Therapeutic potential of intravenous Xuebijing on transforming growth factor beta1 and procollagen type III peptide in patients with acute paraquat poisoning.

ABSTRACT

OBJECTIVE: Paraquat (PQ) poisoning-induced pulmonary fibrosis causes asphyxiation and death. The therapeutic potential of intravenous Xuebijing therapy in PQ poisoning patients and its underlying immunomodulatory effects on transforming growth factor (TGF)-beta1 and procollagen type III peptide (PIIIP) were investigated. METHODS: Thirty-six acute PQ poisoning patients were randomly assigned to conventional therapy (Group A) and intravenous Xuebijing administration plus conventional therapy (Group B). Twenty volunteers served as controls (Group C). Blood samples were collected upon admission (day 0) and at post-treatment days 5, 10, and 14. TGF-beta1 and PIIIP concentrations were determined by ELISA and analyzed for intra- and inter-group differences over time. One-month follow-up was conducted for determining the mortality rate. RESULTS: TGF-beta1 and PIIIP levels were significantly higher in PQ poisoning patients and increased over time (Groups A and B vs C, P < 0.01). However, the TGF-beta1 and PIIIP levels were consistently significantly lower in Group B compared with those of Group A (P < 0.01). The 1-month mortality rate was also lower in Group B compared with that of Group A (P < 0.05). PQ poisoning patients showed remarkably high levels of TGF-beta1 and PIIIP, which increased as PQ-induced pulmonary fibrosis progressed. CONCLUSION: Treatment with intravenous Xuebijing plus conventional therapy significantly lowered TGF-beta1 and PIIIP levels, which indicates therapeutic efficacy in the treatment of PQ poisoning patients.