加味参苓白术散改善琥珀酸诱导的软骨细胞氧化应激损伤

doi:10.3877/cma.j.issn.1674-134X.2026.04.009

中华关节外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 470 -480. doi: 10.3877/cma.j.issn.1674-134X.2026.04.009

基础论著

加味参苓白术散改善琥珀酸诱导的软骨细胞氧化应激损伤

赵吉逢¹^,²^,³, 陶家声¹^,²^,³, 叶志龙¹^,²^,³, 卫杨文祥¹^,²^,³, 林晓东¹^,²^,³, 宋艺哲¹^,²^,³, 黄译蝶¹^,²^,³, 倪新玲¹^,²^,³, 陈伟坚²^,³, 刘文刚¹^,²^,³^,^†(

)

¹ 510405　广州中医药大学第五临床医学院
² 510095　广州，广东省第二中医院（广东省中医药工程技术研究院）骨伤一科
³ 510095　广州，广东省中医药研究开发重点实验室

收稿日期:2026-01-23 出版日期:2026-08-01
通信作者: 刘文刚
基金资助:
广州中医药大学-校院联合科技创新基金项目(GZYSE2024Y07); 广东省第二中医院科研创新基金-卓越团队项目(SEZYY2023B16); 广东省第二中医院“青博启航”计划项目(SEZYY2025QB03)

Modified Shenling Baizhu powder alleviates succinate-induced oxidative stress injury in chondrocytes

Jifeng Zhao¹^,²^,³, Jiasheng Tao¹^,²^,³, Zhilong Ye¹^,²^,³, Yangwenxiang Wei¹^,²^,³, Xiaodong Lin¹^,²^,³, Yizhe Song¹^,²^,³, Yidie Huang¹^,²^,³, Xinling Ni¹^,²^,³, Weijian Chen²^,³, Wengang Liu^†^,¹^,²^,³()

¹The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
²The First Department of Orthopedics, The Second Affiliated Hospital of Traditional Chinese Medicine of Guangdong Province (Guangdong Provincial Institute of Chinese Medicine Engineering Technology), Guangzhou 510095, China
³Guangdong Provincial Key Laboratory of Research and Development of Traditional Chinese Medicine, Guangzhou 510095, China

Received:2026-01-23 Published:2026-08-01
Corresponding author: Wengang Liu

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引用本文：

赵吉逢, 陶家声, 叶志龙, 卫杨文祥, 林晓东, 宋艺哲, 黄译蝶, 倪新玲, 陈伟坚, 刘文刚. 加味参苓白术散改善琥珀酸诱导的软骨细胞氧化应激损伤[J/OL]. 中华关节外科杂志(电子版), 2026, 20(04): 470-480.

Jifeng Zhao, Jiasheng Tao, Zhilong Ye, Yangwenxiang Wei, Xiaodong Lin, Yizhe Song, Yidie Huang, Xinling Ni, Weijian Chen, Wengang Liu. Modified Shenling Baizhu powder alleviates succinate-induced oxidative stress injury in chondrocytes[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2026, 20(04): 470-480.

目的

探讨加味参苓白术散对琥珀酸诱导骨关节炎（OA）软骨细胞线粒体氧化应激损伤的干预作用及其下游机制。

方法

采用细胞计数试剂盒8（CCK-8）法分别检测不同浓度琥珀酸二乙酯（DS）与加味参苓白术散含药血清对软骨细胞活性的影响，采用Dunnett检验。以脂多糖（LPS）诱导建立OA样软骨细胞模型，细胞分组为：对照组、LPS组、DS组、DS+JWSLBZS组（DS+5%加味参苓白术散含药血清）。采用甲苯胺蓝与阿利新蓝染色观察细胞外基质，免疫荧光检测Ⅱ型胶原（COL2）与基质金属蛋白酶13表达；活性氧（ROS）及超氧化物歧化酶（SOD）活性测定评价氧化应激水平，采用Tukey多重比较检验；透射电镜观察线粒体结构。对细胞进行转录组测序，筛选差异表达基因及加味参苓白术散潜在作用基因，并进行基因本体（GO）、京都基因与基因组百科全书（KEGG）及基因集富集分析（GSEA）。

结果

CCK-8结果显示，DS对软骨细胞活性呈剂量依赖性抑制作用，半数抑制浓度（IC₅₀）为15.5 mmol/L；含药血清浓度达到10%时活性下降（q=3.47，P<0.05）；后续实验选取10 mmol/L DS及5%含药血清。与对照组相比，LPS组和DS组基质染色减弱，免疫荧光显示COL2下调、MMP13上调；DS+JWSLBZS组干预后上述异常较DS组改善。与对照组比较，LPS组及DS组ROS升高、SOD活性降低，并伴线粒体肿胀及嵴结构减少等损伤情况；其中，SOD活性在LPS组与对照组（q=28.88，P＜0.001）、DS组与对照组（q=18.71，P＜0.001）之间差异有统计学意义。含药血清干预后相关指标呈改善趋势，线粒体结构损伤得到改善。转录组学分析显示，LPS组与DS组共有差异表达基因138个，富集于核因子κB（NF-κB）等通路。进一步方向性筛选显示，“异常上调-干预下调”基因集主要富集于丝裂原活化蛋白激酶（MAPK）、瞬时受体电位（TRP）通道相关信号轴，“异常下调-干预上调”基因集主要富集于转化生长因子-β（TGF-β）等基质稳态相关通路；GSEA分析结果与上述富集方向一致。

结论

琥珀酸堆积可诱导软骨细胞出现合成下降、降解增强的代谢失衡表型，并伴随氧化应激升高及线粒体超微结构损伤；加味参苓白术散可能通过调节MAPK信号通路等相关网络，减轻琥珀酸堆积诱导的线粒体氧化应激损伤。

关键词: 中草药, 琥珀酸, 软骨细胞, 线粒体, 氧化应激

Objective

To investigate the effects of modified Shenling Baizhu powder on succinate-induced mitochondrial oxidative stress injury in osteoarthritis (OA) chondrocytes and its potential downstream mechanisms.

Methods

The effects of different concentrations of diethyl succinate (DS) and medicated serum containing modified Shenling Baizhu powder on chondrocyte viability were assessed using the cell counting kit-8 (CCK-8) assay, followed by Dunnett’s test. Subsequently, an OA-like chondrocyte model was established by lipopolysaccharide (LPS) stimulation. The cells were divided into the control group, LPS group, DS group, and DS+JWSLBZS group (DS plus 5% medicated serum containing modified Shenling Baizhu powder). Extracellular matrix changes were evaluated by toluidine blue and alcian blue staining, and the expression levels of type II collagen (COL2) and matrix metalloproteinase (MMP)13 were detected by immunofluorescence. Oxidative stress was assessed by measuring reactive oxygen species (ROS) levels and superoxide dismutase (SOD) activity, with all pairwise comparisons among groups performed using Tukey’s multiple-comparison test. Mitochondrial ultrastructure was examined by transmission electron microscopy. Transcriptome sequencing was performed to identify differentially expressed genes and potential target genes of modified Shenling Baizhu powder, followed by gene ontology (GO), Kyoto encyclopedia of genes and genomes (KEGG), and gene set enrichment analysis (GSEA).

Results

The CCK-8 assay showed that DS inhibited chondrocyte viability in a dose-dependent manner, with a half-maximal inhibitory concentration (IC₅₀) of 15.5 mmol/L. Cell viability decreased when the concentration of medicated serum reached 10% (q=3.47, P<0.05). Therefore, 10 mmol/L DS and 5% medicated serum were selected for subsequent experiments. Compared with the control group, the LPS and DS groups showed weaker extracellular matrix staining, decreased COL2 expression, and increased MMP13 expression; these abnormalities were improved in the DS+JWSLBZS group compared with the DS group. Compared with the control group, the LPS and DS groups showed increased ROS levels and decreased SOD activity, accompanied by mitochondrial swelling, reduced cristae, and other structural abnormalities. Tukey’s multiple-comparison test for SOD activity showed significant differences between the LPS and CON groups (q=28.88, P<0.001) and between the DS and control groups (q=18.71, P<0.001). Following intervention with medicated serum, these indices showed an improving trend, and mitochondrial structural damage was alleviated. Transcriptomic analysis identified 138 differentially expressed genes shared by the LPS and DS groups, which were enriched in pathways including nuclear factor-κB (NF-κB) signaling. Further directional screening showed that the “abnormally upregulated–intervention downregulated” gene set was mainly enriched in mitogen-activated protein kinase (MAPK) signaling and transient receptor potential (TRP) channel-related signaling axes, whereas the “abnormally down regulated–intervention up regulated” gene set was mainly enriched in matrix homeostasis-related pathways, including transforming growth factor-β (TGF-β) signaling. The GSEA results were consistent with these enrichment patterns.

Conclusions

Succinate accumulation may induce a metabolically imbalanced phenotype in chondrocytes characterized by reduced matrix synthesis and enhanced matrix degradation, accompanied by increased oxidative stress and mitochondrial ultrastructural damage. Modified Shenling Baizhu powder may alleviate succinate accumulation-induced mitochondrial oxidative stress injury by regulating MAPK signaling and related networks.

Key words: Drugs, Chinese herbal, Succinic acid, Chondrocytes, Mitochondria, Oxidative stress

表1 不同浓度DS或JWSLBZS干预24 h后软骨细胞活性［%，（

x ¯

±s）］

Table 1 Chondrocyte viability after 24 h DS or JWSLBZS treatment at different concentrations

DS浓度（mmol/L）DS concentration	样本数 Sample number	细胞活性 Cell viability	JWSLBZS含量（%） JWSLBZS concentration	样本数 Sample number	细胞活性 Cell viability
0	4	107.500±11.640	0	4	102.840±8.570
0.5	4	96.500±8.600	1.25	4	101.640±4.010
1	4	95.280±1.140	2.5	4	101.040±6.690
5	4	79.730±9.270^a	5	4	103.410±7.580
10	4	62.110±7.160^b	10	4	88.190±1.200^c
15	4	38.350±3.770^b	20	4	73.120±4.210^d
20	4	12.920±1.040^b	-	-	-
30	4	0.380±0.020^b	-	-	-
F值		210.1	F值		16.59
P值		＜0.001	P值		＜0.001

表1 不同浓度DS或JWSLBZS干预24 h后软骨细胞活性［%，（

x ¯

±s）］

Table 1 Chondrocyte viability after 24 h DS or JWSLBZS treatment at different concentrations

DS浓度（mmol/L）DS concentration	样本数 Sample number	细胞活性 Cell viability	JWSLBZS含量（%） JWSLBZS concentration	样本数 Sample number	细胞活性 Cell viability
0	4	107.500±11.640	0	4	102.840±8.570
0.5	4	96.500±8.600	1.25	4	101.640±4.010
1	4	95.280±1.140	2.5	4	101.040±6.690
5	4	79.730±9.270^a	5	4	103.410±7.580
10	4	62.110±7.160^b	10	4	88.190±1.200^c
15	4	38.350±3.770^b	20	4	73.120±4.210^d
20	4	12.920±1.040^b	-	-	-
30	4	0.380±0.020^b	-	-	-
F值		210.1	F值		16.59
P值		＜0.001	P值		＜0.001

图1 DS（琥珀酸二乙酯）对软骨细胞活性的剂量–反应曲线

Figure 1 Dose-response curve of DS (diethyl succinate) on chondrocyte activity

图2 加味参苓白术散改善DS诱导的软骨细胞基质代谢失衡的显微镜下图。图A为各组软骨细胞甲苯胺蓝及阿利新蓝染色结果（×5）；图B为各组软骨细胞COL2及MMP13免疫荧光染色结果（×20）注：COL2-Ⅱ型胶原蛋白；MMP-基质金属蛋白酶；DAPI-4’，6-二脒基-2-苯基吲哚；红色为COL2或MMP13，蓝色为DAPI

Figure 2 Images of modified Shenling Baizhu powder alleviates DS-induced imbalance of matrix metabolism in chondrocytes under microscope. A shows the results of toluidine blue and Alcian blue staining of chondrocytes in each group (×5); B shows the immunofluorescence staining results of COL2 and MMP13 in chondrocytes in each group (×20) Note: COL2-collagen type Ⅱ; MMP-matrix metalloproteinase; DAPI-4’，6-diamidino-2-phenylindole; red indicates COL2 or MMP13, and blue indicates DAPI

表2 各组软骨细胞SOD活性比较［U/mg，（

x ¯

±s）］

Table 2 Comparison of SOD activity of chondrocytes in each group

组别 Groups	样本数 Sample number	SOD活性 SOD activity
对照组	3	2.050±0.128
LPS组	3	1.440±0.067^a
DS组	3	1.713±0.051^a
DS+JWSLBZS组	3	1.877±0.024^ab
F值		145.6
P值		＜0.001

表2 各组软骨细胞SOD活性比较［U/mg，（

x ¯

±s）］

Table 2 Comparison of SOD activity of chondrocytes in each group

组别 Groups	样本数 Sample number	SOD活性 SOD activity
对照组	3	2.050±0.128
LPS组	3	1.440±0.067^a
DS组	3	1.713±0.051^a
DS+JWSLBZS组	3	1.877±0.024^ab
F值		145.6
P值		＜0.001

图3 加味参苓白术散改善DS（琥珀酸二乙酯）诱导的线粒体氧化应激损伤。图A为各组软骨细胞ROS荧光染色（×10）；图B为各组软骨细胞线粒体超微结构透射电镜图像（比例尺=2 μm），箭头示线粒体损伤

Figure 3 Modified Shenling Baizhu powder ameliorates DS (diethyl succinate)-induced mitochondrial oxidative stress injury. A shows ROS fluorescence staining of chondrocytes in each group (×10); B shows transmission electron microscopy images of the mitochondrial ultrastructure of chondrocytes in each group (scale bar=2 μm), arrows indicate mitochondrial damage

图4 “琥珀酸堆积-炎症”共性差异基因谱及功能通路特征分析。图A为LPS组与对照组差异基因火山图；图B为DS组与对照组差异基因火山图；图C为LPS vs对照组与DS vs对照组差异基因Venn图；图D为交集差异基因的GO（基因本体）功能富集分析；E为交集差异基因的KEGG（京都基因与基因组百科全书）通路富集散点图注：LPS-脂多糖；DS-琥珀酸二乙酯；CON-对照组

Figure 4 Analysis of the shared differentially expressed gene profile and functional pathway characteristics associated with succinate accumulation and inflammation. A shows the volcano plot of differentially expressed genes between the LPS and control groups; B shows the volcano plot of differentially expressed genes between the DS and control groups; C shows the Venn diagram of differentially expressed genes identified in the LPS group vs control group and DS group vs control group; D shows the GO (gene ontology) functional enrichment analysis of the overlapping differentially expressed genes; E shows the KEGG (Kyoto encyclopedia of genes and genomes) pathway enrichment dot plot of the overlapping differentially expressed genes Note: LPS-lipopolysaccharide; DS-diethyl succinate; CON-control group

图5 加味参苓白术散调控琥珀酸堆积诱导的异常转录谱。图A为DS+JWSLBZS组与DS组差异基因火山图；图B为DS+JWSLBZS组vs DS组差异基因GO功能注释分析；图C为Venn图，DS组vs对照组上调基因与DS+JWSLBZS vs DS下调基因交集；图D为上述交集基因的KEGG（京都基因与基因组百科全书）通路富集分析；图E为MAPK信号通路的GSEA富集曲线；图F为TRP通道的GSEA富集曲线；图G为Venn图：DS组vs对照组下调基因与DS+JWSLBZS vs DS上调基因；图H为上述交集基因的KEGG通路富集分析；图I为TGF-β信号通路的GSEA富集曲线注：CON-对照组；DS-琥珀酸二乙酯；JWSLBZS-加味参苓白术散含药血清；GO-基因本体；TRP-瞬时受体电位；GSEA-基因集富集分析；MAPK-丝裂原活化蛋白激酶；TGF-β-转化生长因子-β；UP-上调基因；DOWN-下调基因

Figure 5 Modified Shenling Baizhu powder regulates the abnormal transcriptional profile induced by succinate accumulation. A shows the volcano plot of differentially expressed genes between the DS+JWSLBZS and DS groups; B shows the GO functional annotation analysis of differentially expressed genes in the DS+JWSLBZS vs DS groups comparison; C shows the Venn diagram of the overlap between upregulated genes in the DS vs control groups comparison and down regulated genes in the DS+JWSLBZS vs DS groups comparison; D shows the KEGG (Kyoto encyclopedia of genes and genomes) pathway enrichment analysis of the overlapping genes; E shows the GSEA enrichment plot of the MAPK signaling pathway; F shows the GSEA enrichment plot of TRP channels; G shows the Venn diagram of the overlap between down regulated genes in the DS vs control groups comparison and upregulated genes in the DS+JWSLBZS vs DS groups comparison; H shows the KEGG pathway enrichment analysis of the overlapping genes; I shows the GSEA enrichment plot of the TGF-β signaling pathway Note: CON-control group; DS-diethyl succinate; JWSLBZS-medicated serum containing modified Shenling Baizhu powder; GO-gene ontology; TRP- transient receptor potential; GSEA-gene set enrichment analysis; MAPK-mitogen-activated protein kinase; TGF-β-transforming growth factor-β; UP-up regulation; DOWN-down regulation

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Modified Shenling Baizhu powder alleviates succinate-induced oxidative stress injury in chondrocytes

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Modified Shenling Baizhu powder alleviates succinate-induced oxidative stress injury in chondrocytes