摘要:
目的:观察经控制释放材料纳米柔性纳米脂质体制成的外用甲氨蝶呤对类风湿性关节炎大鼠血清γ-干扰素和白细胞介素4的影响.方法:实验于2005-03/11在中南大学湘雅医院中西结合研究所完成.80只健康的SD大鼠随机分为5组:正常组10只,其余γ0只大鼠采用皮下注射牛Ⅱ型胶原和完全福氏佐剂制备类风湿性关节炎模型,再随机分为模型组10只,0.5%甲氨蝶呤组20只;0.25%甲氨蝶呤柔性纳米脂质体组20只,0.5%甲氨蝶呤柔性纳米脂质体组20只.正常对照组大鼠自由饮水,模型组每天灌服1.5 mL蒸馏水,其余各组于初次免疫7 d后给药,于大鼠右后足分别涂抹0.5%甲氨蝶呤外敷剂、0.25%和0.5%甲氨蝶呤柔性纳米脂质体,约2.0~4.0 g/只(视关节大小而定),每周一次.采用关节炎指数积分法评定关节症状,关节指数积分越高,关节症状越严重.给药后第45天采用酶联免疫吸附法检测各组大鼠血清γ-干扰素和白细胞介素4水平.结果:纳入大鼠80只,均进入结果分析.①各组大鼠关节炎指数积分给药前14 d无明显区别,模型组随着时间延长,关节炎指数积分增加;0.5%甲氨蝶呤组、0.25%甲氨蝶呤柔性纳米脂质体组和0.5%甲氨蝶呤柔性纳米脂质体组于给药后25 d达高峰,但仍低于模型组(分别为1.51±0.99,0.98±0.57,0.88±0.49,1.68±1.24,t=2.956,5.461,5.244,P<0.01).②给药后45 d模型组、0.5%甲氨蝶呤组、0.25%甲氨蝶呤柔性纳米脂质体组和0.5%甲氨蝶呤柔性纳米脂质体组γ-干扰素水平明显高于正常对照组,白细胞介素4水平明显低于正常对照组[γ-干扰素分别为(120.75±1.43),(104.41±1.71),(88.75±1.58),(83.60±1.86),(56.15±2.07)ng/L,t=-64.016,-67.970,-36.928,-48.092,P<0.01;白细胞介素4分别为(23.28±0.13),(36.45±0.15),(46.46±0.16),(48.47±0.12),(61.23±0.27)ng/L,t=398.098,328.973,179,924,186.796,P<0.01].0.5%甲氨蝶呤组、0.25%甲氨蝶呤柔性纳米脂质体组和0.5%甲氨蝶呤柔性纳米脂质体组γ-干扰素水平明显低于模型组(t=21.387,46.365,43.639,P<0.01),白细胞介素4水平明显高于模型组(t=-238.74,-514.575,-385.096,P<0.01).0.25%甲氨蝶呤柔性纳米脂质体组和0.5%甲氨蝶呤柔性纳米脂质体组γ-下扰素水平明显低于0.5%甲氨蝶呤组(t=36.581,30.124,P<0.01),自细胞介素4水平明显高于0.5%甲氨蝶呤组(t=-282.406,-203.685,P<0.01).0.25%甲氨蝶呤柔性纳米脂质体组γ-干扰素和白细胞介素4与0.5%甲氨蝶呤柔性纳米脂质体组相比,无显著差异(P>0.05).结论:外用甲氨蝶呤柔性纳米脂质体通过其智能控制释放效应,下凋血清γ-干扰素及上调血清白细胞介素4水平的作用明显优于普通外用甲氨蝶呤.