Effect Of Chinese Angelica Decoction On Late-phase Reaction Of Chronic Urticaria

1 ObjectiveSince the research about chronic urticaria(CU) mainly concentrated on the early-phase reaction (EPR)of it and the study about the effect of Chinese herb on the late-phase reaction(LPR) of CU was almost blank in the past, this topic research the functional mechanism of Chinese herb on CU in respect to inhibiting the late-phase reaction(LPR) for the first time. This topic research the inhibitory effect of Chinese Angelica Decoction(CAD) on LPR of CU and leukotriene B4 which is a very important inflammatory mediator in the LPR of CU. This topic will expand new treatment and research method for CU at the angle of anti-inflammation.2 Method2. 1 Literature investigationThe literature on chronic urticaria(CU) was summarized in order to systematically fathom the current situation of CU. The literature investigation indicates that the foundational research of Chinese herb on CU is scarce, and especially the research about Chinese herb on late-phase reaction of CU is almost blank.2. 2 Clinical studyAdopting the rule of single blind , random and contrast , 120 cases were divided into four groups ,group A taking Chinese angelica decoction, group B taking Mizolastine, group C taking Montelukast, and group D taking loratadine. Compare the early curative effect, prostecdtive efficacy, relapse rate and the serum level of leukotriene B4 in the four groups.2. 3 Experimental study2.3.1 Mice passive cutaneous anaphylaxis test(PCA)Adopting the rule of random and contrast, sensitized NIH mice were divided into seven groups, the sensitized control group (group A), high-dose group of CAD(group B), low-dose group of CAD(group C), mizolastine group(group D), montelukast group(group E), loratadine group(group F), dexamethasone group(group G). PCA was induced by intraperitoneal antiserum injection. And the mice were treated with gastric infusion simultaneously. 30 minutes Later after the last feeding, antigen attack was conducted. Then these mice were executed, their blood was collected, and the sensitized section of skin was cutted. Inhibitory rate of PCA in seven groups were measured by colorimetric determination. The serum level of LTB4 was detected by ELISA method. Correlation between inhibitory rate of PCA and serum level of leukotriene B4 was measured.2. 3. 2 Inhibition test on release of leukotriene B4 from spleen lymphocytes of sensitized miceAdopting the rule of random and contrast, BALB/c mice were divided into normal control group and sensitized control group. The sensitized group was divided into eight groups, the sensitized control group (group A),DMSO group(group B), high-dose group of CAD(group C), low-dose group of CAD(group D), mizolastine group(group E), montelukast group(group F), loratadine group(group G), dexamethasone group(group H).Mice were sensitized by intraperitoneal injections of OVA. The spleen lymphocytes were isolated and lymphocytes concentration was regulated with cell culture solution. Then the spleen lymphocytes were incubated with drug solution above-mentioned prior to antigen re-attack with OVA. ELISA was applied to detect the level of LTB4 in cell culture supernate in every group.3 Results3.1 Clinical studyStatistic analysis indicated that no difference of early curative effect was found among Chinese angelica decoction(A), mizolastine(B) andloratadine(D) (P>0. 05) . The early curative effect of montelukast (C) was lower than other three groups (P<0. 05).In the follow-up visits in 4 weeks and 8 weeks, there was no significant difference among group A, B and C in respect to prostecdtive efficacy and relapse rate(P>0. 10). The prostecdtive efficacy of group D was lower and the relapse rate of group D was higher than group A, B, C(P<0.05).The relapse interval of group A, B and C was obviously longer than group D(P<0. 05).The prior-treatment serum level of leukotriene B4 of every group was significantly higher than that of normal control group (P<0. 001). After 4 weeks treatment, the post-treatment serum level of group A and B degraded to be statistically similar to normal control group(P>0. 25) and was significantly lower than prior-treatment (P<0. 001). The post-treatment serum level of group C was lower than prior-treatment(P<0. 05). The descent extent of group C was less than group A and B(P<0. 05). There was no statistically difference between prior-treatment and post-treatment serum level of LTB4 of group D(P>0. 50).3. 2 Experimental study3.2.1 Mice passive cutaneous anaphylaxis test(PCA)Group B, C, D, E, F and G could significantly inhibit PCA in mice(P<0. 001). The inhibitory rate of dexamethasone(group G) was strongest among all groups(P<0.001). The inhibitory effect of group B, D, F was statistically similar(P > 0. 50). The inhibitory effect of group C, E was statistically similar (P>0. 50) and inferior to group B, D, F(P<0. 001).The serum level of LTB4 in group B, C, D,E,G was significantly lower than that of group A(sensitized control group) and group F(P<0. 01). The serum level of LTB4 in group B(high-dose) was significantly lower than group C (low-dose)(P<0. 05).Statistic analysis indicated that the inhibitory rate of group B, C, D, G was in linear negative correlation to the serum level of LTB4 respectively (P<0. 05). While the inhibitory rate of group E, F was not in linear negative correlation to the serum level of LTB4.3.2.2 Inhibition test on release of leukotriene B4 from spleen lymphocytes of sensitized miceThe release level of LTB4 of sensitized control group(group A) was significantly higher that of normal control group(P<0.001).Group B, F, G could not inhibit the release of LTB4 from spleen lymphocytes. Group B, F, G was statistically similar to group A in release level of LTB4(P >0. 50). Group. C.D.E.H could significantly inhibit the release of LTB4 from spleen lymphocytes. The release level of LTB4 in group C, D, E, H differed statistically from group A, B(P<0. 01). The inhibitory effect of group H was stronger than group C, D, E(P<0. 05). Meanwhile,the inhibitory effect of group C was superior to group D,E(P<0. 05).4 ConclusionChinese angelica decoction(CAD) is a effective complex prescription for chronic urticaria(CU). The early curative effect, prostecdtive efficacy of CAD was significant. CAD could degrade the relapse rate of CU and prolong the relapse interval. CAD could inhibit LTB4 which is a very important inflammatory mediator in the late-phase reaction(LPR) of CU.The inhibitory effect on LTB4 of CAD was in a dose-dependent manner.A conclusion can be drawn that Chinese angelica decoction can inhibit the late-phase reaction of chronic urticaria. The inhibition on LTB4 is one kind of functional mechanism to explain the curative effect of CAD.