Pachymaran Alleviates Acute Gouty Arthritis by Inhibiting NLRP3 Inflammasome Activation and Pyroptosis.

Objective: Acute gouty arthritis is the most common rheumatic diseases, and leads to a heavy clinical burden, thereby to explore the treatment effects of pachymaran on acute gouty arthritis and elucidate its mechanism are meaningful. Methods: Eighteen SPF C57BL/6 mice were randomly divided into three groups: the sham group, model group, and pachymaran group (200mg/kg), with 6 mice in each group. The acute gouty arthritis model of mice was established by injecting 0.025 mL sodium urate solution into the right ankle cavity of the mice. The pachymaran group was given 200mg/kg of pachymaran intragastrically, in the sham group and model group were given the same volume of normal saline, respectively, for 7 consecutive days. Blood samples were collected from the orbital venous plexus 1 h after the last administration, all mice were killed, and ankle tissue samples were collected. The pathological changes of mouse ankle synovial tissue were observed by HE staining. The expression levels of IL-1ß and IL-18 inflammatory factors in the serum of mice were determined by ELISA. The ultrastructure of the synovial tissue of the mouse ankle joint was observed by transmission electron microscope. The protein expression levels of NLRP3, ASC, IL-1ß, IL-18, GSDMD, and Caspase-1 in synovial tissue of mouse ankle were detected by Western blot assay. Mouse chondrocytes were cultured and divided into groups I, II, III, and IV. Group I was the control group without any drug intervention. The cells in groups II, III, and IV were stimulated with sodium urate solution (100µg/mL), and groups III and IV were intervened by pachymaran (200µg/mL), among which the NLRP3 agonist Nigericin sodium salt intervened group IV. The expression levels of NLRP3, IL-1ß, GSDMD, and Caspase-1 proteins were detected by Western blot assay, and the apoptosis rate was detected by flow cytometry. Results: Compared with the sham group, the pathological injury of mice ankle synovial tissue in the model group was significantly aggravated, as the membrane was incomplete, mitochondria were swollen, the ridge was unclear or even disappeared, and the pathological injury of mice ankle synovial tissue in the pachymaran group was significantly improved vs model group; the serum levels of IL-1ß and IL-18 were increased in model group vs sham group, and pachymaran decreased these index vs model group; Compared with the sham group, protein expression levels of NLRP3, ASC, IL-1ß, IL-18, GSDMD, and Caspase-1 were significant increased in model group, and pachymaran suppressed these proteins vs model group. The TEM results showed that in model group the wide swelling of mitochondria accompanied by disappearance of mitochondrial cristae vs sham group, and the mitochondrial ridge was slightly damaged, or the mitochondria were only swollen, and the ridge was still clearly visible in pachymaran group. In vitro experiments, Compared with group I, the protein expression levels of NLRP3, IL-1ß, GSDMD, Caspase-1, and the apoptosis rate of chondrocytes in group II were significantly increased. Compared with group II, the protein expression levels of NLRP3, IL-1ß, GSDMD, Caspase-1, and the apoptosis rate of chondrocytes in group III were significantly decreased. Compared with group III, the protein expression levels of NLRP3, IL-1ß, GSDMD, Caspase-1, and the apoptosis rate of chondrocytes in group IV were significantly increased. Conclusion: Pachymaran maintain the structural integrity of joints and alleviate the progression of acute gouty arthritis by inhibiting NLRP3 inflammasome activation and pyroptosis, pachymaran may be used and applied to clinical treatment.

Regulatory Effects of Quercetin on Bone Homeostasis: Research Updates and Future Perspectives.

The imbalance of bone homeostasis has become a major public medical problem amid the background of an aging population, which is closely related to the occurrence of osteoporosis, osteoarthritis, and fractures. Presently, most drugs used in the clinical treatment of bone homeostasis imbalance are bisphosphonates, calcitonin, estrogen receptor modulators, and biological agents that inhibit bone resorption or parathyroid hormone analogs that promote bone formation. However, there are many adverse reactions. Therefore, it is necessary to explore potential drugs. Quercetin, as a flavonol compound with various biological activities, is widely distributed in plants. Studies have found that quercetin can regulate bone homeostasis through multiple pathways and targets. An in-depth exploration of the pharmacological mechanism of quercetin is of great significance for the development of new drugs. This review discusses the therapeutic mechanisms of quercetin on bone homeostasis, such as regulating the expression of long non-coding RNA, signaling pathways of bone metabolism, various types of programmed cell death, bone nutrients supply pathways, anti-oxidative stress, anti-inflammation, and activation of Sirtuins. We also summarize recent progress in improving quercetin bioavailability and propose some issues worth paying attention to, which may help guide future research efforts.

Potential Therapeutic Mechanism of Radix Angelicae Biseratae and Dipsaci Radix Herb Pair against Osteoarthritis: Based on Network Pharmacology and Molecular Docking.

Background: A major contributor to older disability is osteoarthritis. Radix Angelicae Biseratae (known as Duhuo in China, DH, the dried rhizome of Angelica pubescens) and Dipsaci Radix (known as Xuduan in China, XD, the dried rhizome of Dipsacus asper Wall) herb pair (DXHP) is widely used to treat osteoarthritis, but the underlying molecular mechanisms still have not been revealed. This research aimed to illustrate the therapeutic mechanism of DXHP against osteoarthritis through the techniques of network pharmacology and molecular docking. Methods: Gene targets for osteoarthritis and active ingredients for DXHP were screened based on the pharmacology public database and the gene-disease target database. The software program Cytoscape was used to visualize the active chemical target-disease gene network. The STRING biological information website was used to investigate protein interactions. On the Metascape bioinformatics website, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were carried out. The molecular docking of the important chemicals and primary targets identified by the aforementioned screening was performed using Autodock software. Results: Twenty-six active substances from the DXHP that had strong connections to 138 osteoarthritis-related targets were screened out. According to network analysis, TNF, GAPDH, IL-6, AKT-1, IL-1B, and VEGFA are prospective therapeutic targets, while osthole, cauloside A, ammidin, angelicone, beta-sitosterol, and asperosaponin VI may be significant active components. 1705 biological processes (BP), 155 molecular functions (MF), and 89 cellular components (CC) were identified by GO analysis. KEGG analysis indicated that IL-17, NF-kappa B, HIF-1, MAPK, and AGE-RAGE signaling pathways are potentially involved. Molecular docking showed that cauloside A, osthole, and ß-sitosterol have excellent binding activity with main targets. Conclusions: This study comprehensively illuminated the active ingredients, potential targets, primary pharmacological effects, and relevant mechanisms of the DXHP in the treatment of OA. These findings provide fresh thoughts into the therapeutic mechanisms of the main active ingredients of DXHP and provide a reference for further exploration and clinical applications of DXHP.

Third dose of anti-SARS-CoV-2 inactivated vaccine for patients with RA: Focusing on immunogenicity and effects of RA drugs.

Objectives: To evaluate the immunogenicity of the third dose of inactivated SARS-CoV-2 vaccine in rheumatoid arthritis (RA) patients and explore the effect of RA drugs on vaccine immunogenicity. Methods: We recruited RA patients (n = 222) and healthy controls (HC, n = 177) who had been injected with a third dose of inactivated SARS-CoV-2 vaccine, and their neutralizing antibody (NAb) titer levels were assessed. Results: RA patients and HC were age- and gender-matched, and the mean interval between 3rd vaccination and sampling was comparable. The NAb titers were significantly lower in RA patients after the third immunization compared with HC. The positive rate of NAb in HC group was 90.4%, while that in RA patients was 80.18%, and the difference was significant. Furthermore, comparison of NAb titers between RA treatment subgroups and HC showed that the patients in the conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARDs) group exhibited no significant change in NAb titers, while in those receiving the treatment of biological DMARDs (bDMARDs), Janus Kinase (JAK) inhibitors, and prednisone, the NAb titers were significantly lower. Spearman correlation analysis revealed that NAb responses to SARS-CoV-2 in HC did differ significantly according to the interval between 3rd vaccination and sampling, but this finding was not observed in RA patients. In addition, NAb titers were not significantly correlated with RA-related laboratory indicators, including RF-IgA, RF-IgG, RF-IgM, anti-CCP antibody; C-RP; ESR; NEUT% and LYMPH%. Conclusion: Serum antibody responses to the third dose of vaccine in RA patients were weaker than HC. Our study will help to evaluate the efficacy and safety of booster vaccination in RA patients and provide further guidance for adjusting vaccination strategies.

Immunogenicity of Inactivated SARS-CoV-2 Vaccines in Patients With Rheumatoid Arthritis: A Case Series.

Objectives: Attenuated humoral response to mRNA SARS-CoV-2 vaccines has been reported in some patients with autoimmune disease, e.g., rheumatoid arthritis (RA). However, data of immune responses to inactivated SARS-CoV-2 vaccine in the RA population are still unknown. Herein, the safety and immunogenicity of inactivated SARS-CoV-2 vaccines in RA patients were analyzed. Methods: Seventy five RA patients and 26 healthy controls (HC) were respectively recruited from Yunnan Provincial Hospital of Traditional Chinese Medicine and the community in Kunming city. Neutralizing Antibody (NAb) Test ELISA kit was used to measure the percentage of inhibition. AKA (anti-keratin antibody) positivity was detected using indirect immunofluorescence. Rheumatoid factor (RF)-IgA was detected by ELISA. RF-IgG, RF-IgM, and anti-cyclic citrullinated peptide (CCP) antibodies were measured by chemiluminescence. ESR (erythrocyte sedimentation rate) was detected by ESR analyzer. C-RP (c-reactive protein) was detected by immunoturbidimetry. NEUT% (percentage of neutrophils) and LYMPH% (percentage of percentage) were calculated by a calculation method. Results: Compared with the HC group, the percentage of inhibition was significantly lower in RA patients receiving two doses of vaccines. Vaccines-induced percentage of inhibition was the lowest in RA patients who had not been vaccinated. In total 80.77% of the HC group had a percentage of inhibition ≧20%, compared with 45.24% of vaccinated RA patients and 6.06% of unvaccinated RA patients. Spearman correlation analysis revealed that antibody responses to SARS-CoV-2 did not differ between RA patients according to their age and disease duration. Furthermore, the results showed that no correlation was found between the percentage of inhibition and indices for RA, including RF-IgA, IgG, IgM; anti-CCP antibody; ESR; C-RP; NEUT% and LYMPH%. Conclusion: Our study showed inactivated vaccine-induced SARS-COV-2 antibody responses differ in RA patients and healthy subjects, emphasizing the importance of a third or fourth vaccination in RA patients.