Patent Application
20160220602
1. Field of the Invention
The present invention relates to the field of Traditional Chinese medicine (TCM). More specially, the invention relates to a use of traditional Chinese medicinal in preparation for the prevention or treatment of Crohn's disease.
2. Description of Related Art
Crohn's disease is a kind of inflammatory bowel disease. Usually, a serie of signals occur in patients' colon, small intestine or stomach, e.g. inflammation, hyperemia or lymphatic swelling. The main difference from another inflammatory bowel disease, the ulcerative colitis (UC), lies in inflammatory position and inflammation itself. Histopathologically, any segment of digestive system may be affected, e.g. the small intestine, colon, stomach and esophagus, and the common sites include the terminal ileum and adjacent colon segment and right-half colon. UC, however, just occurs in colon and rectum, which is common in rectum and sigmoid. Microscopically, Crohn's disease may affect whole inner wall of bowel, while UC is restricted to mucosa.
Crohn's disease is a chronic and recurrent disease. Due to unknown cause, effectively therapeutic drugs have not yet been developed. By now, the drugs used for treating Crohn's disease mainly include glucocorticoid, salicylic acid, immunosuppressive agents, antibiotics, methotrexate and biological agents (e.g. infliximab). Although these drugs are proven to have the effect to change the natural process of disease, they cannot completely alleviate the conditions of disease and decrease the incidence of complications. Moreover, the chemicals of glucocorticoid and immunosuppressive agents often cause obvious adverse reaction and longtime administration will likely result in damage to the body.
In this case, the technical staff in prior arts hopes to develop effective traditional Chinese medicine preparations used for treating Crohn's disease by means of TCM technique. For example, Chinese patent (CN 102716383A) disclosed a TCM composition prepared with 15 raw medicines in accordance with formula. Because there were a lot of raw medicines in the composition, they had too complicated prescription-compounding to make it conducive to industrial production. Chinese patent (CN 102048728A) disclosed a use of artemisinin derivatives in preparation of medicine for treating Crohn's disease. However, as disclosed in the specification, the artemisinin derivatives were used for maintain treatment. That is to say, the artemisinin derivatives were not able to cure Crohn's disease radically.
Chinese patent (CN 1192787C) disclosed a TCM preparation used for treating UC. By further research, it is first discovered that the TCM preparation has an excellent effect on Crohn's disease with no significant adverse reaction. Herein, aforementioned literature was entirely incorporated into the text by reference.
The objective of present invention is to provide a use of a TCM preparation in preparation of medicine for preventing and/or treating Crohn's disease. The preparation comprises the raw materials as 1-10 wt % of Sanguis Draxonis (Xuejie), 15-40 wt % of Radix Paeoniae Rubra (Chi Shao), 1-20 wt % of Indigo Naturalis (Qing Dai), 1-10 wt % of Halloysitum Rubrum (Chi Shi Zhi), 15-40 wt % of Catechu (Er Cha), 1-10 wt % of Calcined Alumen (Ku Fan), 5-30 wt % of Rhizoma Bletillae (Bai Ji) and 1-10 wt % of Calamina (Lu Gan Shi).
Another objective of present invention is to provide a use of the TCM preparation in preparation of medicine for preventing and/or treating extraintestinal manifestations and complications of Crohn's disease, thus ultimately improving extraintestinal manifestations and complications of Crohn's disease. The preparation comprises the raw materials as 1-10 wt % of Sanguis Draxonis (Xuejie), 15-40 wt % of Radix Paeoniae Rubra (Chi Shao), 1-20 wt % of Indigo Naturalis (Qing Dai), 1-10 wt % of Halloysitum Rubrum (Chi Shi Zhi), 15-40 wt % of Catechu (Er Cha), 1-10 wt % of Calcined Alumen (Ku Fan), 5-30 wt % of Rhizoma Bletillae (Bai Ji) and 1-10 wt % of Calamina (Lu Gan Shi).
Another objective of present invention is to provide a method for preventing and/or treating Crohn's disease. The method comprises administering to a patient in need thereof a preventive and/or therapeutic amount of the TCM preparation or a medicine composition comprising the TCM preparation.
According to present invention, the TCM preparation is competent to treating the Crohn's disease as long as its dose reaches effective dose, once or several times per day, preferably once per day. When the TCM preparation is used for preventing the Crohn's disease, its dose may be conditionally reduced.
In one embodiment, the present invention relates to a use of a TCM preparation in preparation of medicine for preventing and/or treating the Crohn's disease. The preparation comprises the raw materials as 1-10 wt % of Sanguis Draxonis (Xuejie), 15-40 wt % of Radix Paeoniae Rubra (Chi Shao), 1-20 wt % of Indigo Naturalis (Qing Dai), 1-10 wt % of Halloysitum Rubrum (Chi Shi Zhi), 15-40 wt % of Catechu (Er Cha), 1-10 wt % of Calcined Alumen (Ku Fan), 5-30 wt % of Rhizoma Bletillae (Bai Ji) and 1-10 wt % of Calamina (Lu Gan Shi).
Preferably, the preparation comprises the raw materials as 3-7 wt % of Sanguis Draxonis, 25-35 wt % of Radix Paeoniae Rubra, 5-15 wt % of Indigo Naturalis, 1-5 wt % of Halloysitum Rubrum, 25-35 wt % of Catechu, 1-5 wt % of Calcined Alumen, 10-20 wt % of Rhizoma Bletillae and 1-5 wt % of Calamina.
Mostly preferably, the preparation comprises the raw materials as 5.1 wt % of Sanguis Draxonis, 30.3 wt % of Radix Paeoniae Rubra, 10.1 wt % of Indigo Naturalis, 3 wt % of Halloysitum Rubrum, 30.3 wt % of Catechu, 3 wt % of Calcined Alumen, 15.2 wt % of Rhizoma Bletillae and 3 wt % of Calamina.
In another embodiment, the present invention relates to a use of the TCM preparation in preparation of medicine for preventing and/or treating extraintestinal manifestations and complications of the Crohn's disease.
In preferable embodiment, the complications of the Crohn's disease include one or more kinds of intestinal obstruction, intestinal fistula, lower gastrointestinal massive hemorrhage, intestinal perforation, septicemia, abdominal abscess and anal diseases.
In another preferable embodiment, the extraintestinal manifestations of the Crohn's disease include oral mucositis, e.g. the aphthous ulcer; skin pathological changes, e.g. the erythema nodosum (EN), the pyoderma gangrenosum (PG) and non-specific rash; eye pathological changes, e.g. the iridocyclitis and conjunctivitis; arthral lesion, e.g. the arthral pain and arthritis; hepatobiliary lesion, e.g. abnormal liver function and gallstone.
According to present invention, the TCM preparation can be prepared into any one of pharmaceutically acceptable dosage forms, including but not limited to: enema; tablet, e.g. the suger-coated tablet, film-coated tablet and enteric-coated tablets; capsule, e.g. the hard capsule and soft capsule; oral liquid; buccal tablet; granule; instant powder; pill; dripping pill; pulvis, paste, e.g., the ointment and paste; Dan; suspension; powder; solution, e.g. the injection; suppository; cream; spray; dry powder inhalation; aerosol; drop; lozenge and patch.
According to present invention, the enema is prepared by the method disclosed in Chinese Patent (CN1192787C). The dosage forms of tablet, capsule, oral liquid, buccal tablet, granule, instant powder, pill, dripping pill, pulvis, paste, Dan, suspension, powder, solution, suppository, cream, spray, dry powder inhalation, aerosol, drop, lozenge and patch may be prepared by the conventional methods known in prior arts.
According to present invention, the enema includes conventional carriers, e.g. the diluent, lubricant and wetting agent etc.
According to present invention, the orally-administrated dosage forms of TCM preparations include conventional carriers, e.g. one or more kinds of the adhesive, filling agent, diluent, tableting agent, lubricant, disintegrating agent, colorant agent, flavoring agent, wetting agent. If necessary, the tablet may be coated.
According to present invention, the filling agents include cellulose, mannitol, lactose and other analogous filling agent. Competent disintegrating agents include starch, polyvinylpyrrolidone (PVP) and starch derivative (e.g. sodium hydroxyethyl starch). Competent lubricants include magnesium stearate. Competently pharmaceutically acceptable wetting agents include sodium dodecyl sulfate.
According to present invention, oral solid preparations of TCM preparations can be prepared by a conventional method of blending, filling, tableting or granulating etc. Blending is repeated to make the active pharmaceutical ingredients (API) distributed uniformly in the final dosage form.
According to present invention, oral liquid preparations are in dosage form of either water-soluble or oil-soluble suspension, solution, emulsion, syrup or elixir, or drying powder that is always reconstituted with water or other suitable solvent before clinical use. The oral liquid preparation may contain conventional excipients, e.g. suspending agent, such as the sorbitol, syrup, methylcellulose, gelatin, hydroxy ethyl cellulose, hydroxy methyl cellulose, aluminum stearate gel or hydrogenated edible fat; emulsifying-agent, e.g. lecithin, sorbitan monoleate or arabic gum; non-aqueous excipient (including edible oil) e.g. almond oil, fractionated coconut oil, oil ester, propylene glycol or ethanol as well as preservative, e.g. methylparaben, nipasol, sorbic acid. If necessary, conventional flavoring agent or colorant agent can be included.
According to present invention, as for injections, the preparation unit contains the TCM preparation as API and aseptic excipients. Whether the API is dissolved or suspended in the liquid depends on the type and concentration of excipients. Generally, solution is prepared by dissolving the TCM preparation in the excipients as the API, sterilizing, loading into an appropriate vial or ampoule and sealing. Some pharmaceutically acceptable adjuvant, e.g. local anesthetic, preservative and buffering agent can be added as required. In order to improving its stability, before loaded into the vial, this TCM preparation of present invention can be frozen and treated in vacuum to remove water.
According to present invention, the TCM preparation can be prepared by optionally adding pharmaceutically acceptable excipients. The excipients are selected, as follows: sugar alcohol, e.g. mannitol, sorbitol, xylitol; amino acid, e.g. cysteine hydrochloride, methionine, glycine, Vitamin C; EDTA disodium, EDTA calcium disodium salt; inorganic salt, e.g. one valence alkali carbonate, acetate, phosphate or its aqueous solution, sodium chloride, potassium chloride, sodium pyrosulfite, sodium bisulfite, sodium thiosulfate; calcium carbonate, calcium bicarbonate; stearate, e.g. calcium stearate, magnesium stearate; inorganic acid, e.g. hydrochloride, sulfate, phosphoric acid; organic acid, e.g. acetic acid; organic acid salt, e.g. sodium lactate; polysaccharide, cellulose and its derivatives, e.g. maltose, glucose, fructose, dextran, sucrose; lactose, cyclodextrin (β-cyclodextrin), starch, mercaptoacetic acid; silicon derivative; alginate; gelatin; PVP, glycerol; Tween-80, agar gel; surfactant; phospholipids; Kaolin; talcum powder etc.
According to present invention, use and dose of the TCM preparation depend on the condition of patients in clinic. In preferable example, the TCM preparation is used in dosage form of enema for treating the Crohn's disease, administered to patients once or several times per day, preferably once per day; 60-80 ml per time, preferably 80 ml per time. Dose of the TCM preparation may be reduced conditionally, when using it for preventing the Crohn's disease, for example, but not limit to, ½, ⅓ and ¼ of therapeutically effective dose.
Technical scheme of present invention will be further elaborated by following preparative examples and trial examples. However, it should be understood that the protecting scope of present invention is not limited to these examples. Herein, the TCM preparations are prepared by the method disclosed in Chinese patent (CN 1192787 C).
The raw materials by following weight were used to prepare the TCM preparation a.
14 g of Sanguis Draxonis, 84 g of Radix Paeoniae Rubra, 28 g of Indigo Naturalis, 8.4 g of Halloysitum Rubrum, 84 g of Catechu, 8.4 g of Calcined Alumen, 42 g of Rhizoma Bletillae and 8.4 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation b.
22.1 g of Sanguis Draxonis, 69 g of Radix Paeoniae Rubra, 25 g of Indigo Naturalis, 25 g of Halloysitum Rubrum, 69 g of Catechu, 17 g of Calcined Alumen, 28 g. of Rhizoma Bletillae and 22.1 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation c.
19 g of Sanguis Draxonis, 67 g of Radix Paeoniae Rubra, 27.1 g of Indigo Naturalis, 19 g of Halloysitum Rubrum, 67 g of Catechu, 14.1 g of Calcined Alumen, 47 g of Rhizoma Bletillae and 17 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation d.
11 g of Sanguis Draxonis, 91 g of Radix Paeoniae Rubra, 19 g of Indigo Naturalis, 14 g of Halloysitum Rubrum, 91 g of Catechu, 12.2 g of Calcined Alumen, 28 g of Rhizoma Bletillae and 11 g of Calamina
The raw materials by following weight were used to prepare the TCM preparation e.
8 g of Sanguis Draxonis, 97 g of Radix Paeoniae Rubra, 14 g of Indigo Naturalis, 6 g of Halloysitum Rubrum, 97 g of Catechu, 2.2 g of Calcined Alumen, 47 g of Rhizoma Bletillae and 6 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation f.
3 g of Sanguis Draxonis, 42 g of Radix Paeoniae Rubra, 16 g of Indigo Naturalis, 4 g of Halloysitum Rubrum, 45 g of Catechu, 4 g of Calcined Alumen, 13 g of Rhizoma Bletillae and 5 g of Calamina
The raw materials by following weight were used to prepare the TCM preparation g.
13 g of Sanguis Draxonis, 56 g of Radix Paeoniae Rubra, 23 g of Indigo Naturalis, 9 g of Halloysitum Rubrum, 58 g of Catechu, 12 g of Calcined Alumen, 29 g of Rhizoma Bletillae and 9 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation h.
20 g of Sanguis Draxonis, 71 g of Radix Paeoniae Rubra, 35 g of Indigo Naturalis, 13 g of Halloysitum Rubrum, 66 g of Catechu, 19 g of Calcined Alumen, 47 g of Rhizoma Bletillae and 13 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation i.
23 g of Sanguis Draxonis, 95 g of Radix Paeoniae Rubra, 44 g of Indigo Naturalis, 20 g of Halloysitum Rubrum, 83 g of Catechu, 23 g of Calcined Alumen, 68 g of Rhizoma Bletillae and 19 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation j.
27 g of Sanguis Draxonis, 110 g of Radix Paeoniae Rubra, 56 g of Indigo Naturalis, 26 g of Halloysitum Rubrum, 105 g of Catechu, 27 g of Calcined Alumen, 81 g of Rhizoma Bletillae and 25 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation k.
1 g of Sanguis Draxonis, 16 g of Radix Paeoniae Rubra, 1 g of Indigo Naturalis, 1 g of Halloysitum Rubrum, 16 g of Catechu, 1 g of Calcined Alumen, 3 g of Rhizoma Bletillae and 1 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation 1.
17 g of Sanguis Draxonis, 40 g of Radix Paeoniae Rubra, 20 g of Indigo Naturalis, 10 g of Halloysitum Rubrum, 40 g of Catechu, 10 g of Calcined Alumen, 30 g of Rhizoma Bletillae and 10 g of Calamina.
The raw materials by following weight were used to prepare the TCM preparation m.
6 g of Sanguis Draxonis, 94 g of Radix Paeoniae Rubra, 20 g of Indigo Naturalis, 10 g of Halloysitum Rubrum, 40 g of Catechu, 10 g of Calcined Alumen, 70 g of Rhizoma Bletillae and 10 g of Calamina.
Trial example 1 preliminary study of concentration for efficacy evaluation in zebra fish of the
Crohn's disease model
Fish farm water of wild-type AB strain zebra fish Crohn's disease model (1L reverse osmosis water added with 200 mg instant sea salt with the conductivity of 480-510 μS/cm, pH value of 6.9-7.2 and hardness of 53.7-71.6 mg/L CaCO3) was added with the TCM preparation (a) prepared by the method of EXAMPLE 1 in the concentration of 0.1%, 0.25%, 0.5%, 0.75% and 1% by volume. At the same time, the control group was given. At each concentration of the preparation (a), 30 zebra fish were treated, during which zebra fish death number was counted daily and the dead fish was removed in time. The relationship between the concentration of TCM preparation and lethality was seen in tablel, and the concentration-lethality curve present in
By using OriginPro 8.0 software, MNLC (Maximam Non-lethal concentration) of the TCM preparations was calculated as 0.3% by volume.
According to the results of concentration explored preliminarily in Trial example 1, there were 3 levels set in treatment group to evaluate the efficacy in zebra fish Crohn's disease model, respectively in volume ratio of 1/10 MNLC (0.03%), ⅓ MNLC (0.1%) and MNLC (0.3%) (Hereafter abbreviated as “treatment group 1 of preparation a”, “treatment group 2 of preparation a” and “treatment group 3 of preparation a”). Meanwhile, the positive control group, blank control group, Crohn's disease model group and excipient control group were set in the research. In the positive control group, the prednisolone was finally at concentration of 10 μM in fish farm water. The enema excipient disclosed in Chinese patent (CN 1192787 C) was used in the excipient control group, including adding PEG-400 solutions containing tragacanth and potassium sorbate into the fish farm water in the volume ratio of 0.3%. Wherein, the PEG-400 solution was prepared following method: adding 1.5 g of tragacanth and 2 g of potassium sorbate (particle size of 150 μm) into 28ml PEG.
Zebra fish Crohn's disease model was established with TNBS (2,4,6-trinitrobenzenesulfonic acid), mainly exhibiting inflammation. 30 zebra fish were randomly given to each group. 48 hours after respectively being treated with aforementioned TCM preparation (a) in treatment groups (above-mentioned three concentrations), aforementioned prednisolone in the positive control group and aforementioned excipient in the excipient control group, 10 fish in each group were randomly selected to observe and photograph. The image analysis software was used to analyze the pictures. Meanwhile, intestine mucosal thickness, intestinal diameter and intestinal area were observed carefully under the microscope and the intestinal diameter and intestinal area analyzed quantitatively. Therapeutic ratio of tested drug in zebra fish Crohn's disease was calculated in accordance with the intestinal area in each group. The calculation formula was present as follows:
Theraputic ratio (%)=[1-(treatment group-blank control group)/(model group-blank control group)]×100%
Statistically analyzed results were expressed as mean±SE. Variance analysis was used for comparison among many groups and Dunnett's T test for comparison between two groups. P<0.05 showed a statistically significant difference.
As shown in
The prednisolone in the positive control group had theraputic ratio of 74±3.40% in zebra fish Crohn's disease model, having statistically significant difference (p<0.01) in comparison with the model group. Partial theraputic ratio of 39±9.30% was found in the treatment group 1 of preparation (a) at 0.3%. The treatment group 2 and 3 of preparation (a) had theraputic ratio of 70±7.49% and 73±4.81% respectively in zebra fish Crohn's disease model, having extremely significant difference (p<0.001) in comparison with the model group.
Theraputic ratio of tested drugs in zebra fish Crohn's disease model was seen in table 2.
As shown in above table, the TCM preparation had excellent therapeutic effect on Crohn's disease, and even at low concentration it showed theraputic effect on Crohn's disease.
Method was the same as the one in Trial example 2, except that the transgenic neutrophil fluorescent zebra fish was adopted. The TCM preparation (a) prepared by the method of Example 1 was added into the fish farm water in the transgenic neutrophil fluorescent zebra fish Crohn's disease model in the volume ratio of 0.03%, 0.1% and 0.3% to evaluate the effect of the preparation on inflammation regression in zebra fish Crohn's disease model.
The image analysis software was used to quantitatively analyze distribution of neutrophil in inflammatory tissues. Inflammation regression ratio of tested drugs in zebra fish Crohn's disease model was calculated on the basis of the number of neutrophil in bowel. The formula calculated for inflammation regression was present as follows:
Inflammation regression ratio (%)=[1-(treatment group-blank control group)/(model group-blank control group)]×100%
Statistically analyzed results were expressed as mean±SE. Variance analysis and Dunnett's T test were used. P<0.05 showed a statistically significant difference.
As shown in
The prednisolone in the positive control group had the inflammation regression ratio of 81±2.48%, having statistically significant difference (p<0.01) compared with the model group. The treatment groups 1, 2 and 3 of preparation (a) had therapeutic ratio of 49±3.50%, 63±6.48% and 77±3.50% respectively, each group having statistically extremely significant difference (p<0.001) compared with the model group.
Inflammation regression ratio of tested drugs in zebra fish Crohn's disease model was seen in table3.
As shown in above table, the TCM preparation had excellent effect of regressing inflammation on the Crohn's disease model, and even at low concentration it showed effect of regressing inflammation bn Crohn's disease.
Method was the same as the one in Trial example 2. Drugs were administered to the Crohn's disease model. After being treated, the zebra fish were fixed with 4% paraformaldehyde and transferred to 70% ethanol. The intestinal tissue was determined by histopathological research after dehydration, embedding, sectioning and H&E dyeing.
As shown in
According to the results of above Trial Examples 2-4, the TCM preparation could effectively improve the intestinal thickness, reduce the intestinal dilation caused by inflammation, facilitate inflammatory regression and ameliorate in the Crohn's disease model. Compared with the Crohn's disease model, all quantitative evaluation indices (e.g. therapeutic ratio and inflammation regression ratio) in the TCM preparations had statistically extremely significant difference (p<0.001). No therapeutic effects were found on the Crohn's disease in the excipient control disease.
1. Animals: SD rats, half male and female, weighing 180-220 g, were purchased from Animal center, Institute of Hygiene and Environmental Medicine, Academy of Military Medical Sciences of PLA with the certificate Number SCXK-2009-003.
2. Drug and reagent: Mesalamine, used as positive drug, was provided by Tasly Pharmaceutical Group Co. Ltd. 5% TNBS was purchased from Sigma Inc. IFN-γ, IL-1, IL-4, IL-10 and Gln Elisa assay kits were purchased from bioswamp Inc. Stool occult blood assay kit was provided by Nanjing Jiancheng Bioengineering Institute.
3. Apparatus: AB135-S electronic analytical scale was purchased from Mettle Toledo Inc. Switzerland.
Grouping: experiment was carried out by using two ways of intracolonic and intragastric administrations. Hence, rats were divided into following groups: the blank control intragastric group, the model intragastric group, the positive control intragastric group, the TCM preparation j high-dose intragastric group, the middle-dose intragastric group, the low-dose intragastric group, the blank control intracolonic group, the model intracolonic group, the positive control intracolonic group, the TCM preparation j high-dose intracolonic group, the middle-dose intracolonic group and the low-dose intracolonic group. There were 10 rats each group.
Method for establishing rat model: referring to Morris method, TNBS was used to induce the SD rat Crohn's disease model (abbreviated as “TNBS model”). 24 hours before modeling, the SD rats were fasted but water was given. After weighing, the SD rats were anesthetized by intraperitoneal injection of pentobarbital sodium. {circumflex over (1)} Preparation of TNBS enema liquid: 5% TNBS was mixed with anhydrous ethanol in the volume ratio of 2:1, loaded in bottle and stored at 4° C. {circumflex over (2)} Clyster: in the modeling group, rats were treated by clyster of TNBS solution in the ratio of 150 mg/kg rat weight (namely 4.5 ml/kg rat weight), and in the blank control group, the rats treated by clyster of 0.9% (w/v) normal saline in the same ratio. The enemator (a latex tube with outer diameter of 2 mm) was inserted the anus 6-8 cm inside, and the enema liquids injected. The rats were inverted by lifting tails for 1 min to make TNBS fully take effect in intestinal cavity, preventing the solution from overflowing.
Administration method: after modeling, the TCM preparation j saline solutions at corresponding dose were administered to the groups of preparation j of all doses and the mesalamin saline solution, a positive drug, administrated to the positive control group. The rats of blank control group were normally fed with free access to water and the same volume of normal saline was given in the same administration routes by referring to the dosage regime of aforementioned treatment groups. The rats of model group were administrated with the same volume of normal saline in the same administration routes. The dose of each group was as follows: mesalamin group at 100 mg/kg rat weight, the TCM preparation J high-dose group at 2.023 g raw medicine/kg rat weight, the middle-dose group at 1.012 g raw medicine/kg rat weight and the low-dose group at 0.506 g raw medicine/kg rat weight. In both intragastric and intracolonic routes, test drugs saline solution or normal saline were administrated in a ratio of 0.7 ml/100 g rat weight, once per day consecutively for 21 days.
After being treated as disclosed above, the rats in each group were evaluated by following indices.
(1) General Indices: weight change and stool (e.g. fecal occult blood, bloody stool and diarrhea) was observed every day to calculate DAI (disease activity index) score.
DAI score=(weight loss percentage+stool character fraction+hematochezia fraction)/3
(2) Serum indices: after final administration, the testing rats were fasted but given water. 24 hours later, blood was gained from abdominal aorta. Serum IFN-γ, IL-1, IL-4, IL-10 and Gln in intestinal mucosa were determined by enzyme-linked immunosorbent assay (ELISA) in rats.
(3) Pathological indices: the colon of rats was taken out. The gross colon tissue damage was scored, subsequently examined and scored histopathologically by conventional HE staining. The scoring criteria were seen in table 5.
Statistical analysis: Spss 17.0 statistical software was used to analyze above scores. Data were expressed as Mean±SD and t-test used for comparison between groups. P≦0.05 showed a statistically significant difference.
By intragastric administration or intracolonic administration, the results were seen following table 6-11.
(1) Results of general indices (DAI scores)
As shown in table 6 and
As shown in table 7 and
Compared with the TCM preparation j group administered intragastrically, the intracolonic administration of high-dose preparation j could clearly improve DAI scores in rats.
(2) Corresponding results of serum indices
As shown in table 8 and
Compared with the blank control group, the serum content of IL-1 was increased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-1 was decreased clearly in the positive control group rats, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-1 was decreased to a certain extent in the TCM preparations j high-dose, middle-dose and low-dose groups; especially the decreased degree in the rats of the high-dose group was most obvious (p<0.01).
Compared with the blank control group, the mucosa Gln content was decreased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the mucosa Gln content was all increased in the TCM preparations j high-dose, middle-dose, low-dose groups and model group, having statistically significant difference (respectively p<0.01, p<0.05, p<0.01, p<0.05).
Compared with the blank control group, the serum content of IL-4 was decreased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-4 was increased clearly in the positive control group rats, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-4 was decreased to a certain extent in the TCM preparations j high-dose, middle-dose and low-dose groups; especially the increased degree in the rats of the middle-dose group was most obvious, having statistically significant difference (p<0.05).
Compared with the blank control group, the serum content of IL-10 was decreased slightly in the model group, having statistically significant difference (p<0.05). Compared the model group, the serum content of IL-10 was increased to a certain extent in the rats of positive control group, but did not have statistically significant difference (p<0.01). Compared the model group, the serum content of IL-10 was decreased slightly in the TCM preparations j high-dose and middle-dose, having statistically significant difference (p<0.05).
TNBS-induced Crohn's disease is mainly Th1 cell-mediated, displaying the increased content of IFN-γ and IL-1, decreased or normal expression of IL-4 and IL-10. Decreased content of IFN-γ and IL-1 in rats of the TCM preparations j group at all doses showed that the TCM preparation had a certain therapeutic effect on TNBS-induced Crohn's disease. Mucosa Gln content in the model group was significantly lower than the one in the blank control group, indicating that TNBS could result in mucosa cell injuries. The TCM preparation j was able to increase mucosa Gln content in rats of model group, showing that the TCM preparation could be used for treating TNBS-induced Crohn's disease.
As shown in table 9 and
Compared with the blank control group, the serum content of IL-1 was increased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-1 was decreased clearly in the rats of positive control group, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-1 was decreased to a certain extent in the TCM preparations j high-dose, middle-dose and low-dose groups; especially the decreased degree in the rats of the high-dose group was most obvious (p<0.01).
Compared with the blank control group, the mucosa Gln content was decreased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the mucosa Gln content was all increased in the TCM preparations j high-dose, middle-dose, low-dose groups, of which the high-dose group had statistically significant difference (p<0.01).
Compared with the blank control group, the serum content of IL-4 was increased slightly in the model group, and did not have statistically significant difference. Compared the model group, there was not statistically significant difference in serum IL-4 content among the TCM preparations j high-dose, middle-dose and low-dose groups and the positive control group.
Compared with the blank control group, the serum content of IL-10 was decreased slightly in the model group, having statistically significant difference (p<0.05). Compared the model group, there was not statistically significant difference in serum IL-10 content among the TCM preparations j high-dose, middle-dose and low-dose groups and the positive control group
Compared with the TCM preparation j by intragastric administration, serum contents of IFN-γ, IL-1 and Gin were improved more obviously in the high-dose TCM preparation j by intracolonic administration, which was consistent with the result obtained in the DAI scores.
(3) Corresponding results of pathological indices
As shown in table 10 and
As shown in table 11 and
As shown in the research, both intragastric and intracolonic administration of the TCM preparation j was able to alleviate the symptoms of TNBS-induced Crohn's disease in rats, reduce increased amplitude of serum content of INF-γ and IL-1 and increase mucosa Gln content.
Trial example 6 prevention and treatment effect of the TCM preparation k on oxazolone-caused Crohn's disease rat model
1. Animals: SD rats, half male and female, weighing 180-220 g, were purchased from Animal center, Institute of Hygiene and Environmental Medicine, Academy of Military Medical Sciences of PLA with the certificate Number SCXK-2009-003.
2. Drug and reagent: mesalamine, used as positive drug, was provided by Tasly Pharmaceutical Group Co. Ltd. 5% OXZ was purchased from Sigma Inc. IFN-γ, IL-4 and Gln Elisa assay kits were purchased from bioswamp Inc. Stool occult blood assay kit was provided by Nanjing Jiancheng Bioengineering Institute.
3. Apparatus: AB135-S electronic analytical scale was purchased from Mettle Toledo Inc. Switzerland.
Grouping: the experiment was carried out by using two ways of intracolonic and intragastric administration. Hence, rats were divided into following groups: the blank control intragastric group, the model intragastric group the positive control intragastric group, the TCM preparation k high-dose intragastric group, the middle-dose intragastric group, the low-dose intragastric group, the blank control intracolonic group, the model intracolonic group, the positive control intracolonic group, the TCM preparation k high-dose intracolonic group, the middle-dose intracolonic group and the low-dose intracolonic group. There were 10 rats each group.
Method for establishing rat model: referring to the Heller method, OXZ was used to induce the SD rat Crohn's disease model (abbreviated as “OXZ model”). Neck and back skin of rats were shaved (2 cm×2 cm). Ethanol was used to prepare 5% (w/v) OXZ solution, and 0.3 ml resultant OXZ solution was dripped on the skin of rats. After the solution was air-dried naturally, skin allergy occurred in rats. The sensitized rats were adaptively raised for 5 days, clysterd and anesthetized by intraperitoneal injection of pentobarbital sodium. A latex tube with outer diameter of 2mm was inserted the anus 6-8 cm inside, through which 0.45 ml of 5% OXZ solution (w/v) was injected into the anus; the solution was prepared with 50% (v/v) ethanol. After completion, the rats were inverted by lifting tails for 60s to make the solution totally absorbed. Rats in the blank control group were treated by the same method with 50% (v/v) ethanol with no OXZ. If the rats manifested dark hair color, body weight loss, poor appetite, lassitude, watery stool or diarrhea, the model establishment was success.
Administration method: after successful model establishment by OXZ, the drug was given to rats. The TCM preparation k saline solutions at corresponding dose were administered to the groups of preparation k of all doses and the mesalamin saline solution, a positive drug, administrated to the positive control group. The rats of blank control group were normally fed, given with water and the same volume of normal saline was given in the same administration routes by referring to the dosage regime of aforesaid treatment groups. The rats of model group were administrated with the same volume of normal saline in the same administration routes. The dose of each group was as follows: mesalamin group at 100 mg/kg rat weight, the TCM preparation k high-dose group at 2.023 g raw medicine/kg rat weight, the middle-dose group at 1.012 g raw medicine/kg rat weight and the low-dose group at 0.506 g raw medicine/kg rat weight. In both intragastric and intracolonic routes, test drugs saline solution or normal saline were administrated in a ratio of 0.7 ml/100 g rat weight, once per day for 11 days consecutively. At 5th day after administration, 5% OXZ solution was given by the modeling method to the TCM preparation k high-dose, middle-dose and low-dose groups, the positive control group, the model group to establish model, and 50% ethanol was intrarectally given to the blank control group.
After being treated as disclosed above, the rats in each group were evaluated by following indices.
(1) General Indices: weight change and stool (e.g. stool occult blood, bloody stool and diarrhea) were observed every day to calculate DAI score.
DAI score=(weight loss percentage+defecate character fraction+hematochezia fraction)/3
(2) Serum indices: after final administration (on 11th day), the rats were fasted but given water. 24 hours later, blood was gained from abdominal aorta. Serum IFN-γ, IL-4, and Gln in intestinal mucosa were determined by ELISA in rats.
(3) Phathological indices: the colon of rats was taken out. The gross colon tissue damage was scored, followed by histopathological examination and scoring by conventional HE staining. The scoring criteria were seen in table 13.
Statistical analysis: Spss 17.0 statistical software was used to analyze above scores. Data were expressed as Mean±SD and t-test used for comparison between groups. P≦005 showed a statistically significant difference.
By intragastric administration or intracolonic administration, the results were seen following table 14-19.
(1) Results of general indices (DAI scores)
As shown in table 14 and
As shown in table 15 and
Compared with the TCM preparation k intracolonic group, intragastric administration of high-dose and middle-dose preparations k had stronger effect on improving DAI scores in rats.
(2) Corresponding results of serum indices
As shown in table 16 and
Compared with the blank control group, the serum content of IL-4 was increased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-4 was decreased clearly in the positive control group rats, having statistically significant difference (p<0.05). Compared the model group, the serum content of IL-4 was decreased to a certain extent in the TCM preparations k high-dose and middle-dose groups, having statistically significant difference (respectively p<0.01 and p<0.05).
Compared with the blank control group, the mucosa Gln content was decreased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the mucosa Gln content was all increased in the TCM preparations k high-dose, middle-dose, low-dose groups and model group, having statistically significant difference (respectively p<0.01, p<0.01 and p<0.05).
OXZ-induced Crohn's disease is mainly Th2 cell-mediated, displaying the increased content of IL-4, decreased or normal expression of IFN-γ. The TCM preparations k group at all doses could decrease the content of IL-4 in rats, showing that the TCM preparation had a certain therapeutic effect on OXZ-induced Crohn's disease. Mucosa Gln content in the model group was significantly lower than the one in the blank control group, indicating that OXZ could result in mucosa cell injuries. The TCM preparation k was able to increase mucosa Gln content in rats of model group, showing that the TCM preparation could be used for treating OXZ-induced Crohn's disease.
As shown in table 17 and
Compared the model group, no significant difference was found on the serum content of IFN-γ in the TCM formulations k high-dose, middle-dose and low-dose groups and positive control group.
Compared with the blank control group, the serum content of IL-4 was increased significantly in the model group, having statistically significant difference (p<0.01). Compared the model group, the serum content of IL-4 was decreased significantly in the positive control group, having statistically significant difference (p<0.05). Compared the model group, the serum content of IL-4 was decreased to a certain extent in the TCM preparations k high-dose, middle-dose and low-dose groups; especially having statistically significant difference in the rats of the high-dose and middle-dose groups (respectively p<0.05 and p<0.05).
Compared with the blank control group, the mucosa Gln content was decreased markedly in the model group, having statistically significant difference (p<0.01). Compared the model group, the mucosa Gln content was all increased to a certain extent in the TCM preparations k high-dose, middle-dose, low-dose groups, having no statistically significant difference.
Compared with the TCM preparation k by intragastric administration, serum content of IL-4 was improved more obviously in the high-dose TCM preparation k by intracolonic administration.
(3) Corresponding results of pathological indice
As shown in table 18 and
As shown in table 19 and
As shown in the research, both intragastric and intracolonic administration of the TCM preparation k were able to alleviate the symptoms of OXZ-induced Crohn's disease in rats, reduce increased amplitude of serum content of IL-4. Intracolonic administration of the TCM preparation k was able to produce a better improving effect than the intragastric.
| Number | Date | Country | Kind |
|---|---|---|---|
| 201310259296.4 | Jun 2013 | CN | national |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/CN2014/080812 | 6/26/2014 | WO | 00 |
