Medicine for treating or preventing macrophage mediated diseases and application thereof

Abstract

The application of amniotic fluid in preparation of a medicine for treating and / or preventing macrophage-mediated diseases, a medicine for treating and / or preventing M1 type macrophage-mediated diseases, a medicine for treating and / or preventing M2 type macrophage-mediated diseases and a preparation for treating and / or preventing TLR4 / NF-kappa B signal channel-mediated diseases, and the application of amniotic fluid in preparation of a medicine for treating and / or preventing TLR4 / NF-kappa B signal channel-mediated diseases. The invention also discloses an application of the compound in a preparation for inhibiting the number of M1 type macrophage groups and improving the proportion of M2 type macrophage types, or a preparation for promoting transformation of M1 type macrophage to M2 type macrophage. The amniotic fluid comes from eggs with the embryonic age of 5-12 days or eggs of other poultry except for chickens with the development period corresponding to the development period of the eggs with the embryonic age; or from the embryo of a rodent with the gestational age of 8-14 days, or from the embryo of other non-human mammals other than the rodent with the developmental stage corresponding to the developmental stage of the rodent with the gestational age of 8-14 days.

Description

Drugs for treating or preventing macrophage-mediated diseases and their use Technical Field

[0001] The present invention relates to a drug for treating or preventing macrophage-mediated diseases and its application. Background Art

[0002] Macrophages manifest themselves in different types under different stimuli, expressing either inducible nitric oxide synthase (iNOS) or arginase, and are accordingly designated as M1 and M2 macrophages. In inflammatory diseases, M1 macrophages are enriched at sites of early inflammation and activated by proinflammatory cytokines such as LPS, TNFα, and IFNγ. They subsequently promote the development of inflammation by secreting inflammatory cytokines such as IL-12, protecting the body from foreign substances. In the later stages of inflammation, M2 cells play a role in suppressing inflammation, repairing tissues, and remodeling tissue structure. The M1 / M2 macrophage population ratio fluctuates over time during the development of inflammation, ultimately completely eliminating the effects of inflammation. However, in certain chronic inflammatory conditions and certain acute phases, the M1 / M2 cell population ratio is imbalanced, and excessive M1 cell activation can lead to severe tissue damage and subsequent adverse symptoms such as a more severe cytokine storm. Therefore, M2 macrophages are closely related to anti-inflammatory responses and immune homeostasis, participate in tissue repair, tissue and organ remodeling, scar formation and injury healing, and have immunosuppressive effects.

[0003] Different types of miRNAs, transcription factors, and other noncoding RNAs derived from exosomes regulate M2 macrophage polarization through distinct signaling pathways. Among them, the Toll-like receptor 4 (TLR4) / NF-κB signaling pathway plays a central regulatory role in the inflammatory response. In its inactive state, NF-κB activity is inhibited by IκB. However, upon stimulation by cytokine receptors such as TLRs and TNF receptors, IκB kinase activation leads to IκB phosphorylation, which in turn leads to proteasomal degradation and release of NF-κB for nuclear translocation, activating the corresponding gene transcription. NF-κB activation can lead to the synthesis and release of inflammatory cytokines.

[0004] With the increasing incidence of diabetes, diabetic ulcers have become one of the most common chronic and difficult-to-treat wounds in clinical practice. Persistent chronic inflammation is a hallmark of diabetic skin wounds. Due to the complex microenvironment of diabetic wounds, characterized by hypoxia, infection, ischemia, inflammation, and oxidative stress, diabetic ulcers are often prolonged and recurrent. Traditional debridement and dressing changes are limited in their effectiveness. Therefore, effective and cost-effective treatment of diabetic ulcers has become a pressing issue.

[0005] During wound healing, M1 macrophages are responsible for phagocytizing necrotic tissue and cell debris, while M2 macrophages are involved in suppressing inflammation and promoting tissue regeneration. Diabetic wounds are often in a state of hyperinflammation, with a large number of M1 macrophages present in the wound tissue, and the conversion of macrophages to M2 macrophages is blocked. Notably, previous studies have shown that increasing the M2 phenotype may be an important factor in diabetic wound repair.

[0006] Summary of the Invention

[0007] A first aspect of the present invention provides the use of amniotic fluid in the preparation of a medicament for treating and / or preventing macrophage-mediated diseases, wherein the amniotic fluid is derived from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, and even more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of the eggs of the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

[0008] The present invention also provides the use of amniotic fluid in the preparation of a medicament for treating and / or preventing diseases mediated by M1 macrophages, wherein the amniotic fluid is derived from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, and even more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of the eggs with the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

[0009] The present invention also provides the use of amniotic fluid in the preparation of a medicament for treating and / or preventing diseases mediated by M2 macrophages, wherein the amniotic fluid is derived from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, and even more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of the eggs with the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

[0010] The present invention also provides the use of amniotic fluid in preparing a preparation for treating and / or preventing diseases mediated by the TLR4 / NF-κB signaling pathway, wherein the amniotic fluid is from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, and even more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of the eggs with the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

[0011] The present invention also provides the use of amniotic fluid in preparing a preparation for inhibiting the number of M1 macrophage populations and increasing the proportion of M2 macrophage types, or in preparing a preparation for promoting the transformation of M1 macrophages into M2 macrophages, wherein the amniotic fluid is derived from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, and even more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of the eggs of the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

[0012] In one or more embodiments, the medicament or formulation is a cell culture comprising the amniotic fluid and / or embryonic stem cells.

[0013] In one or more embodiments, the drug or preparation is a pharmaceutical composition comprising the amniotic fluid and / or chicken embryonic stem cells and pharmaceutically acceptable excipients.

[0014] In one or more embodiments, the macrophage-mediated disease is selected from the group consisting of: hypertrophic scars; chronic obstructive pulmonary disease; tumors, such as breast cancer, liver cancer; metabolic diseases, such as severe obesity, insulin resistance, and type II diabetes; inflammatory diseases, such as acute pancreatitis and atherosclerosis; cardiovascular diseases, such as myocarditis, myocardial infarction, and arrhythmia; neuropathy, such as Alzheimer's disease; brain diseases, such as cerebral infarction and brain injury; ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, uveal melanoma, Myopia; immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma, alcoholic liver disease, colitis, multiple sclerosis, and periodontitis; arthritis, such as rheumatoid arthritis, bone erosion, synovitis, and osteoarthritis; nephritis, such as acute kidney injury, chronic kidney disease, end-stage renal disease, proliferative glomerulonephritis, membranous nephropathy, diabetic nephropathy, Henoch-Schonlein purpura nephritis, ANCA-associated vasculitis, urinary tract infection, and autosomal dominant polycystic kidney disease; bacterial infectious diseases, such as sepsis; gestational hypertension; diabetes, gestational diabetes, and diabetic nephropathy.

[0015] In one or more embodiments, the M1 macrophage-mediated disease is selected from: involuting hypertrophic scars; chronic obstructive pulmonary disease; tumors, such as breast cancer and liver cancer; metabolic diseases, such as severe obesity, insulin resistance, and type 2 diabetes; inflammatory diseases, such as acute pancreatitis; coronary artery disease, such as atherosclerosis; kidney disease; obesity; cardiovascular diseases, such as myocarditis and myocardial infarction; brain diseases, such as cerebral infarction and brain injury; ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, and uveal melanoma; immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma, alcoholic liver disease, colitis, multiple sclerosis, periodontitis, and osteoarthritis; diabetes, gestational diabetes, and diabetic nephropathy.

[0016] In one or more embodiments, the M2 macrophage-mediated disease is selected from: hypertrophic scars in the proliferative phase; tumors, such as breast cancer and liver cancer; metabolic diseases, such as insulin resistance and type II diabetes; inflammatory diseases, such as acute pancreatitis; cardiovascular diseases, such as myocardial infarction, myocardial failure, atherosclerosis, coronary artery disease, and myocarditis; cerebral infarction; ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, and uveal melanoma; immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma, alcoholic liver disease, colitis, multiple sclerosis, periodontitis, and osteoarthritis; diabetes, gestational diabetes, and diabetic nephropathy.

[0017] In one or more embodiments, the disease mediated by the TLR4 / NF-κB signaling pathway is selected from: systemic lupus erythematosus; vascular inflammation, such as atherosclerosis, coronary heart disease; myocarditis, such as myocardial ischemia tissue inflammation, myocardial damage; hepatitis, such as liver failure, alcoholic liver damage, inflammatory immune response during alcohol metabolism; fatty liver; pneumonia, such as acute lung injury, chronic obstructive pulmonary disease, silicosis; nephritis, such as acute kidney injury, lupus nephritis; inflammatory bowel disease, such as acute enteritis, ulcerative colitis, radiation proctitis; gastritis, such as chronic atrophic gastritis; Inflammation; acute respiratory tract infections, such as pneumonia, bronchitis, pharyngitis, sinusitis, and otitis media; periodontitis and hyperuricemia; allergic rhinitis and allergic rhinitis; mastitis; arthritis, such as acute gouty arthritis, chronic arthritis, and rheumatoid arthritis; inflammation of wound tissue and hypertrophic scars; polycystic ovary syndrome; tumors, such as pituitary prolactin adenoma, adrenocorticotropic hormone adenoma, and intracranial aneurysm; infectious diseases, such as bacterial infection, fungal infection, and viral infection; allergic diseases, such as skin allergic diseases, bronchial asthma, allergic rhinitis, and allergic purpura. BRIEF DESCRIPTION OF THE DRAWINGS

[0018] Figure 1 shows a schematic diagram of how ceAF alleviates LPS-stimulated RAW 264.7 cell inflammation via the TLR4 / NF-κB signaling pathway. In Figure (D), each group of four histograms corresponds to, from left to right, CD206, Arg-1, iNOS, TNF-α, IL-6, IL-1β, TLR4, NF-κB, and plκB.

[0019] Figure 2 is a schematic diagram of ceAF inducing RAW264.7 polarization into M2 macrophages in vitro.

[0020] Figure 3 is a schematic diagram showing how ceAF promotes wound healing in STZ-induced diabetic mice.

[0021] Figure 4 is a schematic diagram showing that ceAF improves the histological parameters of wounds in STZ-induced diabetic mice.

[0022] Figure 5 is a schematic diagram showing that ceAF improves wound healing-related indicators in STZ-induced diabetic mice.

[0023] Figure 6 shows a schematic diagram of ceAF regulating wound-related inflammatory factors in STZ-induced diabetic mice. In panel B, each pair of columns of histograms constitutes a group, and each group of histograms corresponds to CD206, Arg-1, iNOS, TNF-α, IL-6, and IL-1β, from left to right. DETAILED DESCRIPTION

[0024] It should be understood that within the scope of the present invention, the above-mentioned technical features of the present invention and the technical features specifically described below (such as embodiments) can be combined with each other to form a preferred technical solution.

[0025] The present invention is completed by discovering that chicken embryo amniotic fluid (ceAF) can induce macrophage transformation from M1 to M2 through the TLR4 / NF-κB signaling pathway.

[0026] amniotic fluid

[0027] Amniotic fluid can come from poultry eggs and non-human mammals. Poultry eggs refer to poultry eggs. Preferred poultry are poultry, such as chickens, ducks and geese. Preferably, the present invention uses poultry eggs with an embryonic age of 5-20 days, preferably 6-15 days. It should be understood that the suitable embryonic age may not be the same for different poultry eggs. For example, when using chicken eggs, it is preferred to use eggs with an embryonic age of 5-12 days, more preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, and more preferably eggs with an embryonic age of 7-8 days. When using eggs from other poultry species, eggs whose developmental period corresponds to the developmental period of eggs of the above-mentioned embryonic ages can be used. For example, when using duck eggs, duck eggs with an embryonic age of 8-10 days, especially 8-9 days, may be the best. In some specific embodiments, ceAF refers to amniotic fluid extracted from chicken embryos that are 6-8 days old.

[0028] Conventional methods can be used to obtain amniotic fluid from poultry eggs. For example, the blunt end of an egg of appropriate embryonic age can be tapped to crack the eggshell, and the eggshell can be peeled open to form an opening approximately 2 cm in diameter. The shell membrane and vitelline membrane are then carefully torn apart with tweezers, taking care not to damage the amnion. The amnion and associated tissues encasing the embryo are then poured from the shell into a culture dish. The amniotic fluid used in the present invention can then be extracted by piercing the amnion with a syringe until the amnion is firmly attached to the embryo.

[0029] Herein, amniotic fluid can also be from non-human mammals, particularly rodents, such as from mice. Other non-human mammals can be common livestock, such as cattle, sheep, dogs, cats, pigs, etc. In certain embodiments, the amniotic fluid is from an embryo of a rodent with a gestational age of 8-14 days, or from an embryo of a non-human mammal corresponding to the developmental period of a rodent with a gestational age of 8-14 days. Conventional methods can be used to obtain amniotic fluid. For example, the abdominal cavity of a mouse that is pregnant for 8-14 days is cut open with surgical scissors, the uterus is carefully removed and cut open, and the amniotic membrane is pierced with a syringe to extract the amniotic fluid until the amniotic membrane is close to the embryo, thereby obtaining the amniotic fluid used in the present invention.

[0030] It should be understood that, if necessary, the amniotic fluid can be centrifuged to separate possible impurities, such as egg yolk, to obtain as pure amniotic fluid as possible. The supernatant obtained after centrifugation is the amniotic fluid used in the present invention. It should be understood that all steps to obtain amniotic fluid must be performed under sterile conditions; in addition, the "amniotic fluid" described herein refers to "pure" amniotic fluid, that is, amniotic fluid separated from poultry eggs or non-human mammalian embryos, does not contain other components in poultry eggs or non-human mammalian embryos, and is not contaminated by exogenous substances. Pure amniotic fluid can be stored in a refrigerator below -60°C and thawed before use.

[0031] The amniotic fluid described herein can be used as an active ingredient in a drug for in vivo administration to a subject in need thereof to promote cell growth and tissue repair in vivo. For example, an effective amount of the amniotic fluid described herein, or a pharmaceutical composition containing the amniotic fluid, can be administered to a subject in need thereof.

[0032] It should be understood that, in combination with CN 201810911038.2, CN 201810909485.4, CN 201810909193.0 and CN 201910887556.X, the amniotic fluid from various sources described in the present invention has the same or similar biological activity. When used in the present invention, they can all be used to regulate the TLR4 / NF-κB signaling pathway, inhibit M1 macrophages, and increase M2 macrophages, thereby treating or preventing diseases that benefit from the regulation of the TLR4 / NF-κB signaling pathway and macrophage-mediated diseases.

[0033] Herein, the animal may be a mammal, especially a human.

[0034] disease

[0035] Toll-like receptors (TLRs) are a family of receptors that mediate innate immunity, especially TLR4, which can recognize a variety of pathogen-associated molecular patterns (PAMPs) and activate inflammatory cells. They can recognize the exogenous ligand - lipopolysaccharide (LPS), and can also recognize endogenous ligands expressed during arterial injury. They can regulate pathological processes such as cholesterol metabolism, plaque stability, cell apoptosis, inflammation and vascular remodeling, and immune response. After TLRs bind to ligands, they ultimately lead to the activation of NF-κB, regulating the expression of inflammation and immune-related genes.

[0036] NF-κB plays a role in multiple stages of disease development, including inflammatory responses, foam cell formation, vascular smooth muscle proliferation, and apoptosis. It regulates enzymes (such as cyclooxygenase-2) involved in early low-density lipoprotein (LDL) modification and inflammatory lipid formation. Activated NF-κB also promotes the transcription of adhesion molecules, proinflammatory cytokines, chemokines, growth factors, and other factors, all of which play a crucial role in the development and progression of inflammatory diseases.

[0037] In this article, diseases mediated by the TLR4 / NF-κB signaling pathway include but are not limited to: inflammatory reactions caused by neuropathy and / or vascular lesions, selected from systemic lupus erythematosus (Ji Juan. The role of abnormal activation of TLR4 signaling leading to aging of bone marrow mesenchymal stem cells in the occurrence of systemic lupus erythematosus [D]. Nantong University, 2017.); vascular inflammation, atherosclerosis (Li Hongmei, Wang Xian. Research progress on the correlation between TLR4 / MyD88 / NF-κB signaling pathway and atherosclerotic cardiovascular disease [J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2017, 9(09): 1132-1134.), coronary heart disease (Lin Yongjun et al. Effect of Ginkgo Biloba Dropping Pills on TLR4 / NF-κB signaling pathway and immune function in patients with coronary heart disease. The impact of the immune system on the immune system [J]. Strait Pharmacy, 2017, 29(03): 89-92.); myocarditis, such as myocardial ischemic tissue inflammation (Zhou Xueling. Exploration of the mechanism of action of Huoxin Pills in anti-acute myocardial ischemic inflammatory response based on TLR4 / NF-κB signaling pathway [D]. Fujian University of Traditional Chinese Medicine, 2020. DOI: 10.27021 / d.cnki.gfjzc.2020.000334.), myocardial injury (Wei Hao et al. Analysis of the protective mechanism of HIF-1α on myocardial injury in rats with myocardial ischemia-reperfusion through TLR4 / NF-κB signaling pathway [J]. Journal of Clinical and Experimental Medicine, 2019, 18(10): 1017-1020.); hepatitis, such as liver failure (Liu Qiaohong , Liu Jiangkai, Li Suling. Efficacy of Jiedu Huayu Tongfu Granule in the treatment of patients with subacute and acute-on-chronic liver failure and its effect on TLR4 / NF-κB inflammatory pathway [J]. Journal of Integrated Traditional Chinese and Western Medicine for Hepatology, 2018, 28(05): 264-267.), alcoholic liver injury (Zhu Xiaoning, Wang Jing, Zhang Yurong, Yin Yue, Peng Mengyun, Zeng Yong. Qutan Huoxue Decoction upregulates SOCS1 to inhibit TLR4 / NF-κB signaling pathway and improve liver injury in mice with non-alcoholic fatty liver disease [J]. World Science and Technology-Modernization of Traditional Chinese Medicine, 2020, 22(12): 4293-4299.), inflammatory immune response during alcohol metabolism (Yin Xiaolei, Lu Weina, Feng Liying. LPS / TLR4 signaling pathway in non-alcoholic liver disease Fatty liver disease. World Chinese Journal of Digestion 2013; 21(28): 2957-2962. DOI: 10.11569 / wcjd.v21.i28.2957); fatty liver (Yin Xiaolei, Lu Weina, Feng Liying. Role of LPS / TLR4 signaling pathway in non-alcoholic fatty liver disease. World Chinese Journal of Digestion 2013; 21(28): 2957-2962. DOI: 10.11569 / wcjd.v21.i28.2957); pneumonia, such as acute lung injury (Niu Zequn, Wang Liming, Feng Hui, Sun Jiangli, Pei Honghong, Pan Longfei. Study on the role of TLR4 / NF-κB signaling pathway in rats with acute severe pancreatitis-related lung injury[J].Modern Digestion and Interventional Diagnosis and Treatment, 2019, 24(12): 1404-1407.), chronic obstructive pulmonary disease (Chen Xunchun, Li Minglan, Pan Biyun, Wang Yanying, Ding Yipeng. TLR4 / NF-κB signaling pathway activates LncRNA RP11-20G6 regulates airway inflammation and remodeling in chronic obstructive pulmonary disease [J]. Journal of Anhui Medical University, 2022, 57(4): 586-593), silicosis (Zhu Lili. Study on the role of TLR4 and RAGE-mediated inflammatory factors in the pathogenesis of silicosis [D]. Shanxi Medical University, 2014.); nephritis, such as acute kidney injury (Zhan Yun, Zhang Yingjie, Leng Bin. Astragaloside IV improves lipopolysaccharide-induced acute vascular endothelial injury through the TLR4 / NF-κB pathway [J]. Pharmacology and Clinical Medicine of Traditional Chinese Medicine, 2018, 34(03): 77-80.DOI: 10.13412 / j.cnki.zyyl.20 18.03.019.), lupus nephritis (Chen Ning. Expression and significance of HMGB1 / TLR / NF-κB signaling pathway in renal tissue of lupus nephritis mice [D]. Hebei Medical University, 2010.); inflammatory bowel disease, such as acute enteritis (Li Xuehui et al. Effect of CD11b agonist leukadherin-1 on the pathogenesis of experimental colitis in mice and its mechanism study [J]. Chinese Journal of Microbiology and Immunology, 2019(12): 904-905-906-907-908-909-910.), ulcerative colitis (Lin Xiaoyuan, Liu Jiemin. TLR4 / MyD8 ... Signaling pathway and ulcerative colitis [J]. Gastroenterology, 2013, 18(04): 244-246.), radiation proctitis (Zhu Chaofu, An Baiping, Huang Hongjie, Du Chi, Wu Yongjun, Lan Lan, Li Dan, Lei Dongmei, Li Shijie, Ao Rui. Exploration of the mechanism of action of Toli Xiaodusan in the treatment of radiation proctitis based on TLR4 / NF-κB signaling pathway [J]. Journal of Anhui Medical University, 2020, 55(09): 1367-1373. DOI: 10.19405 / j.cnki.issn1000-1492.2020.09.010.); gastritis, such as chronic atrophic gastritis (Zhou Wei, Yuan Xingxing. Effects of American cockroach extract on TLR4 / NF-κB signaling pathway in rats with chronic atrophic gastritis [J]. World Chinese Journal of Digestion, 2017, 25(21): 1945-1951.); acute respiratory tract infections, such as pneumonia (Guo Shasha. Role of TLR-MYD88-NF-κBP65 dependent signaling pathway in lung tissue of mice with mycoplasma pneumonia [D]. Qingdao University, 2017.), bronchitis (Wu Ning, Huang Yuxiao, Shi Xue, Chen Jinlun, Peng Lingfeng, Yang Lulu, Xu Hong, Sun Jianfei, Liu Hua. Effects of Miao medicine "Gannujinyan" on TLR4-MyD88-NF-κB signaling pathway in rats with chronic bronchitis [J].Journal of Guizhou Medical University, 2020, 45(11): 1283-1288. DOI: 10.19367 / j.cnki.2096-8388.2020.11.009.), pharyngitis (Xu Jinhong. Study on the mechanism of Zizheng Dihuang Decoction in treating acute pharyngitis based on TLR4 / NF-κB signaling pathway [D]. Anhui University of Traditional Chinese Medicine, 2020. DOI: 10.26922 / d.cnki.ganzc.2020.000216.), sinusitis (Xiao Jia Ning, Xue Shanshan, Ni Pingmin, Wang Zhuo, Wu Yongjun. Study on the mechanism of action of Biyuan mixture on acute sinusitis based on NF-κB signaling pathway [J]. Journal of Nanjing University of Chinese Medicine, 2022, 38(3): 247-253.doi: 10.14148 / j.issn.1672-0482.2022.0247), otitis media (CN201180025442.6, Luo Luncai, Tong Yan, Zhang Xingguo, et al. Study on the effect of Yuyang capsule on otitis media based on TLR4 / MyD88 / NF-κB pathway [J]. Journal of Nanjing University of Chinese Medicine, 2022, 38(3): 247-253.doi: 10.14148 / j.issn.1672-0482.2022.0247 The role of otitis media in the regulation of periodontitis and hyperuricemia (Guo Zhuling, Tang Han, Huang Miao, et al. Research progress on the TLR4 / NF-κB signaling pathway in regulating periodontitis and hyperuricemia and their interactions [J]. Chinese Journal of Stomatological Research: Electronic Edition, 2021, 15 (1): 5.); Asthma (Li Hongjia. Study on the mechanism of quercetin regulating asthma airway inflammation through TLR4 / NF-κB signaling [D]. Shandong University, 2015. ); allergic rhinitis (Yin Lili. Expression and mechanism of TREM-1, TLR4, TNF-a and NF-κB in nasal mucosa of mice with allergic rhinitis [D]. Huazhong University of Science and Technology, 2013.), allergic rhinitis (Hu Chen, Liang Chenyang, Zhou Weiguo. Expression and role of inflammation-mediated TLR4 / NF-kB pathway in patients with allergic rhinitis [J]. Labeled Immunoassay and Clinic, 2018, 25(06): 788-790+838.); mastitis (Lu Jinye, Gu Beibei. TLR4 / My Research progress on the D88 / NF-κB signaling pathway and mastitis [J]. Animal Husbandry and Veterinary Medicine, 2018, 50(11): 127-129.); arthritis, such as acute gouty arthritis (LUO Fei, MEI Yan. Effects of procyanidins on TLR4 / NF-κB signaling pathway in rats with acute gouty arthritis. Chinese Journal of Clinical Pharmacology and Therapeutics. 2018, (1): 41-46. DOI: 10.12092 / j.issn.1009-2501.2018.01.008), chronic arthritis (Yu Bijun. The role of TLR signaling pathway in chronic inflammatory arthritis [J]. International Journal of Immunology, 2007, 30(06): 443-447.), rheumatoid arthritis (Bai Lin, Yang Yuxin, Wan Qiaofeng, et al. Baicalin alleviates synovitis in rats with rheumatoid arthritis via TLR2 / NF-κB pathway [J]. Chinese Pharmacological Bulletin, 2017, 33(11): 1569-73.); wound tissue inflammation, hypertrophic scars (Li Qiang. TRAIL, DR5 and NF-κB Study on the expression and significance of p65 in granulation tissue and hypertrophic scar of human difficult-to-heal wounds [D]. Shandong University, 2008.); Polycystic ovary syndrome (Yao Zhilin, Huang Yinghong, Xu Xiaojuan. Effect of Bushen Huatan Decoction on TLR4 / NF-κB inflammatory signaling pathway, oxidative stress and insulin resistance in female mice with polycystic ovary syndrome [J]. Sichuan Traditional Chinese Medicine, 2019, 37(11): 6.); Pituitary prolactin adenoma (Guo Runzhu. Study on the pharmacological effects and mechanism of hordenine on hyperprolactinemia and prolactin adenoma [D]. Hubei University of Chinese Medicine, 2019. DOI: 10.27134 / d.cnki.ghbzc.2019.000015.); Adrenocorticotropin-stimulating hormone adenoma (Wu Q, Feng Y, Liu L, Liu Y, Liu X, Zhang L, Li Y, Wang L.Corticotropin-Releasing Factor Aggravates Ischemic Stroke Injury by the Inflammatory Activation of Microglia. Endocrinology. 2022 Mar 1; 163(3): bqac013.doi: 10.1210 / endocr / bqac013.PMID: 35137012.), intracranial aneurysms (Wang Y, Jin J. Roles of macrophages in formation and progression of intracranial aneurysms.Zhejiang Da Xue Xue Bao Yi Xue Ban.2019 Apr 25; 48(2): 204-213. Chinese. doi: 10.3785 / j.issn.1008-9292.2019.04.13. PMID: 31309760; PMCID: PMC8800668.) and other tumors; infectious diseases, such as bacterial infection, fungal infection and viral infection (Shan Jialing, Cheng Hongyu, Wen Le, Zhong Guoyue, Zhu Jixiao. Research progress on the mechanism of TLR / MyD 88 / NF-κB signaling pathway in different diseases[J].Chinese Pharmacological Bulletin, 2019, 35(4): 451-455); allergic diseases, such as skin allergic diseases, bronchial asthma, allergic rhinitis (Shan Jialing, Cheng Hongyu, Wen Le, Zhong Guoyue, Zhu Jixiao. Research progress on the mechanism of TLR / MyD 88 / NF-κB signaling pathway in different diseases [J]. Chinese Pharmacological Bulletin, 2019, 35(4): 451-455) and Henoch-Schonlein purpura (Wang Ziwei, Yang Lijun. Expression and significance of TLR9, MyD88 and NF-κB in Henoch-Schonlein purpura [J]. Chinese Modern Doctor, 2016, 54(29): 9-12).

[0038] The amniotic fluid described in this article can inhibit the activation of the TLR4 / NF-κB signaling pathway, thereby treating or preventing various diseases mediated by the TLR4 / NF-κB signaling pathway.

[0039] In this article, macrophage mediation refers to the role of the dynamic balance and imbalance of cell subpopulations with different functional characteristics in macrophages in the pathological process of the disease. Macrophage-mediated diseases include but are not limited to hypertrophic scars (Li Zhenjiang, Li Shujun, Zhou Jian, et al. Study on macrophage activation-related factors in hypertrophic scar tissue at different stages [J]. Journal of Zunyi Medical University, 2022, 45(1): 87-91); chronic obstructive pulmonary disease (Xing Shigang. Study on the role of macrophages in the pathogenesis of chronic obstructive pulmonary disease [J]. Chinese Practical Medicine, 2019, 14(12): 196-197); tumors, such as breast cancer and liver cancer; metabolic diseases, such as severe obesity, insulin resistance, and type II diabetes; inflammatory diseases, such as acute pancreatitis and atherosclerosis (Wang Yongkang, Li Jiayi, Guan Fei, Lei Jiahui. Macrophage polarization mechanism and its role in common diseases [J]. Tropical Diseases and Parasitology, 2022, 20(2): 103-108112); cardiovascular diseases, such as myocarditis, myocardial infarction, arrhythmia (Dong Jingwei, Miao Liu. Research progress on macrophage function and its role in heart disease [J]. Contemporary Chinese Medicine, 2022, 29(16): 49-52); neurological diseases, such as Alzheimer's disease; brain diseases, such as cerebral infarction (Wang Jiahe. Foreword - Research progress on macrophages and related diseases [J]. Practical Geriatrics, 2021, 35(12): 1217-1218), brain damage (Diao Zhongji, Lei Rui, Yin Shi, Liu Hongling, Liu Qing. M1 macrophage water Correlation analysis between M1 / M2 polarization of macrophages and the severity and prognosis of coronary heart disease [J]. Chinese Medical Innovation, 2022, 19(4): 161-165); ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, uveal melanoma, myopia (Qu Ruyi, Zhou Mengxian, Bi Hongsheng, Guo Dadong. Research progress on the mechanism of macrophage polarization in the occurrence and development of ophthalmic diseases [J]. New Progress in Ophthalmology, 2022, 42(3): 239-243); immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma (Jia Rui, Hui Yi, Yan Shuguang (guidance), Li Jingtao. Macrophage M1 / M2 polarization and immune inflammatory disease Research progress on the relationship between macrophage polarization and its effects on inflammatory diseases [J]. Chinese Journal of Immunology, 2021, 37(22): 2791-2797), alcoholic liver disease, colitis (Wu Yan, Zhang Dingran, Wang Xinhui, Xu Hongyang, Liu Peiyao, Qi Zhili. Research progress on macrophage polarization and its effects on inflammatory diseases [J]. Chinese Journal of Animal Husbandry, 2021, 57(7): 22-26), multiple sclerosis (Li Xing, Wang Dandan, Tang Qi, Liu Jie, Gu Zhongyi, Zhao Huan, Sun Hongchen. Research progress on the transcriptional regulation of macrophage polarization and its effects on related diseases [J]. Journal of Jilin University: Medical Edition, 2016, 0(3): 622-625), periodontitis (Zhou Qi, Sun Huijuan, Yu Donghua, Liu Shumin.The mechanism of macrophage M1 / M2 polarization in different diseases [J]. Chinese Pharmacological Bulletin, 2020, 36(11): 1502-1506); arthritis, such as rheumatoid arthritis, bone erosion, and synovitis (Wang Dongyi, Shen Junyi, Lu Le, Cai Hui. Correlation between macrophage polarization imbalance and rheumatoid arthritis disease activity and bone erosion [J]. Journal of Medical Postgraduates, 2021, 34(8): 823-828), Osteoarthritis (Zhou Qi, Sun Huijuan, Yu Donghua, Liu Shumin. Mechanism of macrophage M1 / M2 polarization in different diseases [J]. Chinese Pharmacological Bulletin, 2020, 36(11): 1502-1506); Nephritis, such as acute kidney injury, chronic kidney disease, end-stage renal disease, proliferative glomerulonephritis, membranous nephropathy, diabetic nephropathy, Henoch-Schonlein purpura nephritis, ANCA-associated vasculitis, urinary tract infection, autosomal dominant polycystic ovary syndrome Kidney (Ding Na, Wang Bo, Huang Bintao, Hao Jian. Research progress on macrophage migration inhibitory factor in the pathogenesis of nephritis [J]. Hebei Medicine, 2021, 27 (1): 170-174); bacterial infectious diseases, such as sepsis (Huang Xuechao, Shen Shiyang, Mo Ran. Research progress on macrophage membrane biomimetic nano-drug delivery system for the treatment of inflammatory diseases [J]. Chinese Drug Evaluation, 2021, 38 (4): 279-283); gestational hypertension (Zhao Caizhen, Qiao Fuyuan. Macrophages and gestational hypertension [J]. Chinese Journal of Eugenics and Genetics, 2006, 14 (3): 126-128); diabetes, gestational diabetes, diabetic nephropathy (Zhou Qi, Sun Huijuan, Yu Donghua, Liu Shumin. The mechanism of macrophage M1 / M2 polarization in different diseases [J]. Chinese Pharmacological Bulletin, 2020, 36 (11): 1502-1506).

[0040] Macrophages include two subtypes, M1 and M2. M1 macrophages are also called pro-inflammatory phenotype macrophages. Their main function in the body is to phagocytize foreign substances such as bacteria and endogenous substances such as apoptotic cell fragments, thereby protecting tissues and organs from invasion by foreign substances. In inflammatory diseases, M1 macrophages are enriched in the early stages of inflammation and are activated by pro-inflammatory factors. They promote the occurrence and development of inflammation by secreting inflammatory factors, protecting the body from invasion by foreign substances. In the later stages of inflammation, M2 cells play a role in inhibiting inflammation, repairing tissues, and reconstructing tissue structures. Therefore, M2 macrophages are also called anti-inflammatory phenotype or immunoregulatory macrophages. During the development of inflammation, the ratio of the number of M1 / M2 macrophage populations changes over time, eventually completely eliminating the effects of inflammation.

[0041] In this article, M1 macrophage-mediated refers to the effects of M1 macrophages in diseases, such as being activated by proinflammatory factors, secreting inflammatory factors, and protecting the body from invasion by foreign substances. Diseases mediated by M1 macrophages include but are not limited to hypertrophic scars in the regressive phase (Li Zhenjiang, Li Shujun, Zhou Jian, et al. Study on macrophage activation-related factors in hypertrophic scar tissue at different stages [J]. Journal of Zunyi Medical University, 2022, 45(1): 87-91); chronic obstructive pulmonary disease (Xing Shigang. Study on the role of macrophages in the pathogenesis of chronic obstructive pulmonary disease [J]. Chinese Practical Medicine, 2019, 14(12): 196-197); tumors, such as breast cancer and liver cancer; metabolic diseases, such as severe obesity, insulin resistance, and type II diabetes; inflammatory diseases, such as acute pancreatitis (Wang Yongkang, Li Jiayi, Guan Fei, Lei Jiahui. Macrophage polarization mechanism and its role in common diseases [J]. Tropical Diseases and Parasitology, 2022, 20(2): 103-108112); coronary artery disease, such as atherosclerosis; kidney disease; obesity (Diao Zhongji, Lei Rui, Yin Shi, Liu Hongling, Liu Qing. Correlation analysis between M1 macrophage levels and severity and prognosis of coronary heart disease [J]. Chinese Medical Innovation, 2022, 19(4): 161-165); cardiovascular diseases, such as myocarditis and myocardial infarction (Dong Jingwei, Miao Liu. Research progress on macrophage function and its role in heart disease [J]. Chinese Contemporary Medicine, 2022, 29(16): 49-52); brain diseases, such as cerebral infarction (Wang Jiahe. - Research progress on macrophages and related diseases [J]. Practical Geriatrics, 2021, 35(12): 1217-1218), brain injury (Diao Zhongji, Lei Rui, Yin Shi, Liu Hongling, Liu Qing. Correlation analysis between M1 macrophage levels and severity and prognosis of coronary heart disease [J]. Chinese Medical Innovation, 2022, 19(4): 161-165); ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, uveal melanoma (Qu Ruyi, Zhou Mengxian, Bi Hongsheng, Guo Dadong. Research progress on the mechanism of macrophage polarization in the occurrence and development of ophthalmic diseases [J]. New Progress in Ophthalmology, 2022 , 42(3): 239-243); immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma (Jia Rui, Hui Yi, Yan Shuguang (guidance), Li Jingtao. Research progress on the relationship between macrophage M1 / M2 polarization and immune inflammatory diseases [J]. Chinese Journal of Immunology, 2021, 37(22): 2791-2797), alcoholic liver disease, colitis (Wu Yan, Zhang Dingran, Wang Xinhui, Xu Hongyang, Liu Peiyao, Qi Zhili. Research progress on macrophage polarization and its effect on inflammatory diseases [J]. Chinese Journal of Animal Husbandry, 2021, 57(7): 22-26), multiple sclerosis (Li Xing, Wang Dandan, Tang Qi, Liu Jie, Gu Zhongyi, Zhao Huan, Sun Hongchen.Research progress on transcriptional regulation of macrophage polarization and its impact on related diseases [J]. Journal of Jilin University: Medical Edition, 2016, 0(3): 622-625), periodontitis, osteoarthritis; diabetes, gestational diabetes, diabetic nephropathy (Zhou Qi, Sun Huijuan, Yu Donghua, Liu Shumin. Mechanism of action of macrophage M1 / M2 polarization in different diseases [J]. Chinese Pharmacological Bulletin, 2020, 36(11): 1502-1506).

[0042] In some embodiments, diseases mediated by M1 macrophages include, but are not limited to, immune inflammatory diseases, metabolic diseases, diabetes, and tumors. In an exemplary embodiment, the disease mediated by M1 macrophages described herein is persistent chronic inflammation of diabetic wounds.

[0043] In this article, M2 macrophage mediation refers to the role of M2 macrophages in inhibiting inflammation and inflammatory factors, promoting wound healing and repair, etc. in diseases. Diseases mediated by M2 macrophages include but are not limited to hypertrophic scars in the hyperplastic phase (Li Zhenjiang, Li Shujun, Zhou Jian, et al. Study on macrophage activation-related factors in hypertrophic scar tissue at different stages [J]. Journal of Zunyi Medical University, 2022, 45(1): 87-91); tumors, such as breast cancer and liver cancer; metabolic diseases, such as insulin resistance and type II diabetes; inflammatory diseases, such as acute pancreatitis (Wang Yongkang, Li Jiayi, Guan Fei, Lei Jiahui. Macrophage polarization mechanism and its role in common diseases [J]. Tropical Diseases and Parasitology, 2022, 20(2): 103-108112); cardiovascular diseases, such as myocardial infarction, myocardial failure, atherosclerosis, Coronary artery disease (Zhang Xiangning, Dang Guohui, Feng Juan (guidance). Regulation of exosomes on M2 macrophages and their role in cardiovascular disease [J]. Chinese Journal of Immunology, 2022, 38(10): 1257-1262), myocarditis (Dong Jingwei, Miao Liu. Research progress on macrophage function and its role in heart disease [J]. Contemporary Chinese Medicine, 2022, 29(16): 49-52); cerebral infarction (Wang Jiahe. Foreword - Research progress on macrophages and related diseases [J]. Practical Geriatrics, 2021, 35(12): 1217-1218); ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal Transplantation, Sjögren's syndrome, uveal melanoma (Qu Ruyi, Zhou Mengxian, Bi Hongsheng, Guo Dadong. Research progress on the mechanism of macrophage polarization in the occurrence and development of ophthalmic diseases [J]. New Progress in Ophthalmology, 2022, 42(3): 239-243); immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma (Jia Rui, Hui Yi, Yan Shuguang (guidance), Li Jingtao. Research progress on the relationship between macrophage M1 / M2 polarization and immune inflammatory diseases [J]. Chinese Journal of Immunology, 2021, 37(22): 2791-2797), alcoholic liver disease, colitis (Wu Yan, Zhang Dingran, Wang Xinhui, Xu Hongyang, Liu Peiyao, Qi Zhili. Macrophages Polarization and its effects on inflammatory diseases [J]. Chinese Journal of Animal Husbandry, 2021, 57(7): 22-26), multiple sclerosis (Li Xing, Wang Dandan, Tang Qi, Liu Jie, Gu Zhongyi, Zhao Huan, Sun Hongchen. Research progress on transcriptional regulation of macrophage polarization and its effects on related diseases [J]. Journal of Jilin University: Medical Edition, 2016, 0(3): 622-625), periodontitis, osteoarthritis; diabetes, gestational diabetes, diabetic nephropathy (Zhou Qi, Sun Huijuan, Yu Donghua, Liu Shumin. The mechanism of action of macrophage M1 / M2 polarization in different diseases [J]. Chinese Pharmacological Bulletin, 2020, 36(11): 1502-1506).

[0044] In some embodiments, the diseases mediated by M2 macrophages include but are not limited to immune inflammatory diseases, metabolic diseases, diabetes and tumors. In an exemplary embodiment, the disease mediated by M2 macrophages described herein is persistent chronic inflammation of diabetic wounds.

[0045] In some embodiments, the amniotic fluid described herein treats and prevents macrophage-mediated diseases by reducing the number of M1 macrophages and increasing the proportion of M2 macrophages.

[0046] In a particularly preferred embodiment of the present invention, amniotic fluid, especially avian egg amniotic fluid as described herein, more preferably chicken egg amniotic fluid is used to prevent or treat macrophage-mediated diseases.

[0047] Pharmaceutical composition

[0048] The present invention also provides a pharmaceutical composition comprising the amniotic fluid described herein, especially the amniotic fluid in poultry eggs, more preferably the amniotic fluid of eggs with an embryonic age of 5-12 days, more preferably 6-11 days, more preferably 6-9 days, and more preferably 7-8 days. The pharmaceutical composition can be amniotic fluid or a lyophilized agent thereof frozen below -60°C, such as lyophilized amniotic fluid. The pharmaceutical composition may also contain other pharmaceutically acceptable carriers or excipients, such as physiological saline for injection, water for injection, or glucose injection. Preferably, the pharmaceutical composition contains 5-40% (v / v) or 10%-35% amniotic fluid, preferably 15-30%.

[0049] The pharmaceutical composition containing amniotic fluid described herein also generally contains a pharmaceutically acceptable excipient. Herein, "pharmaceutically acceptable excipient" refers to a carrier, diluent and / or excipient that is pharmacologically and / or physiologically compatible with the subject and the active ingredient, including but not limited to: antibiotics, humectants, pH regulators, surfactants, carbohydrates, adjuvants, antioxidants, chelating agents, ionic strength enhancers, preservatives, carriers, glidants, sweeteners, dyes / colorants, flavor enhancers, wetting agents, dispersants, suspending agents, stabilizers, isotonic agents, solvents or emulsifiers. In some embodiments, pharmaceutically acceptable excipients may include one or more inactive ingredients, including but not limited to: stabilizers, preservatives, additives, adjuvants, sprays, compressed air or other suitable gases, or other suitable inactive ingredients used in combination with the pharmacodynamic compound. More specifically, suitable pharmaceutically acceptable excipients can be excipients commonly used in the art for diabetic foot. In one or more embodiments, suitable pharmaceutically acceptable excipients for sprays are selected from one or more of the following: water, gluconolactone, sodium benzoate, arbutin, sodium hyaluronate, niacinamide, and glycerin. In one or more embodiments, suitable pharmaceutically acceptable excipients for coatings or dressings are selected from one or more of the following: water, glycerin, panthenol, magnesium ascorbyl phosphate, niacinamide, sodium hyaluronate, phenoxyethanol, caprylyl glycol, and sorbic acid. The content of pharmaceutically acceptable excipients can be determined according to actual conditions in the art.

[0050] Spraying, coating, or applying medication to a wound generally requires the addition of a dressing. A "dressing" is a wound dressing used to cover a sore, wound, or other lesion. Wound dressings include passive dressings, interactive dressings, and bioactive dressings. Wound dressings suitable for the present invention are known in the art.

[0051] In addition to amniotic fluid, the pharmaceutical composition described herein may also contain other active ingredients that help the patient recover from wounds, including but not limited to Centella asiatica extract, rose hydrosol, licorice root extract, olive leaf extract, calendula flower extract, white willow bark extract, lavender extract, lemon fruit extract, hydrolyzed soy protein, mugwort extract, tea extract, thyme extract, purple coneflower extract, Hypericum perforatum flower / leaf extract, aloe barbadensis leaf juice powder, and yeast extract.

[0052] Uses and treatments

[0053] The present invention also provides the use of the amniotic fluid described in any embodiment herein in the preparation of a preparation for treating and / or preventing diseases mediated by the TLR4 / NF-κB signaling pathway. On the other hand, the present invention also provides the use of the amniotic fluid described in any embodiment herein in the preparation of a preparation for treating and / or preventing macrophage-mediated diseases. On the other hand, the present invention also provides the use of the amniotic fluid described in any embodiment herein in the preparation of a preparation for treating and / or preventing M1 macrophage-mediated diseases. On the other hand, the present invention also provides the use of the amniotic fluid described in any embodiment herein in the preparation of a preparation for treating and / or preventing M2 macrophage-mediated diseases. On the other hand, the present invention also provides the use of the amniotic fluid described in any embodiment herein in the preparation of a reagent for inhibiting the number of M1 macrophage populations and increasing the proportion of M2 macrophage types. On the other hand, the present invention also provides the use of the amniotic fluid described in any embodiment herein in the preparation of a preparation for promoting the conversion of M1 macrophages to M2 macrophages.

[0054] In some embodiments, the present invention provides the use of the amniotic fluid described in any embodiment herein in the preparation of a reagent for one or more of the following purposes: (1) increasing the healing rate of a patient's wound; (2) promoting the growth of new blood vessels in the patient's wound; (3) reducing the proinflammatory factors IL-6 and TNF-α in patients with inflammation, and increasing TGF-β1 and IL-10 in patients with inflammation; (4) promoting the formation of type III collagen in the patient's wound, or increasing the ratio of type III collagen to type I collagen in the patient's wound; and (5) reducing the transcription and translation levels of iNOS, TNF-α, IL-6 and IL-1β in patients with inflammation, and increasing the transcription and translation levels of CD206 and Arg-1 in patients with inflammation.

[0055] In some embodiments, the present invention also provides amniotic fluid or a composition containing the amniotic fluid described in any embodiment of the present invention for treating and / or preventing diseases mediated by the TLR4 / NF-κB signaling pathway, for treating and / or preventing macrophage-mediated diseases, for treating and / or preventing M1 macrophage-mediated diseases, for treating and / or preventing M2 macrophage-mediated diseases, for inhibiting the number of M1 macrophage populations, increasing the proportion of M2 macrophage types, and / or promoting the transformation of M1 macrophages to M2 macrophages.

[0056] Also provided herein is a method for treating and / or preventing diseases mediated by the TLR4 / NF-κB signaling pathway, comprising administering to a subject in need thereof a therapeutically effective amount of the amniotic fluid described herein or a composition containing the amniotic fluid.

[0057] The present invention also provides methods for treating and / or preventing macrophage-mediated diseases. The present invention also provides methods for treating and / or preventing diseases mediated by M1 macrophages. The present invention also provides methods for treating and / or preventing diseases mediated by M2 macrophages. These methods comprise the step of administering to a subject in need thereof a therapeutically effective amount of amniotic fluid or a composition comprising the amniotic fluid described herein.

[0058] The present invention also provides a method for promoting the conversion of M1 macrophages to M2 macrophages, comprising administering to a subject in need thereof an effective amount of the amniotic fluid described herein or a composition containing the amniotic fluid. In some embodiments, the method can be used to treat or prevent diseases that benefit from an increase in M2 macrophages, including but not limited to the diseases described above. The method can be either an in vivo method or an in vitro method.

[0059] This article also provides a method for tissue repair in an inflamed subject, which comprises using the amniotic fluid described herein or a composite dressing prepared with the amniotic fluid as the main raw material, or a cell culture medium containing the amniotic fluid described herein to culture tissue cells of interest in vitro, and after forming a tissue matrix, implanting the tissue matrix into the tissue damage or defect site.

[0060] In some embodiments, the present invention also provides a method for increasing the healing speed of a patient's wound, the method comprising applying the amniotic fluid described herein or a pharmaceutical composition containing the amniotic fluid to the patient's wound, or applying a composite dressing prepared with the amniotic fluid of the present invention as the main raw material. In some embodiments, the present invention also provides a method for promoting the growth of new blood vessels in a patient's wound, the method comprising applying the amniotic fluid described herein or a pharmaceutical composition containing the amniotic fluid to the patient's wound, or applying a composite dressing prepared with the amniotic fluid of the present invention as the main raw material. In some embodiments, the present invention also provides a method for reducing the pro-inflammatory factors IL-6 and TNF-α in patients with inflammation, and increasing TGF-β1 and IL-10 in patients with inflammation, the method comprising administering to the patient an effective amount of the amniotic fluid described herein or a pharmaceutical composition containing the amniotic fluid. In some embodiments, the present invention also provides a method for promoting the formation of type III collagen in a patient's wound, or a method for increasing the ratio of type III collagen to type I collagen in a patient's wound, the method comprising applying the amniotic fluid described herein or a pharmaceutical composition containing the amniotic fluid to the patient's wound, or applying a composite dressing prepared with the amniotic fluid of the present invention as the main raw material. In some embodiments, the present invention also provides a method for reducing the transcription and translation levels of iNOS, TNF-α, IL-6 and IL-1β in patients with inflammation, and increasing the transcription and translation levels of CD206 and Arg-1 in patients with inflammation, the method comprising administering to the patient an effective amount of the amniotic fluid described herein or a pharmaceutical composition containing the amniotic fluid.

[0061] As used herein, a therapeutically effective amount refers to a dose that can achieve treatment, prevention, alleviation, and / or relief of a disease or condition in a subject. The therapeutically effective amount can be determined based on factors such as the patient's age, sex, the condition and its severity, and other physical conditions. As used herein, a subject or patient generally refers to a mammal, and more particularly, a human.

[0062] Herein, the dosage and frequency of administration can be determined by medical staff according to the specific condition, the age and gender of the patient, etc. Generally, for the treatment of a specific disease, a therapeutically effective amount refers to a dosage that is sufficient to improve or alleviate the symptoms associated with the disease in some way. Such a dosage can be administered as a single dose, or can be administered according to an effective treatment regimen. The dosage may cure the disease, but administration is usually to improve the symptoms of the disease. Repeated administration is generally required to achieve the desired symptom improvement. For example, for a dose given to a person, it can usually be 1-200 ml / time, and can be injected daily or weekly. In certain embodiments, the frequency of administration can be multiple times a day, twice a day, every two days, every three days, every four days, every five days or every six days, or once every half a month, or once a month.

[0063] Cell culture medium

[0064] In certain embodiments, the present invention also provides a cell culture medium comprising an appropriate amount of the amniotic fluid described herein. The content of amniotic fluid in the cell culture medium can be determined based on the type of cells being cultured. For example, the amount of amniotic fluid added can range from 0.1% to 30% by weight of the cell culture medium, such as 1% to 25% or 3% to 20%. An appropriate cell culture medium can be selected based on the cells to be cultured. Exemplary cell culture media include, but are not limited to, various commercially available culture media, such as DMEM, RPMI 1640, MEM, DMEM / F12, and the like.

[0065] The present invention will be further described below by way of specific examples. It should be understood that these examples are merely illustrative and are not intended to limit the scope of the present invention. The methods and reagents used in the examples are, unless otherwise stated, conventional methods and reagents in the art.

[0066] Materials and Methods

[0067] Antibodies and reagents

[0068] PE CD206 antibody (12-2069-42) and FITC F4 / 80 antibody (11-4801-82) were purchased from eBioscience. Arginase 1 (Arg-1; 93668), α-SMA (19245), and CD206 (24595) were purchased from CST. GAPDH (ab181602), iNOS (ab178945), TNF-α (ab183218), IL-6 (ab290735), IL-1β (ab254360), and CD31 (ab281583) were purchased from Abcam. TLR4 (A5258), NF-κB-p65 (A19653), and p-IKB (AP0707) were purchased from ABclonal. Trizol reagent and SYBR green were purchased from Vazyme Biotech. STZ (S0130) and glucose (D9434) were purchased from Sigma-Aldrich.

[0069] Preparation of ceAF

[0070] Fertilized chicken eggs were incubated at 38°C and 50% humidity. CeAFs were isolated between days 6 and 8 of incubation. After centrifugation (2500 × g, 20 min), the supernatant was filtered using a 0.22 μm sterile filter (Millipore, USA). The filtered samples were aliquoted and stored at −80°C.

[0071] Cell culture

[0072] RAW264.7 cells were provided by the Cell Bank of the Chinese Academy of Sciences and cultured in high-glucose DMEM supplemented with 10% FBS and 1% diabody at 37°C and 5% CO2. High-glucose conditions consisted of DMEM containing 40 mM glucose. CeAF was added to the culture medium at various concentrations (0%, 1%, 5%, 10%, and 20%) for subsequent experiments.

[0073] Animals and wound management

[0074] The experimental protocol was approved by the Animal Care and Ethics Committee of Nanjing Drum Tower Hospital. C57BL / 6 mice (male, 8 weeks old) were obtained from the Model Animal Research Center of Nanjing University and housed in a specific pathogen-free environment with unrestricted access to water and food. Eighteen mice in each group were intraperitoneally injected with 50 mg / kg streptozotocin (STZ, in sodium citrate buffer) daily for 5 days to construct an STZ-induced diabetic model. Blood glucose was measured in the mice three weeks later, and mice with blood glucose levels >16.7 mM were classified as diabetic. To establish an excisional wound model, an 8 mm circular biopsy punch was performed on the dorsal skin of the mice after depilation. After modeling, 10% ceAF was topically applied to the wound surface every day, and control mice were given an equal volume of PBS. Wound images were taken on days 0, 3, 5, 7, and 11, and the wound area was measured using ImageJ software (National Institutes of Health). Wound tissue samples were collected on days 5 and 10 after injury for subsequent experiments.

[0075] Histology and immunofluorescence staining

[0076] The wound edge tissue was fixed, dehydrated, embedded in paraffin, and sliced ​​at 5 μm thickness. Masson's trichrome (MT), hematoxylin-eosin (H&E), and Sirius red staining were performed according to standardized histological procedures. To evaluate macrophage polarization and angiogenesis, CD206, iNOS, CD31, and α-SMA monoclonal antibodies (1 μg / ml) were stained at 4°C overnight. Then, specific fluorescent secondary antibodies were incubated, followed by DAPI staining.

[0077] RAW264.7 cells were rinsed with PBS, fixed in 4% paraformaldehyde, permeabilized with 0.1% Triton X-100, and blocked with 3% BSA. Cells were then incubated with the corresponding primary and secondary antibodies as directed. All images were captured using an Olympus FluoView FV3000 confocal microscope (Tokyo, Japan).

[0078] RNA isolation and RT-qPCR

[0079] Total RNA was isolated from cells and wound edge tissues using Trizol reagent according to the manufacturer's instructions. RT-qPCR was performed using the StepOne RT-qPCR system (Applied Biosystems, USA) with SYBR green dye. After normalization with GAPDH, 2 -ΔΔCT Methods The relative gene levels were determined. The primer sequences are shown in Table 1.

[0080] Table 1: Primer sequences used for RT-qPCR (SEQ ID NO: 1-14)

[0081] Western blotting (WB) analysis

[0082] Protein samples were isolated from lysed skin tissue and cells using RIPA lysis buffer (KeyGEN, China). A BCA assay was performed to determine the total protein concentration after centrifugation. Protein samples were separated by 10% SDS-PAGE gel and transferred to a PDVF membrane (Millipore, USA). After blocking with 5% BSA, the membrane was incubated with the corresponding primary antibody overnight and the secondary antibody for 1 hour. Protein bands were visualized using an ECL substrate kit (Vazyme, China).

[0083] Flow cytometry

[0084] To determine the polarization tendency of RAW264.7 macrophages, cells were preincubated with FITC-conjugated anti-mouse F4 / 80 antibody and PE-conjugated anti-mouse CD206 antibody for 30 minutes at 4°C in the dark. Cell phenotype was determined using a flow cytometer (FACSCanto II, BD, USA), and data were analyzed using FlowJo software.

[0085] Cell viability test

[0086] RAW264.7 cell viability was assessed using the CCK-8 assay (Beyotime, China). After starvation for 12 hours, cells were exposed to ceAF at concentrations of 0%, 1%, 5%, 10%, or 20%, and then incubated for 24 hours. The cells were rinsed three times with PBS and then covered with 200 μL of incomplete medium (10 μL) containing a CCK-8 mixture and incubated at 37°C. The absorbance was measured at 450 nm using a microplate reader.

[0087] Enzyme-linked immunosorbent assay (ELISA)

[0088] RAW264.7 cells were exposed to 10% ceAF for 48 h, and the cell supernatants were collected for testing. The secreted IL-6, IL-10, TGF-β1, and TNF-α were measured by ELISA kits according to the kit instructions (Elabscience, China).

[0089] Statistical analysis

[0090] Experimental data were analyzed using Graphpad Prism v8.0 software and expressed as Mean ± SEM. Parametric tests were used for data that were normally distributed (Shapiro-Wilk test). If the data were normally distributed, one-way analysis of variance and Newman-Keuls post hoc test were used to compare statistical differences between multiple groups. If the data passed the normality test, the two groups were compared using a two-tailed Student's t-test. The combined effect of two factors was analyzed using a two-way ANOVA, followed by a Tukey post-test. At least three independent determinations were performed, and P < 0.05 was defined as statistically significant.

[0091] Example 1: ceAF alleviates lipopolysaccharide-stimulated RAW264.7 cell inflammation via the TLR4 / NF-κB signaling pathway

[0092] To evaluate the regulatory effect of ceAF on lipopolysaccharide (LPS)-induced cellular inflammation, this example used RAW264.7 cells as experimental cells and stimulated them with LPS (100 ng / ml) for 48 hours to induce cellular inflammation.

[0093] First, the cell proliferation and survival ability was tested using different concentrations of ceAF. CCK8 results showed that with increasing ceAF concentration, the proliferation and survival ability of RAW264.7 increased, reaching a peak at a concentration of 10% (Figure 1, A). RAW264.7 was then divided into a blank control (NC), an LPS stimulation group (LPS), a combined LPS and ceAF intervention group (LPS+ceAF), and a ceAF intervention group (ceAF). qPCR results showed that after LPS stimulation, at the transcriptional level, the expression of M2 macrophage-related genes (CD206) decreased, the expression of M1 macrophage-related genes (iNOS) increased, and the expression of inflammation-related genes (TNF-α, IL-6, IL-1β) increased. These trends were reversed after ceAF intervention (Figure 1, B). Western blotting (WB) experiments were further performed at the translation level, and the same trend results were obtained (Figure 1, CD).

[0094] Example 2: ceAF induces RAW264.7 cells to polarize toward M2 macrophages in vitro

[0095] Flow cytometry and cell immunofluorescence were used to verify that ceAF induced macrophage polarization toward M2. Flow cytometry used CD86 to label macrophages, and CD206 to locate M2 macrophages. Cell immunofluorescence used Arg-1 to locate M2 macrophages. The results showed that ceAF intervention effectively increased the proportion of M2 macrophages at both 48 and 72 hours (Figure 2, AD). RAW264.7 cell supernatants were collected, and ELISA was used to detect inflammatory cytokines. The results showed that the proinflammatory factors IL-6 and TNF-α decreased significantly after ceAF intervention, while the M2-related secretion factors TGF-β1 and IL-10 increased significantly after ceAF intervention (Figure 2, E).

[0096] Example 3: ceAF promotes wound healing in STZ-induced diabetic mice

[0097] To verify the effect of ceAF on wound healing in streptozotocin (STZ)-induced diabetic mice, 8-week-old male mice were divided into two groups. STZ (50 mg / kg) was injected intraperitoneally for five consecutive days. Blood glucose was measured one week later. A blood glucose level >16.7 mM was considered a successful diabetic model. A full-thickness wound with a diameter of 8 mm was created in the central skin of the mouse back using sharp scissors. The control group (DM group) received routine dressing changes daily, while the experimental group received 10% ceAF topical dressing changes daily. Wound photos were recorded with a camera on days 0, 3, 5, 7, and 11. The results showed that starting from the fifth day, the healing speed of the ceAF group was significantly faster than that of the control group (Figure 3, AB). There was no significant difference in the weight and blood glucose of the mice between the two groups on day 11 (Figure 3, CD), and the confounding factors of weight and blood glucose could be ruled out.

[0098] Example 4: ceAF improves histological parameters of wounds in STZ-induced diabetic mice

[0099] This example further confirmed the effect of ceAF on the wounds of STZ-induced diabetic mice through histopathology. H&E staining was performed on the 5th day after wound modeling to observe the infiltration of inflammatory cells in the wound tissue, and it was found that the inflammatory cells in the ceAF group were significantly reduced (Figure 4, AB). MT staining was performed on the 10th day after wound modeling to observe the collagen deposition in the wound tissue, and it was found that the collagen deposition in the ceAF group was significantly increased (Figure 4, CD). After the wounds of both groups were healed, the skin tissue of the healing area was taken for picrosirius red staining to evaluate the healing quality (Figure 4, E). The results showed that the ceAF group had more type III collagen and the control group had more type I collagen, indicating that the ceAF group had less scar formation and better healing quality.

[0100] Example 5: ceAF improves wound healing-related indicators in STZ-induced diabetic mice

[0101] Tissue immunofluorescence further confirmed the effects of ceAF on healing-related markers in STZ-induced diabetic mice. Skin wound margin tissue was obtained on day 5 for co-staining with F4 / 80 and CD206 to locate M2 macrophages, and F4 / 80 and iNOS co-staining to locate M1 macrophages. The ceAF group showed a significant increase in M2 macrophages at the wound margin (Figure 5, A) and a significant decrease in M1 macrophages (Figure 5, B). Skin wound margin tissue was obtained on day 10 for staining with CD31 and α-SMA (Figure 5, CD), indicating a significant increase in neovascularization in the ceAF group.

[0102] Example 6: ceAF can regulate wound-related inflammatory factors in STZ-induced diabetic mice

[0103] To verify the effect of ceAF on wound-related inflammatory factors in STZ-induced diabetic mice in vivo, wound edge tissues were collected on the 5th day after wound modeling for WB and qPCR detection. It was found that the transcription and translation levels of M2 macrophage genes CD206 and Arg-1 were increased in the ceAF group (Figure 6, A, CD), while the transcription and translation levels of M1 macrophage marker gene iNOS and inflammatory-related genes TNF-α, IL-6, and IL-1β were decreased (Figure 6, A, EH).

[0104] In summary, these results demonstrate that ceAF can ameliorate LPS-induced inflammatory responses in RAW264.7 cells in vitro and promote wound healing in STZ-induced diabetic mice in vivo, through regulating the TLR4 / NF-κB signaling pathway.

Claims

1. Use of amniotic fluid in the preparation of a medicament for treating and / or preventing macrophage-mediated diseases; in, The amniotic fluid comes from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of eggs of the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

2. Use of amniotic fluid in the preparation of drugs for treating and / or preventing diseases mediated by M1 macrophages, in, The amniotic fluid comes from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of eggs of the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

3. Use of amniotic fluid in the preparation of drugs for treating and / or preventing diseases mediated by M2 macrophages, in, The amniotic fluid comes from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of eggs of the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

4. Use of amniotic fluid in the preparation of preparations for treating and / or preventing diseases mediated by the TLR4 / NF-κB signaling pathway, in, The amniotic fluid comes from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, more preferably eggs with an embryonic age of 7-8 days, or from eggs of poultry other than chickens whose developmental period corresponds to the developmental period of eggs of the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of non-human mammals other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days.

5. Use of amniotic fluid in the preparation of a preparation for inhibiting the number of M1 macrophages and increasing the proportion of M2 macrophages, or in the preparation of a preparation for promoting the transformation of M1 macrophages to M2 macrophages. in, The amniotic fluid is from eggs with an embryonic age of 5-12 days, preferably eggs with an embryonic age of 6-11 days, more preferably eggs with an embryonic age of 7-9 days, more preferably eggs with an embryonic age of 7-8 days, or eggs of poultry other than chickens whose developmental period corresponds to the developmental period of the eggs of the embryonic age; or from embryos of rodents with a gestational age of 8-14 days, or from embryos of rodents other than rodents whose developmental period corresponds to the developmental period of rodents with a gestational age of 8-14 days. It is not a human mammal embryo.

6. The use according to any one of claims 1 to 5, characterized in that The medicine or preparation is a cell culture containing the amniotic fluid and / or embryonic stem cells, Preferably, the medicine or preparation is a pharmaceutical composition comprising the amniotic fluid and / or chicken embryonic stem cells and pharmaceutically acceptable excipients.

7. The use according to claim 1, wherein The macrophage-mediated disease is selected from the group consisting of: hypertrophic scars; chronic obstructive pulmonary disease; tumors, such as breast cancer and liver cancer; metabolic diseases, such as severe obesity, insulin resistance, and type II diabetes; inflammatory diseases, such as acute pancreatitis and atherosclerosis; cardiovascular diseases, such as myocarditis, myocardial infarction, and arrhythmia; neuropathy, such as Alzheimer's disease; brain diseases, such as cerebral infarction and brain injury; ophthalmological diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, uveal melanoma, and myopia; and immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma, alcoholic liver disease, colitis, multiple sclerosis, and periodontitis. Arthritis, such as rheumatoid arthritis, bone erosion, synovitis, and osteoarthritis; nephritis, such as acute kidney injury, chronic kidney disease, end-stage renal disease, proliferative glomerulonephritis, membranous nephropathy, diabetic nephropathy, Henoch-Schönlein purpura nephritis, ANCA-associated vasculitis, urinary tract infection, and autosomal dominant polycystic kidney disease; bacterial infectious diseases, such as sepsis; gestational hypertension; diabetes, gestational diabetes, and diabetic nephropathy.

8. The use according to claim 2, wherein: The M1 macrophage-mediated diseases are selected from: involuting hypertrophic scars; chronic obstructive pulmonary disease; tumors, such as breast cancer and liver cancer; metabolic diseases, such as severe obesity, insulin resistance, and type II diabetes; inflammatory diseases, such as acute pancreatitis; coronary artery disease, such as atherosclerosis; kidney disease; obesity; cardiovascular diseases, such as myocarditis and myocardial infarction; brain diseases, such as cerebral infarction and brain injury; ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, and uveal melanoma; immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma, alcoholic liver disease, colitis, multiple sclerosis, periodontitis, and osteoarthritis; diabetes, gestational diabetes, and diabetic nephropathy.

9. The use according to claim 3, characterized in that The M2 macrophage-mediated diseases are selected from: hypertrophic scars in the proliferative phase; tumors, such as breast cancer and liver cancer; metabolic diseases, such as insulin resistance and type II diabetes; inflammatory diseases, such as acute pancreatitis; cardiovascular diseases, such as myocardial infarction, myocardial failure, atherosclerosis, coronary artery disease, and myocarditis; cerebral infarction; ophthalmic diseases, such as autoimmune uveitis, retinopathy, keratitis, corneal transplantation, Sjögren's syndrome, and uveal melanoma; immune inflammatory diseases, such as inflammatory bowel disease, autoimmune hepatitis, asthma, alcoholic liver disease, colitis, multiple sclerosis, periodontitis, and osteoarthritis; diabetes, gestational diabetes, and diabetic nephropathy.

10. The use according to claim 4, characterized in that The disease mediated by the TLR4 / NF-κB signaling pathway is selected from: systemic lupus erythematosus; vascular inflammation, such as atherosclerosis and coronary heart disease; myocarditis, such as myocardial ischemia and myocardial damage; hepatitis, such as liver failure, alcoholic liver damage, and inflammatory immune response during alcohol metabolism; fatty liver; pneumonia, such as acute lung injury, chronic obstructive pulmonary disease, and silicosis; Nephritis, such as acute kidney injury and lupus nephritis; inflammatory bowel disease, such as acute enteritis, ulcerative colitis, and radiation proctitis; Gastritis, such as chronic atrophic gastritis; acute respiratory tract infections, such as pneumonia, bronchitis, pharyngitis, sinusitis, otitis media; periodontitis, hyperuricemia; Allergic rhinitis, allergic rhinitis; Mastitis; Arthritis, such as acute gouty arthritis, chronic arthritis, and rheumatoid arthritis; wound tissue inflammation and hypertrophic scars; polycystic ovary syndrome; tumors, such as pituitary prolactin adenoma, adrenocorticotropic hormone adenoma, and intracranial aneurysm; infectious diseases, such as bacterial infection, fungal infection, and viral infection; Allergic diseases, such as allergic skin diseases, bronchial asthma, allergic rhinitis, and allergic purpura.

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