The Study of Syndrome Types of Traditional Chinese Medicine and Differential Gene Expression in Uremic Patients with Long-Term Hemodialysis

• Main Authors: CHEN CHIA-SHENG, 陳嘉聖
• Other Authors: Guang-Wei Chen, Jau-Geng Lin
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/37772405550917855875

博士 === 中國醫藥大學 === 中國醫學研究所 === 94 === The Study of Syndrome Types of Traditional Chinese Medicine and Differential Gene Expression in Uremic Patients with Long-Term Hemodialysis Chia-Sheng Chen Major professor: Guang-Wei Chen Institute of Chinese Medical Science, China Medical University The aim of this study was to explore the association between the Traditional Chinese medicine (TCM) differential syndrome types of uremic patients with long-term hemodialysis (HD) and etiology of uremia, level of dementia and serum biochemical parameters. In addition, differential gene expression between the cold Zheng (CZ) and non-cold Zheng (NCZ) of uremic patients with long-term hemodialysis was investigated by complementary DNA (cDNA) microarray technology. According to the syndrome types criteria of TCM in chronic renal failure, the total 169 HD patients were classified into the following six types. They are: Chi deficiency of Spleen and Kidney (CDSK), Yang deficiency of Spleen and Kidney (YDSK), Yin deficiency of Liver and Kidney (YDLK), deficiencies of Chi and Yin (DCY), deficiencies of Yin and Yang (DYY) and Non-deficiency (ND). Then we evaluated the Mini-mental status examination (MMSE) for these HD patients. Fasting blood (5 ml) was drawn from each HD patient before the dialysis session for biochemical analysis. Results showed that both YDSK and DYY types of HD patients were older, having longer dialysis times and lower MMSE scores than the other types of HD patients. There were no significant differences between the syndrome types of HD patients for their serum biochemical parameters, with the exception of lower levels of albumin and creatinine in YDSK and DYY types, which could result from malnutrition or chronic inflammation state. Moreover, Hemodialysis (HD) patients were randomly selected from the CZ and NCZ groups. The between-group differences in gene expression were assessed using the cDNA microarray. Differential gene expression was further validated by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Results demonstrated that the inflammation-associated genes, such as ALOX5AP, S100A8 and S100A12 were up-regulated, and the genes related to immunity (DEFA4), metabolism (GNG11, PYGB, PRKAR2B), and growth/proliferation (HSF2, DDR2, TK1) were down-regulated in the CZ group. The CZ HD patients had significantly lower serum albumin levels compared with their NCZ counterparts (3.31±0.08 g/dL versus 4.18±0.12 g/dL). In conclusion, the YDSK and DYY types of HD patients were older, having longer dialysis period, intelligence impairment and malnutrition. Up-regulated inflammatory-gene expression (ALOX5AP, S100A8 and S100A12) may play an important role in CZ HD patients. These results could be useful for TCM physicians as diagnosing and treating the patients. Key words: Classical differential diagnosis of Traditional Chinese Medicine (TCM), uremia, hemodialysis, intelligent impairment, Serum biochemical parameters, “Cold” Zheng, cDNA microarray; RT-PCR; Gene expression.