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ObjectiveTo investigate the clinical efficacy of Qihuang Jianpi Zishen Granules in the treatment of systemic lupus erythematosus (SLE) and its effect on the signal transducer and activator of tranSCription 3/mammalian target of rapamycin (STAT3/mTOR) signaling pathway, and to decipher the possible mechanism. MethodSixty female SLE patients who met the criteria in the First Affiliated Hospital of Anhui University of Chinese Medicine from May 2022 to May 2023 were selected and randomized into a control group and an observation group (30 cases in each group). The control group was treated with prednisone acetate + hydroxychloroquine sulfate orally, and the observation group was additionally treated with Qihuang Jianpi Zishen granules. The treatment lasted for 8 weeks. The SLE disease activity (SLEDAI), TCM syndrome score, erythrocyte sedimentation rate (ESR), hypersensitive C-reactive protein (hs-CRP), immune indexes [immunoglobulin G (IgG), C3, C4, CD4+, and CD8+], interleukin (IL)-17, IL-23, interferon (IFN)-γ, 24 h urinary protein (24 h PRO), serum creatinine (SCr), and expression of proteins [STAT3, phosphorylated (p)-STAT3, mTOR protein and STAT3,mTOR mRNA] in the STAT3/mTOR signaling pathway were determined before and after treatment. In addition, the adverse reactions were recorded. ResultAfter 8 weeks of treatment, the total response rate in the observation group was 93.33% (28/30), which was higher than that (70.00%, 21/30) in the control group (χ2=4.007, P<0.05). After treatment, both groups showed declined SLEDAI, TCM syndrome score, ESR, hs-CRP, IgG, CD8+, IL-17, IL-23, IFN-γ, 24 h PRO, SCr, and expression of proteins in the STAT3/mTOR pathway (P<0.01) and elevated levels of C3, C4, and CD4+ (P<0.01). Moreover, the observation group had lower SLEDAI, TCM syndrome score, ESR, hs-CRP, IgG, CD8+, IL-17, IL-23, IFN-γ, 24 h PRO, SCr, and expression of proteins in the STAT3/mTOR pathway (P<0.05, P<0.01) and higher levels of C3, C4, and CD4+ (P<0.05, P<0.01) than the control group after treatment. Neither group showed serious adverse reactions during the treatment period. ConclusionQihuang Jianpi Zishen Granules can ameliorate the inflammatory response, reduce the disease activity, and mitigate the kidney injury in SLE by inhibiting the STAT3/mTOR signaling pathway to regulate the immune function.
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Long non-coding RNAs(lncRNAs)can be involved in regulating gene expression through multiple interactions with DNA,RNA or proteins.Studies have shown that lncRNAs not only regulate innate immune response,but also regulate immune cell development and adaptive immunity.According to recent reports,a number of lncRNAs play a role in the pathogenesis of immune-mediated inflammatory diseases,including systemic lupus erythematosus(SLE),and may become a diagnostic marker and prognostic reference for diseases.This paper summarizes the research progress of lncRNAs in SLE,with the hope of providing more new ideas and methods for the study of SLE.
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ObjectiveTo investigate the clinical efficacy and safety of Qihuang Jianpi Zishen granules in the treatment of cardiac involvement in systemic lupus erythematosus (SLE). MethodA total of 62 SLE patients with cardiac involvement treated in the Department of Rheumatology and Immunology, the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2021 to December 2022 were randomized into control and observation groups (n=31). The control group was treated with methylprednisolone tablets and hydroxychloroquine sulfate tablets, and the observation group with Qihuang Jianpi Zishen granules on the basis of the therapy in the control group. After 12 weeks of treatment, the two groups were compared in terms of the therapeutic effect, cardiac function indicators [left atrial end-diastolic diameter (LADd), left ventricular end-diastolic diameter (LVDd), left ventricular posterior wall thickness (LVPWTd), peak blood flow velocity in early diastolic period (peak E), peak blood flow velocity in late diastolic period (peak A), E/A ratio, stroke volume (SV), left ventricular ejection fraction (LVEF), left ventricular short axis shortening rate (LVFS), and B-type natriuretic peptide (BNP)], vascular damage indicators [nitric oxide (NO), endothelin-1 (ET-1), vascular endothelial growth factor (VEGF), and homocysteine (Hcy)], inflammation indicators [erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (Hs-CRP)], anti-double-stranded DNA (dsDNA) antibodies, disease activity index (SLEDAI) score, mitigation of symptoms and signs, and occurrence of adverse reactions. ResultThe total response rate in the observation group was 87.09%, which was higher than that (67.74%) in the control group (P<0.01), and the incidence of adverse reactions had no significant difference between the two groups. After treatment, the control group showed lowered LVDd, LVPWTd, BNP, ET-1, VEGF, and Hcy (P<0.05) and increased E peak, E/A ratio, SV, LVEF, and LVFS (P<0.05). In the observation group, LADd, LVDd, LVPWTd, peak A, BNP, NO, ET-1, VEGF, and Hcy decreased (P<0.05), while peak E, E/A ratio, SV, LVEF and LVFS increased (P<0.05) after treatment. The treatment in both groups decreased the scores of palpitation, chest tightness, dyspnea, and edema (P<0.05), reduced ESR, Hs-CRP, ds-DNA, and SLEDAI (P<0.05). After treatment, the observation group had lower LADd, LVDd, LVPWTd, peak A, BNP, and scores of palpation, chest tightness, dyspnea, and edema (P<0.05) and higher peak E, E/A ratio, SV, LVEF, and LVFS (P<0.05) than the control group. In addition, the observation group had lower NO, ET-1, VEGF, Hcy, ESR, Hs-CRP, ds-DNA, and SLEDAI than the control group (P<0.05). ConclusionQihuang Jianpi Zishen granules combined with hydroxychloroquine sulfate and methylprednisolone can improve multiple indicators and mitigate the symptoms and signs of SLE patients with cardiac involvement, demonstrating a clinical application value.