抗風濕中藥對細胞激素刺激類風濕滑膜細胞凋亡 ( Apoptosis ) 之影響

周昌德 
中國醫藥學
類風濕關節炎是一自體免疫病,近年來研究已瞭解許多不同組織細胞包括滑膜,關節液中之類纖維細胞及中性白血球易出現細胞凋亡之現象 ( Apooptosis )而細胞凋亡可能是自體免疫病發病之重要機轉,而 Fas 抗原在細胞表現增加或DNA 斷裂增加可反映出細胞是否凋亡. 類風濕關節炎 ( RA ) 傳統仍使用西藥之非類固醇發炎劑 ( NSAID ) 及第二線藥物包括類固醇等免疫抑制劑.而中藥治療 RA 物類相當繁多, 在本人及國外研究顯示雷公藤及疏筋活血湯, 麻杏薏甘湯, 獨活寄生湯等皆有臨床療效, 但是以雷公藤作用快且效用強, 其它中藥在體外實驗其抑制前列腺素及 IL - 2 需相當高濃度才有效. 本研究已採用先前已證實具有抗風濕免疫中藥, 包括雷公藤, 薏以仁湯, 麻杏薏甘湯與西藥Dexamethason 及 Cyclosporin 在體外對從 RA 分離之類纖維細胞 ( 在細胞激素刺激下 ) 以 Flowcytometry 去測定 Fas 抗原表現.另以 H 細胞 D NA斷裂法, 同時瞭解中藥對 RA 滑膜細胞 Fas 表現之影響.此可提供為來中藥治療 RA 有效是否經由對 Apoptosis 影響所造成.
關鍵字：中藥 , 滑膜細胞 , 風濕免疫病 , Fas 抗原

The effect of anti - rheumatic herbs on cytokine - induced apoptosis of rheumatoid synovium

Chung - Tei Chou 
China Medicial College Hospital
Rheumatoid arthritis ( RA ) is an autoimmune disease. In recent ye - ars different tissues including synovium or neutrophils from rheum - atoid joints showed apoptosis. The apoptosis may be the import mec - hanism to develop the auto immune diseases. To know the apoptosis can be taken by the enhanced Fas antigen expression or nuclear DNA fra - gmentation. So far, the main treatment for RA is nonsteroid antiin - flammatory drugs ( NSAID ) and the 2nd line drugs including steroid and o ther immunosuppressive agents. Reports from Mainland China and myself showed Triptergium ( T2 ), Su - Ching - Hao - Hsuei - Tang , Ma - Sin - I - Gan - Tang and Du - Ho - Gi - Sen - Tang etc had cl - inical efficacy for RA or other rheumatic diseases. Th e T2 gave a good and strong clinical response and inhibition of prostaglandin ( PG ) and IL - 2 with a low concentration. However, other anti - rh - eumatic herbs require a very high concentration ( 200 - 500 ug / ml ) herbs and steroid or cyclosporin to s
關鍵字：Herb, Synovial lining cell, Rheumatic and Immune diseases Fas antigen \