大花紅景天在慢性阻塞性肺病病人的互補使用：細胞激素與T 細胞的影響

慢性阻塞性肺病(Chronic obstructive pulmonary disease)是一個以T細胞為主的發炎性疾病。過去研究認為紅景天具有抗發炎作用，但紅景天(Rhodiola)卻未曾用在慢性阻塞性肺病病人身上做為免疫調節劑(Immunomodulator)。在本研究中，慢性阻塞性肺病病人服用大花紅景天(Rhodiola crenulata)每日500毫克(38位病人)或是安慰劑(澱粉/磷酸鹽緩衝鹽水)(19位病人)12週，並與年紀，性別相匹配且沒有使用大花紅景天治療的79位非慢性阻塞性肺病控制組(79位均為健康抽菸者)做比較。研究結果顯示慢性阻塞性肺病病人治療前血清中的IL-2、IL-10以及IFN-γ濃度比起非慢性阻塞性肺病健康控制組都呈現明顯的上升(p < 0.05)。而大花紅景天治療後的慢性阻塞性肺病病人IFN-γ濃度呈現顯著的下降(p < 0.05)，在安慰劑組卻沒有這樣的變化(p > 0.05)。慢性阻塞性肺病病人服用大花紅景天後呈現降低的IFN-γ濃度以及CD8+的計數，但血中的CD4+CD25+FOXP3+以及CD4+CD25+CD45+FOXP3+的表現是明顯增加(p < 0.05)。研究結果也顯示，治療組的慢性阻塞性肺病病人呈現有利的抗發炎效應，較低的慢性阻塞性肺病評估測驗(COPD assessment test；縮寫成CAT)分數以及降低的高敏感性C-反應蛋白濃度(p < 0.05)。這是第一個使用紅景天做為慢性阻塞性肺病病人的互補治療的臨床試驗。T 細胞藉由CD8+ T 細胞增加表現以及IFN-γ濃度上升在慢性阻塞性肺病的致病機轉上不僅扮演一重要的角色，也可能是一個未來治療的潛在可行標的。

Chronic obstructive pulmonary disease (COPD) is an inflammatory disease predominantly involving T cells. Previous studies showed Rhodiola had anti-inflammatory effects, but no study of Rhodiola as an immunomodulator in patients with COPD has been reported. In this study, patients with COPD took Rhodiola crenulata 500 mg (n=38) or placebo (starch/phosphate buffered saline) (n=19) daily for 12 weeks and were compared with untreated, age- and sex-matched 79 non-COPD control (79 healthy smokers). The results showed that serum levels of IL-2, IL-10 and IFN-γ in patients with COPD before treatment are significantly higher than levels in non-COPD controls (p < 0.05). A significant decrease in IFN-γ was seen in the Rhodiola treatment group (p < 0.05) but not in the placebo group (p> 0.05). The effects of Rhodiola treatment in patients with COPD were shown to decrease the IFN-γ concentration and CD8+ count but increase the expressions of CD4+CD25+FOXP3+ and CD4+CD25+CD45+FOXP3+ in the blood significantly (p < 0.05). The results suggested that Rhodiola treatment had beneficial anti-inflammation effects, lower COPD assessment test(CAT) score and decreased high sensitivity C- reactive protein in patients with COPD (p< 0.05). This is the first trial using Rhodiola as a complementary therapy in patients with COPD. T cells play an important role in the pathogenesis of COPD through the increased expression of CD8+ T cells and IFN-γ and may be a viable target for potential therapy.