Astragalus membranaceus improves therapeutic efficacy of asthmatic children by regulating the balance of Treg/Th17 cells

Chin J Nat Med. 2019 Apr;17(4):252-263. doi: 10.1016/S1875-5364(19)30029-9.

Abstract

Astragalus membranaceus may be a potential therapy for childhood asthma but its driving mechanism remains elusive. The main components of A. membranaceus were identified by HPLC. The children with asthma remission were divided into two combination group (control group, the combination of budesonide and terbutaline) and A. membranaceus group (treatment group, the combination of budesonide, terbutaline and A. membranaceus). The therapeutic results were compared between two groups after 3-month therapy. Porcine peripheral blood mononuclear cells (PBMCs) were isolated from venous blood by using density gradient centrifugation on percoll. The levels of FoxP3, EGF-β, IL-17 and IL-23 from PBMCs and serum IgE were measured. The relative percentage of Treg/Th17 cells was determined using flow cytometry. The main components of A. membranaceus were calycosin-7-O-glucoside, isoquercitrin, ononin, calycosin, quercetin, genistein, kaempferol, isorhamnetin and formononetin, all of which may contribute to asthma therapy. Lung function was significantly improved in the treatment group when compared with a control group (P < 0.05). The efficacy in preventing the occurrence of childhood asthma was higher in the treatment group than the control group (P < 0.05). The levels of IgE, IL-17 and IL-23 were reduced significantly in the treatment group when compared with the control group, while the levels of FoxP3 and TGF-β were increased in the treatment group when compared with the control group (P < 0.05). A. membranaceus increased the percentage of Treg cells and reduced the percentage of Th17 cells. A. membranaceus is potential natural product for improving the therapeutic efficacy of combination therapy of budesonide and terbutaline for the children with asthma remission by modulating the balance of Treg/Th17 cells.

Keywords: Asthma; Astragalus membranaceus; Budesonide; Children; Terbutaline; Treg/Th17.

MeSH terms

  • Animals
  • Asthma / drug therapy*
  • Asthma / immunology
  • Astragalus propinquus / chemistry*
  • Budesonide / administration & dosage
  • Cells, Cultured
  • Child
  • Child, Preschool
  • Cytokines / metabolism
  • Drugs, Chinese Herbal / administration & dosage*
  • Drugs, Chinese Herbal / pharmacology*
  • Female
  • Humans
  • Immunologic Factors / administration & dosage*
  • Immunologic Factors / pharmacology
  • Leukocytes, Mononuclear / drug effects
  • Leukocytes, Mononuclear / metabolism
  • Lung / drug effects
  • Lung / physiology
  • Male
  • Swine
  • T-Lymphocytes, Regulatory / cytology
  • T-Lymphocytes, Regulatory / drug effects*
  • Terbutaline / administration & dosage
  • Th17 Cells / cytology
  • Th17 Cells / drug effects*
  • Treatment Outcome

Substances

  • Cytokines
  • Drugs, Chinese Herbal
  • Immunologic Factors
  • Budesonide
  • Terbutaline