Chinese Herbal Medicine for Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis of Randomized, Placebo-Controlled Trials.

OBJECTIVE: To provide evidence on the efficacy and safety of Chinese herbal medicine (CHM) as interventions for systemic lupus erythematosus (SLE). METHODS: Seven electronic databases, including the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Service System (SinoMed), Wanfang, Embase, and PubMed, were comprehensively searched, from their inception to August 16, 2020, for all randomized controlled trials (RCTs) that focused on CHM used alone or in combination with conventional medicine for SLE. Outcomes were SLE activity index (SLEDAI), traditional Chinese medicine symptom/syndrome score (TCMSS), dosage of glucocorticoids, main serological testing, and incidence of adverse events. Data were extracted and pooled using Review Manager 5.3 software. RESULTS: A total of 13 RCTs enrolling 856 participants met our inclusion criteria. Meta-analyses showed that, compared to placebo, CHM had statistically significant effect on reducing SLEDAI score (MD=-1.74, 95% CI: -2.29 to -1.18), diminishing TCMSS (SMD=-0.89, 95% CI: -1.16 to -0.62), decreasing dosage of glucocorticoids (MD=-2.41 mg/d, 95% CI: -3.34 to -1.48), lowering erythrocyte sedimentation rate (MD=-4.78 mm/h, 95% CI: -8.86 to -0.71), and increasing serum complement C4 level (MD=0.03 mg/dL, 95% CI: 0.00 to 0.06). No significant difference was found between CHM and placebo on adverse events. CONCLUSIONS: CHM provided significant beneficial effect on controlling disease activity and reducing dose of glucocorticoids used among SLE patients. Future advanced designed RCTs for CHM treating moderate to severe SLE with multicenter and longer follow-up are urgently needed.

Chinese Herbal Medicine for Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis of Randomized, Placebo-Controlled Trials / 中国结合医学杂志

OBJECTIVE@#To provide evidence on the efficacy and safety of Chinese herbal medicine (CHM) as interventions for systemic lupus erythematosus (SLE).@*METHODS@#Seven electronic databases, including the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Service System (SinoMed), Wanfang, Embase, and PubMed, were comprehensively searched, from their inception to August 16, 2020, for all randomized controlled trials (RCTs) that focused on CHM used alone or in combination with conventional medicine for SLE. Outcomes were SLE activity index (SLEDAI), traditional Chinese medicine symptom/syndrome score (TCMSS), dosage of glucocorticoids, main serological testing, and incidence of adverse events. Data were extracted and pooled using Review Manager 5.3 software.@*RESULTS@#A total of 13 RCTs enrolling 856 participants met our inclusion criteria. Meta-analyses showed that, compared to placebo, CHM had statistically significant effect on reducing SLEDAI score (MD=-1.74, 95% CI: -2.29 to -1.18), diminishing TCMSS (SMD=-0.89, 95% CI: -1.16 to -0.62), decreasing dosage of glucocorticoids (MD=-2.41 mg/d, 95% CI: -3.34 to -1.48), lowering erythrocyte sedimentation rate (MD=-4.78 mm/h, 95% CI: -8.86 to -0.71), and increasing serum complement C4 level (MD=0.03 mg/dL, 95% CI: 0.00 to 0.06). No significant difference was found between CHM and placebo on adverse events.@*CONCLUSIONS@#CHM provided significant beneficial effect on controlling disease activity and reducing dose of glucocorticoids used among SLE patients. Future advanced designed RCTs for CHM treating moderate to severe SLE with multicenter and longer follow-up are urgently needed.

Clinical Efficacy of Qinghao Fuzheng Jiedu Decoction in Treatment of Systemic Lupus Erythematous / 中国实验方剂学杂志

Objective:To study the clinical effect of Qinghao Fuzheng Jiedu decoction on systemic lupus erythematous （SLE）. Method:A total of 109 SLE patients admitted to the Rheumatology and Immunology Department of Wuhan No. 1 Hospital from December 2019 to October 2020 were selected and divided into an observation group （55 cases） and a control group （54 cases） using the random number table. Two cases in the observation group dropped out， leaving a total sample of 53， and one case in the control group dropped out， with 53 cases finally included. Patients in the control group were treated with prednisone tablet and azathioprine. On this basis， those in the observation group further received Qinghao Fuzheng Jiedu decoction. The clinical efficacy， traditional Chinese medicine （TCM） syndrome score， TCM syndrome efficacy， immunoglobulin （Ig） G， IgA， IgM， and complements C3 and C4 of the two groups were compared. The conversion of positive antinuclear antibody （ANA） and anti-double-stranded deoxyribonucleic acid antibody （DS-DNA） titers to negative in two groups after treatment was analyzed. Result:The total clinical efficacy rate of the observation group was significantly higher than that of control group （92.45% vs 73.58%，<italic>χ²</italic>=6.692，<italic>P</italic><0.05）. Before treatment， there were no significant differences in IgG， IgA， IgM， complements C3 and C4， and serum ANA and ds-DNA titers between two groups. After treatment， the levels of IgG， IgA， and IgM and serum ANA and ds-DNA titers in both groups obviously declined， whereas the levels of complements C3 and C4 rose （<italic>P</italic><0.05）. Besides， the levels of IgG， IgA， and IgM and serum ANA and ds-DNA titers in the observation group were lower than those in the control group， while the levels of complements C3 and C4 were higher （<italic>P</italic><0.05）. The negative rates of ANA and ds-DNA in observation group were significantly higher than those in control group （<italic>χ²</italic>=8.040，<italic>P</italic><0.05）. TCM syndrome scores were decreased in both groups after treatment （<italic>P</italic><0.05）， and the score in observation group was lower than that in control group （<italic>P</italic><0.05）. In terms of TCM syndrome efficacy， the total effective rate of observation group was significantly increased as compared with that of the control group （94.34% vs 50.94%，<italic>χ²</italic>=25.112，<italic>P</italic><0.05）. Conclusion:Qinghao Fuzheng Jiedu decoction is effective in treating SLE and has a certain clinical application value.

Alterations of oxygen consumption and extracellular acidification rates by glutamine in PBMCs of SLE patients.

We evaluated plasma glutamine levels and basal mitochondrial oxygen consumption rate (mOCRB) and basal extracellular acidification rate (ECARB) of peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematous (SLE) patients and healthy controls (HCs). Lower plasma glutamine levels correlated with higher SLE disease activity indexes (p=0.025). Incubated in DMEM containing 100mg/dL glucose, SLE-PBMCs displayed lower mOCRB (p=0.018) but similar ECARB (p=0.467) to those of HC-PBMCs, and their mOCRB got elevated (p<0.001) without altering ECARB (p=0.239) by supplementation with 2 or 4mM glutamine. We conclude that impaired mitochondrial respiration of SLE-PBMCs could be improved by glutamine under euglycemic condition.

[Polyunsaturated omega-3 fatty acids and systemic lupus erythematosus: what do we know?]. / Ácidos graxos poli-insaturados ômega-3 e lúpus eritematoso sistêmico: o que sabemos?

Various studies have demonstrated the impact of omega-3 fatty acids on the concentration of C reactive protein (CRP), pro-inflammatory eicosanoids, cytokines, chemokines and other inflammatory mediators. Therefore, the supplementation of these types of lipids may represent additional option treatment for chronic systemic diseases, such as Systemic Lupus Erythematous and other rheumatic diseases. The role of these lipids has not been well established, yet. However, it seems there is a direct relationship between its intake and the decrease of the disease clinical manifestations as well as of the inflammatory status of the patients. Thus, the aim of this manuscript is to present a thorough review on the effects of omega-3 fatty acids in patients with SLE. Bibliographic data set as the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) were searched using as key words: systemic lupus erythematous (SLE), polyunsaturated fatty acids omega-3, eicosapentanoic acid (EPA), docosahexanoic acid (DHA), antioxidants and diet. Manuscripts published up to September 2013 were included. There were 43 articles related to the topic, however only 15 pertained human studies, with three review articles and 12 clinical studies.