含砷中药复方青黄散对骨髓增生异常综合征患者骨髓细胞自噬的调控

Autophagy is an important self degradation pathway in cells. It plays an important role in the occurrence and development of tumors. In vivo and in vitro experiments, autophagy inhibitors combined with chemotherapy drugs can inhibit tumor formation and induce cell death more than chemotherapy alone. Autophagy regulation may represent a new therapeutic target. In the field of MDS therapy, autophagy has been paid more and more attention by researchers, and it has been suggested that autophagy may play an important role in the progression of MDS disease and AML transformation. Arsenic trioxide (As2O3), which is approved by FDA for the treatment of MDS, is able to exert anti-tumor effects by regulating autophagy. Arsenic containing Chinese herbal compound Qinghuang powder (active ingredient As2S2) treatment of MDS curative effect, convenient use, high safety, its mechanism is not completely clear. In this study, patients with MDS before and after oral administration of compound Qinghuang powder, autophagic activity by flow cytometry, qRT-PCR, Western Blot detection and analysis of bone marrow mononuclear cells, so as to understand the compound of MDS in bone marrow cells of patients with Qinghuang powder autophagy regulation and its mechanism, provide new ideas for the study of the mechanism of arsenic in oral medicine.

自噬是细胞内一条重要的自降解途径，参与细胞的发育、分化、衰老和死亡等生理过程，在肿瘤的发生发展中也起着重要的作用。在体内外实验中，自噬抑制剂结合化疗药物比单独使用化疗药物能更大程度抑制肿瘤生成及引起细胞死亡，自噬调控可能代表了一个新的治疗靶点。在MDS治疗领域，自噬也日渐受到研究者们的重视，现有研究表明，自噬可能在MDS疾病进展和向AML转化中起了重要作用。作为FDA批准用于MDS治疗的注射用亚砷酸（As2O3），即能够通过调节自噬发挥抗肿瘤作用。含砷中药复方青黄散（有效成分As2S2）治疗MDS疗效确切、服用方便、安全性高，其作用机理尚未完全明确。本研究将在MDS患者口服复方青黄散前后，应用流式细胞仪、qRT-PCR、Western Blot检测和分析骨髓单个核细胞的自噬活性，从而了解复方青黄散对MDS患者骨髓细胞自噬的调控及其机制，为口服含砷中药的机理研究提供新思路。

自噬是细胞内一条重要的自降解途径，参与细胞的发育、分化、衰老和死亡等生理过程，在肿瘤的发生发展中也起着重要的作用。在MDS治疗领域，自噬也日渐受到研究者们的重视，现有研究表明，自噬可能在MDS疾病进展和向AML转化中起了重要作用。含砷中药复方青黄散（有效成分As2S2）治疗MDS疗效确切、服用方便、安全性高，其作用机理尚未完全明确。.研究结果显示，不同预后的MDS患者存在不同的自噬水平，MDS患者自噬水平显著降低，提示疾病预后差以及疾病进展。复方青黄散治疗MDS的疗效与其调节自噬具有相关性，自噬调控可以作为MDS患者对复方青黄散治疗反应的预测指标。MDS不同中医证型具有自噬水平的变化，提示MDS自噬活性、自噬相关基因以及自噬蛋白表达水平，反应了中医证型的生物学基础。调节自噬水平是复方青黄散治疗MDS的重要机制。

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