南方医科大学学报 ›› 2026, Vol. 46 ›› Issue (4): 880-889.doi: 10.12122/j.issn.1673-4254.2026.04.16
• • 上一篇
收稿日期:2025-10-24
出版日期:2026-04-20
发布日期:2026-04-24
通讯作者:
董健健
E-mail:senorita@ ahtcm.edu.cn;jjdong@ahtcm.edu.cn
作者简介:徐陈陈,主治医师,硕士,E-mail: senorita@ ahtcm.edu.cn
基金资助:
Chenchen XU(
), Yongsheng HAN, Nan CHENG, Jianjian DONG(
)
Received:2025-10-24
Online:2026-04-20
Published:2026-04-24
Contact:
Jianjian DONG
E-mail:senorita@ ahtcm.edu.cn;jjdong@ahtcm.edu.cn
Supported by:摘要:
目的 通过建立PKR沉默Wilson病模型毒牛奶(TX)小鼠,探讨通腑养髓治法(MGDD)通过PKR/eIF2α通路介导的突触损伤对TX小鼠认知功能的改善机制。 方法 将36只TX小鼠随机分为TX组、TX+MGDD组、C16组(PKR抑制剂干预组)及C16+MGDD组,9只/组。C16组与C16+MGDD组先腹腔注射PKR抑制剂C16(300 μg/kg,持续30 d),之后分别灌胃生理盐水或MGDD;TX组与TX+MGDD组则分别灌胃等体积生理盐水或MGDD,持续4周。行为学测试(巴恩斯迷宫与旷场实验)后取脑组织,进行免疫荧光、TUNEL染色、透射电镜(TEM)、RT-qPCR及Western blotting分析。 结果 行为学方面,与C16组相比,C16+MGDD组在边上路程减少(P<0.05),但在中央时间、中央路程、边上时间及目标洞口潜伏期等方面差异无统计学意义。免疫荧光显示,C16+MGDD组阳性细胞数较C16组减少,与TX+MGDD组相近;同时,MGDD治疗的TX小鼠在C16干预前后8-OHdG阳性细胞数差异无统计学意义。TEM观察显示,MGDD或C16干预均能增加突触与囊泡数量,改善突触膜结构清晰度,但MGDD联合C16未产生叠加效应。Western blotting结果显示,C16+MGDD组突触相关蛋白PSD93、PSD95、Synapsin1和Synaptophysin表达较C16组上调(P<0.05);与TX+MGDD组相比,除PSD93外,其余蛋白表达有差异(P<0.05)。在PKR/eIF2α通路方面,RT-qPCR显示C16+MGDD组Pkr、eIF2alpha等mRNA表达与C16组差异无统计学意义;Western blotting提示C16+MGDD组P-eIF2α与CHOP蛋白水平下降,而P-CREB上升,P-PKR与ATF4变化差异无统计学意义。 结论 通腑养髓治法可能通过抑制PKR/eIF2α通路活性,促进突触相关蛋白表达,改善突触结构与功能,从而缓解Wilson病TX小鼠的认知功能障碍。
徐陈陈, 韩永升, 程楠, 董健健. 通腑养髓治法通过抑制PKR介导的突触损伤改善Wilson病TX小鼠认知功能[J]. 南方医科大学学报, 2026, 46(4): 880-889.
Chenchen XU, Yongsheng HAN, Nan CHENG, Jianjian DONG. Modified Gandou Decoction improves cognitive function of TX mice with Wilson's disease by inhibiting the PKR/eIF2α pathway[J]. Journal of Southern Medical University, 2026, 46(4): 880-889.
图2 PKR抑制剂C16对TX小鼠海马PKR磷酸化的抑制作用
Fig.2 Inhibitory effect of C16, a PKR inhibitor, on phosphorylation of PKR in the hippocampus of TX mice. A: Gray-scale band images of phosphorylated PKR and total PKR in the hippocampus of mice. B: Expression levels of phosphorylated PKR and total PKR in the different groups quantified using Western blotting (Mean±SD, n=3). **P<0.01 vs TX group.
图3 PKR抑制背景下"通腑养髓"法对TX小鼠旷场实验中焦虑样行为的影响
Fig.3 Effect of the Modified Gandou Decoction (MGDD) on anxiety-like behaviors of TX mice in open field test. A: Distance traveled in the center zone. B: Time spent in the center zone. C: Distance traveled in the peripheral zone. D: Time spent in the peripheral zone (Mean±SD, n=3). *P<0.05, **P<0.01 vs TX group; #P<0.05 vs C16 group; &&P<0.05 vs TX+MGDD group.
图4 PKR抑制背景下"通腑养髓"法对TX小鼠巴恩斯迷宫空间学习记忆的影响
Fig.4 Effect of MGDD on spatial learning and memory of TX mice. A: Barnes maze test results showing latency to the entry zone of mice in each group. B: Time in the entry zone in each group. C: Representative trajectory of the mice in each group in the test. Data are presented as Mean±SD (n=3-6). *P<0.05, **P<0.01 vs TX group.
图5 PKR抑制背景下"通腑养髓"法对TX小鼠海马神经元凋亡的影响
Fig.5 Effect of the MGDD on the apoptosis of the hippocampus neurons in TX mice. A: Representative immunofluorescence staining images for TUNEL in the hippocampus of mice in each group. Green: TUNEL. Blue: DAPI. Scale bar=200 µm. B: The TUNEL-positive cells of hippocampal neurons in each group of mice (Mean±SD, n=3). **P<0.01 vs TX group; #P<0.05 vs C16 group.
图6 PKR抑制背景下"通腑养髓"法对TX小鼠海马氧化应激损伤的影响
Fig.6 Effect of MGDD on oxidative stress injury in the hippocampus of TX mice. A: Representative immunofluo-rescence staining images for 8-OHdG in the CA1 region of the hippocampus of mice in each group. Red: 8-OHdG. Blue: DAPI. Scale bar=200 µm. B: OHdG-positive cells in the CA1 region of the hippocampus of mice in each group (Mean±SD, n=3). **P<0.01 vs TX group; &P<0.05 vs TX+MGDD group.
图7 PKR抑制背景下"通腑养髓"法对TX小鼠海马突触超微结构的影响
Fig.7 Representative TEM images of synapses in the CA1 region of the hippocampus in each group of mice. The right-side images are enlarged versions of the black boxes on the left images, and the arrows indicate to synaptic vesicles and the pre- and post-synaptic membranes. Scale bars on the left represent 1 µm, and those on the right represent 500 nm.
图8 PKR抑制背景下"通腑养髓"法对TX小鼠海马突触相关蛋白表达的影响
Fig.8 Effect of MGDD on synapse-related protein in the hippocampus of TX mice. A: Gray-scale band images of PSD95, PSD93, Synapsin1, Synaptophysin and α-tubulin in the hippocampus of mice. B: Expression level of synapse-related protein quantified using Western blotting in the different groups (Mean±SD, n=3). **P<0.01 vs TX group; #P<0.05, ##P<0.05 vs C16 group; &P<0.05, &&P<0.05 vs TX+MGDD group.
图9 PKR抑制背景下"通腑养髓"法对TX小鼠海马PKR/eIF2α通路相关基因mRNA表达的影响
Fig.9 Effect of MGDD on PKR/eIF2α‑related mRNA in the hippocampus of TX mice. A-E: Relative expression levels of Pkr, eIF2a, Atf4, Chop and Creb mRNAs (Mean±SD, n=3). *P<0.05, **P<0.01 vs TX group; &P<0.05 vs TX+MGDD group.
图10 PKR抑制背景下"通腑养髓"法对TX小鼠海马PKR/eIF2α/CREB信号通路的关键蛋白表达及磷酸化水平的影响
Fig.10 Effect of MGDD on expression levels of key proteins and phosphorylation in the PKR/eIF2α/CREB signaling pathway in the hippocampus of TX mice. A: Gray-scale band images of PKR, P-PKR, eIF2α, P-eIF2α, CREB, P-CREB and α‑tubulin in the hippocampus of mice. B: Expression levels of phosphorylated protein or total protein. C: Gray-scale band images of ATF4, CHOP and α‑tubulin in the hippocampus of the mice. D: Expression levels of ATF4 and CHOP. Data are presented as Mean±SD (n=3). **P<0.01 vs TX group; ##P<0.05 vs C16 group; &P<0.05, &&P<0.05 vs TX+MGDD group.
| [1] | Rodriguez-Castro KI, Hevia-Urrutia FJ, Sturniolo GC. Wilson's disease: a review of what we have learned[J]. World J Hepatol, 2015, 7(29): 2859-70. doi:10.4254/wjh.v7.i29.2859 |
| [2] | Petruzzelli R, Catalano F, Crispino R, et al. Prion protein promotes copper toxicity in Wilson disease[J]. Nat Commun, 2025, 16(1): 1468. doi:10.1038/s41467-025-56740-x |
| [3] | Członkowska A, Litwin T, Dusek P, et al. Wilson disease[J]. Nat Rev Dis Primers, 2018, 4: 21. doi:10.1038/s41572-018-0018-3 |
| [4] | Wang LY, Wu LM, Wang TT, et al. Gandou Bushen decoction ameliorates cognitive impairment in Wilson disease model TX mice by regulating melatonin synthesis via the SIRT3/FOXO3α pathway[J]. J Sichuan Univ Med Sci Ed, 2025, 56(1): 102-11. |
| [5] | Wang X, Chen H, Zhang XY, et al. Therapeutic targets and natural product screening for cognitive impairments associated with ferroptosis in Wilson's disease[J]. Am J Chin Med, 2024, 52(8): 2423-52. doi:10.1142/s0192415x24500927 |
| [6] | 中华医学会神经病学分会神经遗传学组, 吴志英, 李洵桦, 等. 中国肝豆状核变性诊治指南2021[J]. 中华神经科杂志, 2021, 54(4): 310-9. doi:10.3760/cma.j.cn113694-20200826-00661 |
| [7] | Schilsky ML, Roberts EA, Bronstein JM, et al. A multidisciplinary approach to the diagnosis and management of Wilson disease: Executive summary of the 2022 Practice Guidance on Wilson disease from the American Association for the Study of Liver Diseases[J]. Hepatology, 2023, 77(4): 1428-55. doi:10.1002/hep.32805 |
| [8] | 中华医学会肝病学分会遗传代谢性肝病协作组, 段钟平, 郑素军, 等. 肝豆状核变性诊疗指南(2022年版)[J]. 中华肝脏病杂志, 2022(1): 9-20. doi:10.3760/cma.j.cn501113-20211217-00603 |
| [9] | Hu YY, Wei WB, Liu SY, et al. Changes in neurotransmitter metabolic profiles in copper-loaded rats as assessed by mass spectrometry imaging and the effect of Gandouling intervention[J]. Exp Neurol, 2025, 395: 115460. doi:10.1016/j.expneurol.2025.115460 |
| [10] | Kirk FT, Munk DE, Laursen TL, et al. Cognitive impairment in stable Wilson disease across phenotype[J]. Metab Brain Dis, 2021, 36(7): 2173-7. doi:10.1007/s11011-021-00804-6 |
| [11] | Ma Q, Ying M, Sui XJ, et al. Chronic copper exposure causes spatial memory impairment, selective loss of hippocampal synaptic proteins, and activation of PKR/eIF2α pathway in mice[J]. J Alzheimers Dis, 2015, 43(4): 1413-27. doi:10.3233/jad-140216 |
| [12] | Hugon J, Paquet C. The PKR/P38/RIPK1 signaling pathway as a therapeutic target in Alzheimer's disease[J]. Int J Mol Sci, 2021, 22(6): 3136. doi:10.3390/ijms22063136 |
| [13] | Xu CC, Liu SY, Cheng N, et al. PKR downregulation prevents copper-induced synaptic dysfunction and cognitive impairment in a murine model of Wilson's disease[J]. Front Neurosci, 2024, 18: 1447304. doi:10.3389/fnins.2024.1447304 |
| [14] | 刘松杨, 程 楠, 徐陈陈, 等. 肝豆汤改良方调控PKR/eIF2α通路改善Wilson病模型TX小鼠突触功能障碍的机制研究[J]. 安徽中医药大学学报, 2021, 40(6): 75-81. doi:10.3969/j.issn.2095-7246.2021.06.017 |
| [15] | 饶志红, 杨文明, 杨玉龙, 等. 肝豆状核变性“肝-肾-脑” 轴病机阐释及中医辨治策略[J]. 北京中医药大学学报, 2025, 48(9): 1270-7. |
| [16] | 钱南南, 杨文明, 魏涛华, 等. 肝豆状核变性伏毒阻络病因病机探要[J]. 中国实验方剂学杂志, 2022, 28(12): 133-40. |
| [17] | 杨任民, 韩咏竹, 任明山, 等. 中药治疗肝豆状核变性107例疗效观察[J]. 中医杂志, 1993, 34(11): 676-7. |
| [18] | 徐陈陈, 董健健, 程 楠, 等. 肝豆汤改良方对Wilson’s病模型TX乳鼠神经元内Cyt C/Caspase信号通路的分子调控机制[J]. 中国实验方剂学杂志, 2017, 23(6): 143-8. doi:10.13422/j.cnki.syfjx.2017060143 |
| [19] | 许子夜, 汪 瀚. 基于伏毒理论论治肝豆状核变性的治疗[J]. 临床医学进展, 2025, 15(4), 2002-8. doi:10.12677/acm.2025.1541147 |
| [20] | 徐陈陈. Wilson病炎症因子表达谱及肝豆汤改良方对TX小鼠神经元Cer信号通路调控机制的研究[D]. 合肥: 安徽中医药大学, 2017. |
| [21] | 杨任民. 肝豆状核变性[M]. 北京: 人民卫生出版社, 2015. |
| [22] | Shanaki Bavarsad M, Spina S, Oehler A, et al. Comprehensive mapping of synaptic vesicle protein 2A (SV2A) in health and neurodegenerative diseases: a comparative analysis with synaptophysin and ground truth for PET-imaging interpretation[J]. Acta Neuropathol, 2024, 148(1): 58. doi:10.1007/s00401-024-02816-9 |
| [23] | Yan PP, Liu HC, Zhou T, et al. Crosstalk of Synapsin1 palmitoylation and phosphorylation controls the dynamicity of synaptic vesicles in neurons[J]. Cell Death Dis, 2022, 13(9): 786. doi:10.1038/s41419-022-05235-4 |
| [24] | De Los Reyes DA, Karkoutly MY, Zhang YH. Synapse-associated protein 102-a highly mobile MAGUK predominate in early synaptogenesis[J]. Front Mol Neurosci, 2023, 16: 1286134. doi:10.3389/fnmol.2023.1286134 |
| [25] | Fan X, Wang H, Ping JC, et al. Synaptic scaffold protein PSD-95: a therapeutic target for Alzheimer's disease[J]. Biochem Pharmacol, 2025, 242(Pt 3): 117401. doi:10.1016/j.bcp.2025.117401 |
| [26] | Chung WS, Welsh CA, Barres BA, et al. Do Glia drive synaptic and cognitive impairment in disease[J]? Nat Neurosci, 2015, 18(11): 1539-45. doi:10.1038/nn.4142 |
| [27] | Hu J, Hua Y, Li CQ, et al. cTBS enhanced synaptic plasticity in the affected and unaffected motor cortex after cerebral ischemia via astrocyte-mediated TSP1 pathway[J]. Exp Neurol, 2025, 393: 115409. doi:10.1016/j.expneurol.2025.115409 |
| [28] | Kleidonas D, Kirsch M, Andrieux G, et al. Microglia modulate TNFα-mediated synaptic plasticity[J]. Glia, 2023, 71(9): 2117-36. doi:10.1002/glia.24383 |
| [29] | Greenough MA, Camakaris J, Bush AI. Metal dyshomeostasis and oxidative stress in Alzheimer's disease[J]. Neurochem Int, 2013, 62(5): 540-55. doi:10.1016/j.neuint.2012.08.014 |
| [30] | Mouton-Liger F, Paquet C, Dumurgier J, et al. Oxidative stress increases BACE1 protein levels through activation of the PKR-eIF2α pathway[J]. Biochim Biophys Acta BBA Mol Basis Dis, 2012, 1822(6): 885-96. doi:10.1016/j.bbadis.2012.01.009 |
| [31] | Wang Q, Wang ZW, Li YT, et al. Baicalein improves motor dysfunction and cognitive impairment while promoting remyelination in an animal model of multiple sclerosis through the antioxidant mechanism[J]. Front Pharmacol, 2025, 16: 1659631. doi:10.3389/fphar.2025.1659631 |
| [32] | Liu XQ, Deng YX, Dai Z, et al. Sodium tanshinone IIA sulfonate protects against Aβ1-42-induced cellular toxicity by modulating Aβ-degrading enzymes in HT22 cells[J]. Int J Biol Macromol, 2020, 151: 47-55. doi:10.1016/j.ijbiomac.2020.02.040 |
| [33] | Chen CW, Papadopoli D, Szkop KJ, et al. Plasticity of the mammalian integrated stress response[J]. Nature, 2025, 641(8065): 1319-28. doi:10.1038/s41586-025-08794-6 |
| [34] | Costa-Mattioli M, Walter P. The integrated stress response: From mechanism to disease[J]. Science, 2020, 368(6489): eaat5314. doi:10.1126/science.aat5314 |
| [35] | Sharma V, Sood R, Khlaifia A, et al. eIF2α controls memory consolidation via excitatory and somatostatin neurons[J]. Nature, 2020, 586(7829): 412-6. doi:10.1038/s41586-020-2805-8 |
| [36] | Wek RC, Jiang HY, Anthony TG. Coping with stress: eIF2 kinases and translational control[J]. Biochem Soc Trans, 2006, 34(Pt 1): 7-11. doi:10.1042/bst0340007 |
| [37] | Kolac UK, Goker Bagca B, Donmez Yalcin G, et al. Thymoquinone attenuates poly(I: C)-induced cellular stress via PKR/ATF4/CHOP signaling and autophagy modulation in human alveolar epithelial cells[J]. Toxicol In Vitro, 2025, 111: 106165. doi:10.1016/j.tiv.2025.106165 |
| [38] | Martínez NW, Gómez F, Tapia-Godoy A, et al. PKR-driven ISR signaling controls synaptic translation and structural plasticity in an age-dependent manner[J]. Neurobiol Dis, 2025, 216: 107113. doi:10.1016/j.nbd.2025.107113 |
| [39] | Feng WJ, Lv CH, Cheng L, et al. Targeting ERS-mitophagy in hippocampal neurons to explore the improvement of memory by tea polyphenols in aged type 2 diabetic rats[J]. Free Radic Biol Med, 2024, 213: 293-308. doi:10.1016/j.freeradbiomed.2024.01.044 |
| [40] | You CC, Zhang ZL, Ying HY, et al. Blockage of calcium-sensing receptor improves chronic intermittent hypoxia-induced cognitive impairment by PERK-ATF4-CHOP pathway[J]. Exp Neurol, 2023, 368: 114500. doi:10.1016/j.expneurol.2023.114500 |
| [41] | Wang YH, Wu D, Li DN, et al. The role of PERK-eIF2α‑ATF4-CHOP pathway in sevoflurane induced neuroapoptosis and cognitive dysfunction in aged mice[J]. Cell Signal, 2023, 110: 110841. doi:10.1016/j.cellsig.2023.110841 |
| [42] | Jiang ZH, Belforte JE, Lu Y, et al. eIF2alpha Phosphorylation-dependent translation in CA1 pyramidal cells impairs hippocampal memory consolidation without affecting general translation[J]. J Neurosci, 2010, 30(7): 2582-94. doi:10.1523/jneurosci.3971-09.2010 |
| [43] | Li YF, Cheng YF, Huang Y, et al. Phosphodiesterase-4D knock-out and RNA interference-mediated knock-down enhance memory and increase hippocampal neurogenesis via increased cAMP signaling[J]. J Neurosci, 2011, 31(1): 172-83. doi:10.1523/jneurosci.5236-10.2011 |
| [44] | Smith SG, Haynes KA, Hegde AN. Degradation of transcriptional repressor ATF4 during long-term synaptic plasticity[J]. Int J Mol Sci, 2020, 21(22): 8543. doi:10.3390/ijms21228543 |
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