Traditional Tibetan medicine: therapeutic potential in rheumatoid arthritis.

Rheumatoid arthritis (RA) is a severe inflammatory autoimmune disease characterized by the failed spontaneous resolution of inflammation. The induction of immune regulation and resolution of inflammatory pathways are effective in alleviating inflammation in RA. As the oldest medical system in the world, traditional Tibetan medicine (TTM) has a long history of preventing and treating RA. This review provides a comprehensive overview of medicinal plants with anti-RA activity in the TTM system, using classic books of Tibetan medicine, modern research literature, and drug standards. A total of 27 species have been found to be effective in treating RA, including Tinospora sinensis (Lour.) Merr., Terminalia chehula Retz., P. hookeri (C. B. Clarke) Hock.), and Aconitum pendulum Busch. Alkaloids, flavonoids, polyphenols, and terpenoids have turned out to be the major bioactive components for RA treatment. The inhibition of pro-inflammatory cytokine expression by mediating the NF-κB, MAPK, and JAK/STAT pathways is the core mechanism in RA treatment. In conclusion, this review provides key information and research perspectives for further research on the anti-RA effects of TTM.

An insight into current advances on pharmacology, pharmacokinetics, toxicity and detoxification of aconitine.

Aconitine is a diterpenoid alkaloid, which mainly exists in the plants of Aconitum. In the last decade, a plethora of studies on the pharmacological activities of aconitine has been conducted and demonstrated that aconitine possessed an extensive range of pharmacological activities such as anti-tumor, anti-inflammatory, analgesic, local anesthesia, and immunomodulatory effects. Pharmacokinetic studies indicated that aconitine may have the characteristics of poor bioavailability, wide distribution, and slow elimination. However, studies have also found that aconitine has toxic effects on the heart, nerves, embryos, etc. Therefore, we believe that aconitine may not be suitable for heart patients and pregnant women to treat related diseases. It is important to note that all of these pharmacological effects require further high-quality studies to determine the clinical efficacy of aconitine. This review aims to summarize the advances in pharmacological, pharmacokinetics, toxicity, and detoxification of aconitine in the last decade with an emphasis on its anti-tumor and anti-inflammatory activities, to provide researchers with the latest information and point out the limitations of relevant research at the current stage and the aspects that should be strengthened in future research.

A 52-Year-Old Man With an 11-Month History of Fever, Cough, Chest Pain, Pleural Effusion, and Left Lung Atelectasis.

CASE PRESENTATION: A 52-year-old man was referred to our hospital for cough, fever, chest pain, and progressive dyspnea. He has worked as a full-time security staff at a community center and was in a normal state of health until 11 months prior to referral when he began experiencing cough, expectoration, a high-grade fever (up to 39.7°C), chills, and left chest pain. He visited the local hospital several times with suspected lung cancer. Bronchoscopy showed chronic inflammatory changes in his bronchi. He was given a course of antibiotics, but his fever had not subsided. The patient had visited a bamboo rat farm and consumed bamboo rat meat one year previously. He had never smoked.