China rheumatoid arthritis registry of patients with Chinese medicine (CERTAIN): Rationale, design, and baseline characteristics of the first 11,764 enrollees.

BACKGROUND: Chinese medicine (CM) has become a popular interventional treatment for rheumatoid arthritis (RA). However, limited knowledge about general characteristics and long-term clinical outcomes hampers the development of CM for RA. PURPOSE: The main objectives of the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) were to describe the population of RA patients receiving CM treatment in multiple centers in China using different variables and compare these findings with internationally reported data. STUDY DESIGN: The CERTAIN is a prospective, multicenter, observational disease registry. METHODS: Adult RA patients who fulfilled the 2010 American College of Rheumatology/ European League Against Rheumatism classification criteria for RA and received CM treatment were recruited into the CERTAIN by rheumatologists from 145 hospitals across 30 provinces in China. Data on demographics, disease characteristics, comorbidities, treatments, and adverse events, with a 2-year follow-up, were collected and documented using a predefined protocol. RESULTS: In the 2 years since the study began in September 2019, 11,764 patients have been enrolled (enrolment is ongoing), and 13.10% of participants have completed the 6-month follow-up. We present the baseline characteristics of the first 11,764 enrollees. CONCLUSIONS: The CERTAIN is the first nationwide registry to document comprehensive data on CM treatment in patients with RA. The development of the CERTAIN resource is a significant step forward for Chinese RA patients, herbal medicine users, and research communities and will deepen our understanding of CM for RA. REGISTRATION: The study was registered at ClinicalTrials.gov (NCT05219214).

Antiproliferative potential of piperine and curcumin in drug-resistant human leukemia cancer cells are mediated via autophagy and apoptosis induction, S-phase cell cycle arrest and inhibition of cell invasion and migration.

PURPOSE: Leukemia causes annually a significant number of deaths. The main objective of this study was to investigate the anticancer properties of piperine and curcumin against HL60 leukemia cells and to elucidate the underlying mechanism. METHODS: Antiproliferative effects were assessed by WST-1 cell viability assay. Cell apoptotic effects were studied by DAPI staining assay. Annexin V/propidium iodide (PI) assay was used to assess apoptosis. Electron microscopy was used for detection of autophagy and flow cytometry for cell cycle analysis, while transwell migration assay was used to study the effects on cell migration and invasion. Protein expression was estimated by western blot. RESULTS: The results showed that both piperine and curcumin inhibited significantly the growth of the HL60 cells and exhibited an IC50 of 25 and 30 µM respectively. Further, it was observed that the anticancer effects of piperine and curcumin were due to the induction of mitochondrial-mediated apoptosis which was also associated with enhancement of the Bax expression. Transmission electron microscopy also showed that both curcumin and piperine induced autophagy in the HL-60 leukemia cells. Flow cytometry showed that piperine and curcumin also caused arrest of the HL-60 cells at the S-phase of the cell cycle. Finally wound healing and transwell assays showed that piperine and curcumin suppressed the migration and invasive potential of the HL60 cells. CONCLUSIONS: The present study reveals that piperine and curcumin exhibit significant antitumor activity in human leukemia HL60 cells via multiple mechanisms and may prove promising in the development of systemic therapy for leukemia.

Physcion 8­O­ß­glucopyranoside extracted from Polygonum cuspidatum exhibits anti­proliferative and anti­inflammatory effects on MH7A rheumatoid arthritis­derived fibroblast­like synoviocytes through the TGF­ß/MAPK pathway.

The present study aimed to investigate the anti­arthritic effect of physcion 8­O­ß­glucopyranoside (POGD) and its possible mechanisms. The anti­proliferative effects of POGD on MH7A cells were detected using a CCK­8 assay, and the release of pro­inflammatory cytokines, interleukin (IL)­1ß, IL­6, IL­8, IL­12 and IL­17A, were determined by ELISA. A type II collagen­induced arthritis (CIA) rat model was established to evaluate the anti­arthritic effect of POGD in vivo. The paw volumes, arthritis indices and serum levels of tumor necrosis factor (TNF)­α, IL­1ß, IL­6, IL­8, IL­17A were determined by ELISA. The mRNA expression levels of matrix metalloproteinase (MMP)­2, MMP­3, MMP­9, vascular endothelial growth factor and cyclooxygenase­2 were determined by reverse transcription­quantitative polymerase chain reaction analysis, and the expression levels of transforming growth factor (TGF)­ß1, small mothers against decapentaplegic (Smad)4, Smad7, c­Jun N­terminal kinase (JNK), phosphorylated (p­)JNK, p­P38, P38, p­extracellular signal­regulated kinase (ERK)1/2, ERK1/2, nuclear factor (NF)­κB p65 in the nucleus (N), cytosolic NF­κB p65 (C), and inhibitor of NF­κB (IκB) were determined by western blot analysis. The results indicated that POGD significantly inhibited MH7A cell growth. POGD markedly inhibited paw swelling and the arthritis indices of the CIA rats, and POGD may also inhibit the release of pro­inflammatory cytokines. Furthermore, POGD downregulated the expression levels of TGF­ß1, Smad4, NF­κB p65 (N), p38, p­p38, p­ERK1/2, JNK, p­JNK, TGF­ß1, Smad4, p­JNK, JNK, p­P38, P38, p­ERK1/2, ERK1/2 and NF­κB p65 (N), and upregulated the Smad7, NF­κB p65 (C) and IκB in TNF­α induced MH7A cells. In conclusion, the results suggested that POGD is a promising potential anti­inflammatory drug, and that POGD may decrease the expression of pro­inflammatory cytokines and mediators via inhibiting the TGF­ß/NF­κB/mitogen­activated protein kinase pathways.