人參與pravastatin sodium於純系小鼠之馬兜鈴酸引起腎炎模型的藥效評估及人參成分之含量分析

Effect of ginseng and pravastatin sodium on aristolochic acid-induced nephropathy in inbred mice and quantitative analysis of ginsenoside in ginseng extract

林珮瑜(Pei-Yu Lin)

指導教授 ： 陳世銘

臺北醫學大學/藥學院/藥學研究所/碩士(2009年)

摘要

馬兜鈴酸 (aristolochic acid, AA) 在中草藥引起的腎病變中扮演重要的角色。本研究的目的藉由投予AA引起之馬兜鈴酸腎病變 (aristolochic acid nephropathy, AAN)，評估人參濃縮劑 (ginseng extrat, GE)、pravastatin sodium (P) 及兩者併用對AAN的改善效果。同時也利用High Performace Liquid Chromatography (HPLC) 針對人參的主要活性物質－人參皂苷Rg1，Rd，Rb1－進行含量分析。
給予純系小鼠C3H/He (6 week-old male) 3.0 μg/mL AA當飲用水連續56天，之後治療組分別經口投予GE 250mg/kg、pravastatin sodium 20mg/kg以及GE 250mg/kg合併pravastatin sodium 20mg/kg (GE+P) 連續14天，對照組則投予等量蒸餾水，Normal組則全程給予蒸餾水。藉由測定尿蛋白、尿中N-acetyl-beta-D-glucosaminidase (NAG) 與血中blood urea nitrogen (BUN) 及creatinine，以評估小鼠腎功能；腎組織使用PAS染色觀察病理組織改變，並進行免疫螢光染色 (TGF-β，MMP-9，HGF)，以辨識損傷部位之特異性抗原。
本實驗選用ODS (Octadecylsilyl；C18) 作為層析管柱，測定波長為203 nm，以乙腈 (acetonitrile) 與水的混合液作為移動相，流速為1 ml/min，GE 在乙腈-水30:70的移動相條件下可分離出人參皂苷Rd及Rb1，乙腈-水20:80則可分離出人參皂苷Rg1。
實驗結果顯示，投予GE 250 mg/kg，P 20mg/kg及GE+P之治療組的尿蛋白、NAG、BUN、Scr值都有降低；組織學及免疫螢光染色觀察發現腎組織損傷的情形皆有緩解。含量分析的結果顯示，GE中皂苷含量之依序為人參皂苷Rb1 > Rg1 > Rd。根據上述結果發現，治療藥物之療效依序為GE+P ≧ GE ≧ P，分析結果也證實人參中確實含有活性成分人參皂苷。總結來說，人參濃縮劑、pravastatin以及兩者合併使用對於馬兜鈴酸所造成的腎臟損傷皆有一定的治療效果。

關鍵字

馬兜鈴酸腎病變；人參皂苷Rb1，Rd，Rg1；pravastatin sodium；乙型轉型生長因子；基質金屬蛋白分解酶；肝細胞生長因子；HPLC (High Performance Liquid Chromatography)

並列摘要

Aristolochic acid (AA) has been demonstrated to play a crucial role in Chinese herbs nephropathy. The purposes of this study were to evaluate the therapeutic effect of ginseng extrat (GE), pravastatin sodium (P) and GE combined with pravastatin on AA-induced nephropathy and to quantitatively determine the contents of three ginsenosides-Rg1, Rd, Rb1 -in GE using high performance liquid chromatography (HPLC).
AA was dissolved in distilled water (3μg/ml) as drinking water to C3H/He mice (6 week-old male) for 56 days. The treatment groups were administered orally with GE 250 mg/kg, pravastatin sodium 20 mg/kg and GE 250 mg/kg combined with pravastatin sodium 20 mg/kg (GE+P) once daily for 14 days. The control group was administered with distilled water. The normal group was only administered with distilled water throughout the experiment.
Urine protein (UP), urine N-acetyl-beta-D-glucosaminidase (NAG), blood urea nitrogen (BUN) and serum creatinine (Scr) were determined to evaluate renal function. Renal tissues were served to histological examination (PAS stain and immunofluorescence). The antibodies, including TGF-β (transforming growth factor-β), MMP-9 (matrix metalloproteinase-9), and HGF (hepatocyte growth factor), were chosen to recognize the specific antigens in injury sites.
ODS (Octadecylsilyl；C18) column was used for analyzing ginsenosides in GE with detection at 203 nm. Ginsenosides Rd and Rb1 were separated with acetonitrile-water (30:70) as the mobile phase, while ginsenoside Rg1 was separated under acetonitrile-water (20:80). Flow rate was 1 ml/min.
Compared with the control group, urine protein, NAG, BUN, serum creatinine were decreased in the treatment groups. Among all treatment groups, we observed alleviation in the histological examination, decreased staining intensity of TGF-β and increased intensity of MMP-9 and HGF within the injury tissues. The overall therapeutics efficacy of the treatment was as followed: GE+P ≧ GE ≧ P. Based on quantitative analysis, the contents of three ginsenosides in GE was as followed: Rb1 > Rg1 > Rd. In conclusion, our study demonstrates that GE 250 mg/kg alone use, pravastatin 20 mg/kg alone use and GE 250 mg/kg combined with pravastatin 20 mg/kg can beneficially improve the renal outcomes of AAN.

並列關鍵字

Aristolochic acid nephropathy (AAN)；ginsenoside Rb1, Rd, Rg1； pravastatin sodium；TGF-β (transforming growth factor-β)；MMP-9 (matrix metalloproteinase-9)；HGF (Hepatocyte Growth Factor)； HPLC (High Performance Liquid Chromatography)

參考文獻

1. Vanherweghem JL, Depierreux M, Tielemans C, Abramowicz D, Dratwa M, Jadoul M, Richard C, Vandervelde D, Verbeelen D, Vanhaelen-Fastre R, Vanhaelen M. Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Lancet 1993; 341(8842): 387-391.

2. Arlt VM, Stiborova M, Schmeiser HH. Aristolochic acid as a probable human cancer hazard in herbal remedies: a review. Mutagenesis 2002; 17(4): 265-277.

3. Lee S, Lee T, Lee B, Choi H, Yang M, Ihm CG, Kim M. Fanconi's syndrome and subsequent progressive renal failure caused by a Chinese herb containing aristolochic acid. Nephrology 2004; 9(3): 126-129.

4. Tsai CS, Chen YC, Chen HH, Cheng CJ, Lin SH. An unusual cause of hypokalemic paralysis: aristolochic acid nephropathy with Fanconi syndrome. American Journal of the Medical Sciences 2005; 330(3): 153-155.

5. Laing C, Hamour S, Sheaff M, Miller R, Woolfson R. Chinese herbal uropathy and nephropathy. Lancet 2006; 368(9532): 338.