Study On Clinical And Cytokine Effect Of Andrographolide On Children With Viral Lower Respiratory Tract Infection

Objective: To understand the clinical effect and related cytokines ofandrographolide with viral lower respiratory tract infection; provide a theoretical for theclinical application of andrographolide by observing the relationship between clinicalsymptoms, signs and cytokines, and discussing the possible mechanism ofandrographolide in antiviral infection.Methods: Methods by random sampling, Selection of hospitalized children inRespiratory Department of Dalian Children’s Hospital from November2012to May2013, whose age from three months to three years old met the inclusion criteria，withthe diagnosis of acute pneumonia or acute bronchitis and detection of nasopharyngealsecretion viral antigen positive. The children through the computer random numbergrouping, divided into the andrographolide group88cases and ribavirin group33cases.The andrographolide group on the basis of conventional treatment combined withandrographolide injection; the ribavirin group on the basis of conventional treatmentcombined with ribavirin injection, and seven days is the period of treatment. Childrenwere observed about Flat temperature time, Cough relief time, Wheezing disappearancetime. The children agree with blood55come from andrographolide group and23comefrom ribavirin group will be collected morning fasting venous blood twice. One isbefore treatment and the other time is the day before discharge. The cytokineconcentrations of tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1β),interleukin-12(IL-12), interferon gamma (IFN-γ), interleukin-6(IL-6), transforming growth factor-β (TGF-β), interleukin-4(IL-4), interleukin-10(IL-10), interleukin-13(IL-13) are detected by double antibody sandwich ABC-ELISA method with theblood.Result:1.The time of lowering the body’s temperature in the andrographolide group was2.08±1.04days, while the ribavirin group was3.86±1.67days, the andrographolidegroups is shorter than the ribavirin group in Flat temperature time, there weresignificant differences(P<0.01).The time of cough relief was3.80±1.50days in theandrographolide group, while the ribavirin group was4.79±1.45days, theandrographolide groups is shorter than the ribavirin group in cough relief time, therewere significant differences(P<0.01). The Wheezing disappearance time ofandrographolide groups is4.48±1.74days and5.50±2.10days in the ribavirin group,the andrographolide groups is shorter than the ribavirin group in Wheezingdisappearance time, there were significant differences(P<0.05).2.The cytokines concentrations of TNF-α,IL-12,IL-10,TGF-β,IL-4in theandrographolide group significantly decreased before and after treatment,there weresignificant differences(P<0.05); the concentration of the IFN-γ significantly increased,there were significant differences(P<0.05); while the concentration of IL-1β,IL-6, IL-13change were not obvious, there were no significant differences(P＞0.05). The cytokinesconcentration of IFN-γ in andrographolide group and ribavirin group significantlyincreased after treatment, and there were significant differences(P<0.05); but the changeof IL-1β,TNF-α,IL-12,IL-6,TGF-β,IL-10,IL-13,IL-4is were not obvious, there were nosignificant differences(P＞0.05).3.The andrographolide group and ribavirin group total effective rate was100%,and the total efficiency of two groups was the same.Conclusion:1. Andrographolide can shorten the time of fever, cough, wheezing in acute virallower respiratory infection.2. Andrographolide treatment of viral lower respiratory tract infection may by reducing the release of TNF-α and IL-12to flat temperature effect, by reducing therelease of IL-4, IL-10and TGF-1β to shorten the time of wheezing3. Andrographolide can achieve the antiviral effect in treatment of viral lowerrespiratory tract infection by increasing the concentration of IFN-γ, and than shorten thetime of symptoms and signs.