10/2011; 23(10):616-20.
Tianjin First Central HospitalT’ien-ching-shih, Tianjin Shi, China