Correlation Between NLRP3 Inflammasome Activation And Type 2 Diabetic Macroangiopathy And Tcm Syndromes

Objective:In this study,89 patients with type 2 diabetes mellitus complicated with macroangiopathy and 36 patients with simple type 2 diabetes were tested.The protein expression of NLRP3,caspase-1,IL-1β in peripheral blood mononuclear cells and peripheral serum were detected in patients Protein expression of MCP-1and VCAM-1 and further observation of the expression of NLRP3,caspase-1,IL-1β,MCP-1,and VCAM-1 in various TCM syndromes of type 2 diabetes with macrovascular disease.To explore the correlation between NLRP3 inflammatory bodies and the occurrence and development of type 2 diabetic macroangiopathy.Provide a certain theoretical basis and new ideas for the clinical prevention and treatment of type 2 diabetic macroangiopathy.Methods:According to the 1999 WHO standard for diagnosing diabetes,125 patients asting blood glucose,total cholesterol,triglyceride,glycated hemoglobin,low density lipoprotein,high density lipoprotein,liver function.The expression levels of NLRP3,caspase-1,IL-1β,MCP-1 and VCAM-1 were detected by enzyme-linked immunosorbent assay.A total of 125 patients with type 2 diabetes diagnosed in the inpatient department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were collected.According to the results of color Doppler ultrasound examination of lower extremity arteries,it was divided into a simple T2 DM group and a T2 DM combined with macroangiopathy group.Among them,36 cases were in T2 DM alone group and 89 cases were in T2 DM combined with diabetic macroangiopathy group.Observe the general condition of the two groups of patients,such as the course of disease,BMI,blood sugar,blood lipids,etc.;Doppler color ultrasound observation of the lower extremity common femoral artery inner diameter,arterial blood flow velocity,IMT thickness;using enzyme-linked immunosorbent assay to detect peripheral blood sheets Protein expression of NLRP3,caspase-1 and IL-1β in nuclear cells and protein expression levels of MCP-1 andVCAM-1 in peripheral serum of patients;Western blot was used to detect 89 cases of type 2 diabetes with macrovascular disease and 17 cases of large amputation The protein expressions of NLRP3,caspase-1 and IL-1β in popliteal artery tissues of patients were analyzed,and the correlation of NLRP3,caspase-1 and IL-1β levels with blood glucose and blood lipid was analyzed.At the same time,the components of T2 DM combined with diabetic macroangiopathy according to the 2002 "Guidelines for Clinical Research on New Drugs of Traditional Chinese Medicine" were: 1.Damp-heat spleen and blood stasis group 13 cases;2.Yin-deficiency heat-stress and blood stasis group 19 cases;26 cases in both Qi and Yin deficiency and blood stasis group;4.31 cases in Yin and Yang deficiency and blood stasis group,observe the expression of NLRP3,caspase-1,IL-1β,MCP-1 and VCAM-1 in each TCM syndrome.Results:1.Comparison of lower extremity vascular color Doppler ultrasound between the two groups found that the T2 DM combined with macrovascular lesions group had a significantly lower common femoral artery diameter and arterial blood flow velocity than T2 DM alone,while IMT thickness was significantly increased(P<0.05).2.ELISA method detected the protein concentration of NLRP3,caspase-1,IL-1b in peripheral blood mononuclear cells.Compared with the T2 DM group alone,the expression of NLRP3,caspase-1,IL-1 b in T2 DM combined with macroangiopathy group was significantly increased High,the difference is statistically significant(P <0.05).3.ELISA method detected the concentration of MCP-1 and VCAM-1 in the serum of patients.Compared with T2 DM alone,the concentration of MCP-1 and VCAM-1 in T2 DM combined with macroangiopathy group was significantly increased,which was statistically significant(P <0.05).4.NLRP3,caspase-1,IL-1b protein expression in each plaque group of T2 DM combined with macroangiopathy: compared with the mild plaque group,the NLRP3,caspase-1,IL-1b protein level increased significantly,with statistical significance(P<0.05).Compared with the moderate plaque group,the levels of NLRP3 andcaspase-1 in the severe plaque group were significantly increased(P <0.05),but there was no significant difference in IL-1 b protein expression between the two groups.5.Patients with amputation of T2 DM and macrovascular lesions were tested for NLRP3,caspase-1,IL-1b in popliteal artery tissue by Western Blot.The relationship between NLRP3 inflammatory bodies and blood glucose and blood lipids was investigated.The results showed that the protein expression of NLRP3,caspase-1,IL-1b in popliteal tissue of patients with large vascular disease and amputation was positively correlated with blood glucose,LDL-c,TC,TG Related.6.T2 DM combined with macrovascular lesions of various TCM syndromes found that: yin and yang deficiency groups NLRP3,caspase-1,IL-1b、MCP-1、VCAM-1 protein expression was significantly increased(P <0.05).Conclusions:In this study,through the study of simple T2 DM and T2 DM combined with macroangiopathy,it was found that the activation of NLRP3 inflammatory bodies led to the release of a large number of inflammatory factors caspase-1 and IL-1b,which further induced the increase of MCP-1 and VCAM-1 Migration and adhesion of monocytes.It may be one of the reasons for promoting the development of type 2diabetic macroangiopathy.The expression of NLRP3 inflammasome is also positively correlated with blood glucose and blood lipids.At the same time,with the progression of T2 DM combined with macrovascular disease,the expression of NLRP3 inflammasome showed an upward trend,indicating that the inflammatory response not only runs through the entire course of macrovascular disease,but also may be one of the reasons for the progression of the disease.