Enhancement Of Megakaryocyte Proliferation Under Water Extract Of Agrimonia Pilosa Ledeb On Cytotoxic Agents-induced Thrombocytopenia And Its Clinical Observation

Objective To observe the platelet recovery under water extract of agrimonia pilosa ledeb (APL) in mouse with cyclophosphamide-induced thrombocytopenia and the use of TAX and EPI chemotherpy of patients with breast cancer,as well as the expression levels of bone marrow factor IL-1a;IL-3;IL-6;IL-11,TPO mononuclear cells mRNA in mice and patients, analyze the effects of the water extract of APL on treatment of thrombocytopenia after chemotherapy and explore its mechanism of action.Methods 1.144 healthy mice were randomly divided into 6 groups comprising blank group,model group,the rhIL-11 threatment group,low-dose group of Chinese medicine, middling-dose group of Chinese medicine and high-dose group of Chinese medicine. Cyclo-phosphamide was used to product the model of thrombocytopenia,and the rhIL-11 and medicine was used after the success,the platelet count was observed at the 7th,14th and 21st day.the area and megakaryocyte counts of product were observed by pathological method.The IL-1a,IL-3,IL-6,IL-11 and TPO mRNA expressions of the bone marrow mononuclear cells were observed through RT-PCR method.2.82 breast cancer cases comparing thrombocytopenia were selected,all were using TAX and EPI chemotherapy and divided randomly into APL water extract group,rhIL-11 group and the blank group,APL water extract was used in observing group,the rhIL-11 was used in comparing group and nothing was used in blank group,the patients were observed with peripheral blood platelet count level,the average time of raising peripheral blood platelet count to 100×10~9/L and IL-1α,IL-3,IL-6,IL-11 and TPO content in peripheral blood were detected by ELISA method.Results PartⅠAnimal Experiments1.The platelet count of rhIL-11 group and high dose group was significantly higher than model group in the 14th days(P＜0.01).The platelet count of rhIL-11 group and all APL water extract group was significantly higher than model group in the 21th days(P＜0.01).2.All of the groups of rhIL-11and APL water extract group were higher than model on the hematopoietic capacity in the 14th and 21st days.There is no significant differences in the 14th days(P＞0.05),and the rhIL-11 group and high,middling dose of APL water extract group was significantly higher than model group in the 21 th days(P＜0.01).3.The group numbers megakaryocytic after treatment were higher than the model group in the 14th,21st days(P＜0.01).4.IL-1α,IL-3,IL-6,IL-11,TPO expression:4.1 The expression of IL-1αwas no significant difference.4.2 The expressions of IL-3 of Chinese medicine in each group were higher than the blank group,model group,and rhIL-11 group after treatment on the 14th day.The high and middle APL water extract groups were significantly increased than the blank group,model group,and rhIL-11 group on the 21st day.4.3 The IL-6 expression in each group of traditional Chinese medicine were lower than the blank,model,and rhIL-11 group,but there was no significant difference(P＞0.05).4.4 The expression of IL-11 of Chinese medicine in each group were higher than the blank group,model group,and rhIL-11 group after treatment.4.5 The expression of TPO of middle,high-dose group was higher than model group at the 14th day(P＜0.01).Each Chinese medicine group higher than the blank group at the 21st day(P＜0.01),middle and high-dose group higher than model group(P＜0.01),low-dose group higher than model group at the 21st day(P＜0.05).PartⅡClinical Observation1.The platelet count of each group were higher than before treatment.The observation group compared with blank group(P＜0.05),the rhIL-11 group compared with the blank group (P＜0.01).2.The number of days of under 100×10~9/L for the observation group,the rhIL-11 group were less than the blank(P＜0.01).3.After treatment the level of IL-1αwere decreased after treatment.4.The level of IL-3 of the observation group,the blank group were higher than before treatment,there was significant different in each group(P＜0.01).5.The level of IL-6 of the rhIL-11 group and the blank group after treatment were higher than before,the observation group was decline.The observation group,blank group compared with rhIL-11 group(P＜0.01),There was no difference compared to the blank group and observation group.6.The level of IL-11 of all groups was higher than before the treatment,there was significant different in each group(P＜0.01).7.The level of TPO has increased after treatment in each group,the observation group compared with blank group(P＜0.01),the rhIL-11 group compared with the blank group (P＜0.05).Conclusion 1.The APL water extract has the effect to improving marrow megakaryocytes.It can increase the number of platelets.2.The APL water extract can increase the expression of IL-3,IL-11 and TPO mRNA in bone marrow mononuclear cells.The effect of platelets promotion may be increased by regulating the expression level of IL-3,IL-11 and TPO.3.The clinical observation showed that there was a distinct increase of platelets after using APL water extract,at same time,the levels of IL-3,IL-11 and TPO had increased in peripheral blood.We can confer that the water extract of APL could increase platelet through increasing the expression level of IL-3,IL-11 and TPO.4.The rhIL-11 can increase the IL-6 and TPO mRNA expression levels in bone marrow mononuclear cells and improve the expression level of IL-6 and TPO in peripheral blood of patients.