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BACKGROUND: Studies have demonstrated that β-amyloid peptide (Aβ), a characteristic pathological product of Alzheimer's disease (AD), results in neuronal endoplasmic reticulum stress (ERS). However, the mechanisms of traditional Chinese medicine against ERS in AD are poorly understood.OBJECTIVE: To measure expression levels of protective proteins (GRP78 and GRP94) of ER molecular partners and pro-apoptotic Caspase-12 ER membrane expression following application of traditional Chinese medicine natural cerebrolysin (NC) to treat Aβ_(1-40)-induced ERS.DESIGN, TIME AND SETTING: A parallel-controlled study was performed at the Institute of Integrated Western and Traditional Chinese Medicine, Shenzhen Hospital of Southern Medical University between September 2006 and November 2008.MATERIALS: Sprague Dawley male rats, 6-8 weeks old, were used to harvest tibial and femoral bone marrow. Isolation and purification of mesenchymal stem cells (MSCs) were established from the whole bone marrow by removing non-adherent cells in primary and passage cultures. Aβ_(1-40) was provided by Sigma, USA. NC was provided by Shenzhen Institute of Integrated Chinese and Western Medicine, China. NC was predominantly composed of Renshen (Radix Ginseng), Tianma (Rhizoma Gastrodiae), and Yinxingye (Ginkgo Leaf) in a proportion of 1:2:2. Following conventional water extraction technology, an extract (1: 20) was prepared. Six adult, male, New Zealand rabbits underwent intragastric administration of NC extract (0.976 g/kg per day) for 1 month to prepare NC-positive serum, and the remaining 6 rabbits received intragastric administration of physiological saline to prepare normal blank serum.METHODS: A total of 500 nmol/L Aβ_(1-40) was used to establish ERS models of primary cultured MSCs. AD cell models were incubated with different doses of NC-positive serum (2.5%, 5%, and 10%). MSCs treated with normal blank serum served as normal blank controls.MAIN OUTCOME MEASURES: Reverse transcription-polymerase chain reaction and fluorescent immunocytochemistry were respectively used to measure mRNA and protein expression levels of GRP78, GRP94, and Caspase-12 in MSCs.RESULTS: Following Aβ_(1-40) exposure, mRNA and protein expression levels of GRP78 and GRP94,as well as Caspase-12, significantly increased (P < 0.05), suggesting successful establishment of ERS models. Following NC-positive serum application, mRNA and protein expression levels of GRP78 and GRP94 in MSCs significantly increased (P< 0.05 or P< 0.01). However, mRNA and protein expression levels of Caspase-12 significantly decreased (P< 0.05, or P< 0.01) compared with the ERS model group. These effects were dose-dependent.CONCLUSION: NC downregulated Caspase-12 expression and upregulated GRP78 and GRP94 expression in MSCs in a dose-dependent manner under the state of Aβ_(1-40)-induced ERS.