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ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 1  |  Page : 23-25

The study of differentially expressed serum protein in patients with different traditional chinese medicine syndromes of knee osteoarthritis


1 Department of Orthopedics, Affiliated TCM Hospital of Xinjiang Medical University, Urumqi, China
2 Departments of Orthopaedics, Spine Surgery and Joint Surgery, The University of Tokyo Hospital, 7 Chome-3-1 Hongo, Bunkyo City, Tokyo 113-8655, Japan

Date of Submission19-Jun-2019
Date of Acceptance18-Sep-2019
Date of Web Publication02-Jan-2020

Correspondence Address:
Dr. Y B Zhou
Department of Orthopedics, Affiliated TCM Hospital of Xinjiang Medical University, Urumqi
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MTSP.MTSP_10_19

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  Abstract 


Objectives: To study the distribution characteristics of patients with knee osteoarthritis (KOA) of different traditional Chinese medicine (TCM) syndromes and to reveal the differences from the perspectives of expressions of serum inflammatory indicators. Methods: One hundred and thirty-four patients with KOA treated in our hospital from January 2013 to March 2016 and referring to TCM syndrome types were included in the study and were divided into three types: Yin deficiency in kidney and liver\tendon and vesselstasissyndrome,s pleen and kidney deficiency\ wet injection the osteomere syndrome, kidney Yang deficiency and weak\phlegm stasis syndrome; 24 healthy persons who took physical examination in our hospital were selected as the normal control group. Patients' blood was collected in the morning as the blood samples, and the levels of inflammatory factors (5-TH, interleukin-6 [IL-6], and tumor necrosis factor-α [TNF-α]) were measured in serum. Results: The most common TCM syndrome of KOAin the clinical trialsis Yin deficiency in kidney and liver\tendon and vesselstasissyndrome, the percents of spleen and kidney deficiency\wet injection the osteomere syndrome and kidney Yang deficiency and weak\phlegm stasissyndrome are near, the former is slightly higher than the latter by 3.97%. The levels of IL-6 and TNF-α in the three groups were significantly higher than those in the normal control group, whereas the 5-TH level was significantly lower in the three groups than that in the normal control group (P < 0.05). The levels of IL-6 and TNF-α in the kidney Yang deficiency and weak\phlegm stasis syndrome group were significantly higher than the next two TCM syndrome groups (P < 0.05), whereas the 5-TH level in the kidney Yang deficiency and weak\phlegm stasis syndrome group was significantly lower than the next two TCM syndrome groups (P < 0.05). Conclusions: Yin deficiency in kidney and liver\tendon and vessel stasis syndrome is the most common TCM syndrome of KOA in the clinical trials. The levels of inflammatory factors (5 TH, IL 6, and TNF α) in serum had a close relationship with KOA. In terms of the perspectives of expressions of serum inflammatory indicators, the most serious TCM syndrome of KOA is kidney Yang deficiency and weak\phlegm stasis syndrome.

Keywords: Knee osteoarthritis, traditional Chinese medicine syndromes, yang deficiency, yin deficiency


How to cite this article:
Zhou Y B, Dong Z Y, Deng Y J, Meng Q C. The study of differentially expressed serum protein in patients with different traditional chinese medicine syndromes of knee osteoarthritis. Matrix Sci Pharma 2019;3:23-5

How to cite this URL:
Zhou Y B, Dong Z Y, Deng Y J, Meng Q C. The study of differentially expressed serum protein in patients with different traditional chinese medicine syndromes of knee osteoarthritis. Matrix Sci Pharma [serial online] 2019 [cited 2020 Jul 3];3:23-5. Available from: http://www.matrixscipharma.org/text.asp?2019/3/1/23/274450




  Introduction Top


Osteoarthritis of the knee is the most common type of arthritis in the middle and old age. It accounts for about 40% of the incidence of arthritis.[1] It can be caused by a variety of causes, mostly in hypertensive patients and manual workers and people with more obesity. This disease will bring a very serious problem to the patient.[2] It will be accompanied by the patient for a long time, which will cause the patient to be disabled, lose the basic labor force, bring a heavy burden to the family, and shadow the whole family. Due to the serious effect of osteoarthritis of the knee, it has become an important part of modern medicine, which has attracted more and more attention. Unfortunately, the exact cause of osteoarthritis of the knee has not been clarified so far, so it is usually not symptomatic, so the effect is not good enough. Nitric oxide (NO) is a toxic free radical.[3] Studies have shown that NO is a mediator of osteoarthritis of the knee. A large number of NO will be produced under the stimulation of cytokines, which will harm the synthesis of various cells, lead to cell apoptosis, and eventually lead to abnormal joint function.[4]

Overview

In 1978, scientists found that the cells transformed by the virus secreted a certain factor, called transforming growth factor beta (TGF-beta), which could transform the rat fibroblasts. There are five kinds of growth factors that have been found today, which are TGF-beta 1, 2, 3, 4, and 5, and the factors that exist in the human body are only TGF-beta 1, 2, and 3. They can regulate cell proliferation, differentiation, apoptosis, repair, and so on, and the concentration of TGF-beta in bone tissue is much higher than that of other tissues.[5] Studies have shown that TGF-beta is mainly distributed in the surface layer of cartilage.[6] When cartilage is injured, the body secretes a large number of TGF-beta, which increases the synthesis of polysaccharides and collagen, and promotes the body to return to normal. To explore the relationship between knee osteoarthritis (KOA) and NO and TGF-beta 1, the following studies were carried out.


  Methods Top


Research methods: (1) The blood of all cases was extracted from the experimental group and the control group. (2) Blood sampling requirements: sterile test tube without heat source; blood is the venous blood of patients in early morning. (3) Two groups of kidney deficiency syndrome in the experimental group (1 groups), the blood stasis type patients(2 groups) were treated for half a month respectively, and the blood samples were detected before and after the treatment. The control group was detected directly by blood sampling. (4) Blood treatment: when NO is detected, the treatment of blood is to extract venous blood without anticoagulation treatment and separate and preserve the serum. The treatment of TGF-beta 1 is to extract venous blood and isolate and preserve the plasma. (5) Methods of preservation of blood: freeze at the temperature of 20°C for no more than 5 months. (6) Detection method: NO was detected by a colorimetric method. TGF-beta 1 was detected by double antibody sandwich ELISA.

The case report was verified by the researchers, and each case was required to complete the case report. The completed case reports will be unified for statistical analysis, and the research report will be completed by the main researchers in this experiment. The SPSS 20.0 software (SPSS Statistics 20.0, IBM Corporation) was used for statistical analysis, the measurement data were used (×s), the independent sample t-test was used, the count data were tested by the ×2 test, and the P < 0.05 showed that the difference was statistically significant.

Sixty cases of KOA were randomly selected from February 2010 to February 2017 in Daxing District and Western Medicine Hospital in Beijing, including 30 cases of kidney deficiency syndrome and 30 cases of blood stasis type, which were used as the experimental group in this study, and were respectively used as the 1 and 2 Groups in the study group. Another 30 healthy people in our hospital were selected as the control group as the third group. Detailed information is shown in [Table 1].
Table 1: General data comparison

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  Results Top


Before treatment, the levels of TGF beta 1 and the content of NO in the blood of two groups of kidney deficiency syndrome (1 groups) and blood stasis blockage (2 groups) and control group (3 groups) were detected before treatment in the two groups before treatment of NO and TGF-beta 1 levels. Detailed data such as [Table 2] were detailed.
Table 2: The levels of nitric oxide and transforming growth factor beta 1 in the two groups before treatment

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After the treatment of the two groups of NO and TGF-beta 1 after 2 weeks of treatment, the content of TGF-beta 1 and the content of NO in the blood of two groups of kidney deficiency syndrome (1 groups) and blood stasis type (2 groups) in the experimental group had a certain degree change, the difference was statistically significant. The detailed data are shown in [Table 3].
Table 3: Levels of nitric oxide and transforming growth factor-beta 1 in the two groups after treatment

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Before and after treatment, all group 22 comparison results: before treatment, between three groups 22, the difference was statistically significant (P < 0.05). After treatment, the difference between the 1 and 2 two groups was also statistically significant (P < 0.05). Before treatment, the content of NO in the blood of the two groups of kidney deficiency syndrome (1 groups) and blood stasis type (2 groups) in the experimental group was much higher than that in the control group (Group 3). NO, as an inflammatory factor, will increase significantly when the body changes. In the experimental group, the content of TGF-beta 1 in the blood of the two groups of kidney deficiency syndrome (1 groups) and blood stasis type (2 groups) was much lower than that of the control group (3 groups), and the content of the blood in the kidney deficiency syndrome (1 group) was higher than that of the blood stasis type (2 group) patients (Group 2). The content of the growth factor-beta 1. It may be because TGF-beta has a variety of biological effects.


  Conclusions Top


The traditional Chinese medicine (TCM) syndrome type of KOA has certain correlation with NO and TGF-beta 1. The level of TGF-beta 1 and NO before and after treatment has significant difference between the blood stasis group of the KOA and the kidney deficiency syndrome group. It is helpful for the objective observation of the clinical study of TCM in the treatment of osteoarthritis of the knee. It is helpful for the objective research on the syndrome differentiation of KOA. The TCM syndromes of KOA (kidney deficiency, marrow depletion and stasis blockage) are related to TGF-1 and NO.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Guzman I, Lozada C, Valerio I. THU0468 adipokine serum levels in patients with early knee osteoarthritis with metabolic syndrome and healthy controls. Ann Rheum Dis 2015;74:370.  Back to cited text no. 1
    
2.
Trifonova E, Sazonova O, Zonova E. AB0752 theassociationbetweenclinical symptoms and serum cytokines levels in patients with knee osteoarthritis and comorbidity. Ann Rheum Dis 2016;75 Suppl 2:1162  Back to cited text no. 2
    
3.
Levinger P, Caldow MK, Bartlett JR. The level of FoxO1 and IL 15 in skeletal muscle, serum and synovial fluid in people with knee osteoarthritis: A case control study. Osteoporosis Int 2016;27:1-7.  Back to cited text no. 3
    
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Kalai E, Bahlous A, Charni N, Bouzid K, Sahli H, Laadhar L, Chelly M, et al. AB0832 serumlevels ofAggrecanArgs, Nitege fragments in Tunisian patients with knee osteoarthritis: Clinical, and radiological correlation. Ann Rheum Dis 2015;74:1178-9.  Back to cited text no. 4
    
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Giannitti C, De Palma A, Pascarelli NA, Cheleschi S, Giordano N, Galeazzi M, et al. Can balneotherapy modify microRNA expression levels in osteoarthritis? A comparative study in patients with knee osteoarthritis. Int J Biometeorol 2017;61:2153-8.  Back to cited text no. 5
    
6.
Lu X, Zhang R, Fu F, Shen J, Nian H, Wu T, et al. Simultaneous determination of fangchinoline and tetrandrine in Qi-Fang-Xi-Bi-granules by RP-HPLC. J Chromatogr Sci 2015;53:1328-32.  Back to cited text no. 6
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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