RÉSUMÉ
OBJECTIVES: To evaluate the efficacy and safety of adalimumab (ADA) combined with Tripterygium wilfordii Hook F (TwHF) in the treatment of methotrexate (MTX)-inadequate response patients with rheumatoid arthritis (RA). METHODS: In this multicenter, open-label, randomized controlled clinical trial, 64 RA patients with inadequate response to MTX were 1:1 randomly assigned into treatment or control groups. The treatment group was treated with ADA in combination with TwHF, and the control group was treated with ADA in combination with MTX for 24 weeks. The primary endpoint was the percentage of patients having low disease activity (2.6 ≤ DAS28-ESR < 3.2) and remission rates (DAS28-ESR < 2.6) at week 24. RESULTS: In total, 53 of the 64 patients (82.8%) completed this 24-week clinical trial. By intent-to-treat (ITT) analysis, a comparable outcome was observed between the two groups. The percentage of patients achieving low disease activity in the treatment group and control group were 43.8% and 46.9% (95% CI, 21.28 to 27.48, p = .802). Percentage of patients achieving low disease activity rates were respectively 28.1% and 31.3% in the treatment group and control group (95% CI, 19.18 to 25.58, p = .784). In per-protocol (PP) analysis, the results were consistent with the ITT model. The incidence of adverse events was comparable between the two groups. CONCLUSIONS: There were no significant differences in efficacy and safety between ADA combined with TwHF versus ADA combined with MTX in the treatment of RA. TwHF might be an alternative treatment for RA patients who are intolerant to MTX.
Sujet(s)
Antirhumatismaux , Polyarthrite rhumatoïde , Humains , Adalimumab/effets indésirables , Antirhumatismaux/effets indésirables , Tripterygium , Polyarthrite rhumatoïde/diagnostic , Polyarthrite rhumatoïde/traitement médicamenteux , Polyarthrite rhumatoïde/induit chimiquement , Méthotrexate/effets indésirables , Association de médicaments , Résultat thérapeutiqueRÉSUMÉ
Jinwujiangu capsule (JWJGC) is a traditional Chinese medicine formula used to treat rheumatoid arthritis (RA). However, whether its mechanism is associated with pyroptosis remains unclear. In this study, the ability of JWJGC to inhibit the growth of fibroblast-like synoviocytes of RA (RA-FLS) through pyroptosis was evaluated. The cells isolated from patients with RA were identified by hematoxylin and eosin (H&E) staining, immunohistochemistry, and flow cytometry. After RA-FLS were treated with different concentrations of JWJGC-containing serum, the cell proliferation inhibition rate, expression of caspase-1/3/4/5, NOD-like receptor protein 3 (NLRP3), gasdermin-D (GSDMD), and apoptosis-associated speck-like protein containing a CARD (ASC), concentrations of interleukin-1ß (IL-1ß) and interleukin-18 (IL-18), the activity of lactic dehydrogenase (LDH), and pyroptosis were evaluated. The results showed that JWJGC increased the proliferative inhibition rate, decreased the expression of caspase-1/3/4/5, GSDMD, NLRP3, and ASC, suppressed the expression of IL-1ß and IL-18, induced the activity of LDH, and downregulated the number of double-positive FITC anti-caspase-1 and PI. Generally, our findings suggest that JWJGC can regulate NLRP3/CAPSES/GSDMD in treating RA-FLS through pyroptosis.
RÉSUMÉ
This paper aimed to investigate the effects of Jinwu Jiangu recipe total extract on the IL-17/STAT3 signals in rheumatoid arthritis synovial fibroblasts(RASF). The primary RASFs were cultured by tissue piece method in vitroï¼ and divided into blank control groupï¼ Jinwu Jiangu recipe low dose groupï¼ Jinwu Jiangu recipe middle dose groupï¼ Jinwu Jiangu recipe high dose groupï¼ and tripterygium glycosides control group. They were then treated with corresponding serum free mediumï¼ different doses of Jinwu Jiangu recipe total extract(0.06ï¼ 0.6ï¼ 6.0 g·L⻹)ï¼ and tripterygium glycosides(0.03 g·L⻹) respectively for 24 hours. The gene expression levels of RORαï¼ RORγtï¼ and STAT3 mRNA were detected by polymerase chain reaction(PCR)ï¼ and the protein activity of IL-17R and pSTAT3 were measured by Western blot assay. The results showed that as compared with blank control groupï¼ the expression levels of RORαï¼ RORγtï¼ IL-17R and STAT3 mRNA in RASF were significantly declined(P<0.01). As compared with tripterygium glycosides control groupï¼ Jinwu Jiangu recipe total extract middle dose group and high dose group can down-regulate the expression levels of RORαï¼ RORγtï¼ IL-17R and STAT3 mRNA(P<0.05)ï¼ and the effect was more obvious in high dose group(P<0.01). As compared with blank control groupï¼ the protein expression levels of IL-17R and pSTAT3 in each treatment group were obviously decreased(P<0.01). As compared with tripterygium glycosides control groupï¼ Jinwu Jiangu recipe high dose group had more obvious effect in down-regulating the protein expression of pSTAT3(P<0.01). Thereforeï¼ Miao medicine Jinwu Jiangu recipe total extract can down-regulate the expressions of RORαï¼ RORγtï¼ and STAT3 mRNAï¼ and inhibit the protein activity of IL-17R and pSTAT3 in RASF.
Sujet(s)
Polyarthrite rhumatoïde , Médicaments issus de plantes chinoises/pharmacologie , Récepteurs à l'interleukine-17/métabolisme , Facteur de transcription STAT-3/métabolisme , Cellules synoviales/effets des médicaments et des substances chimiques , Cellules cultivées , Fibroblastes , Régulation de l'expression des gènes , Humains , Membre-1 du groupe F de la sous-famille-1 de récepteurs nucléaires/métabolisme , Membre-3 du groupe F de la sous-famille-1 de récepteurs nucléaires/métabolisme , Membrane synovialeRÉSUMÉ
OBJECTIVE: To explore the effect of Jinwu Jiangu Recipe (JJR) on the expression of synovial cells' nuclear factor-kappaB (NF-kappaB) and serum interleukin 17 (IL-17) in collagen induced arthritis (CIA) rats. METHODS: Totally 60 Wistar rats were randomly divided into 6 groups, i.e., the blank control group, the model group, high, middle, and low dose JJR treatment groups, and the tripterygium control group, 10 in each group. Except rats in the blank control group, CIA model was established in rats of the rest 5 groups. Then they were treated from the 7th day of modeling. After 4 weeks of medication they were sacrificed, serum collected, and synovium of joints were isolated. The expression of serum IL-17 was detected in synovium of joints by enzyme linked immunosorbent assay (ELISA). And the expression of NF-kappaB/P65, Ikappabetaalpha and NF-KappaB/P50 were detected by Western blot. RESULTS: Compared with the blank control group, the serum IL-17 level increased in the model group (P <0. 01). Compared with the model group, the serum IL-17 level obviously decreased in high and middle dose JJR groups and the tripterygium control group (P < 0.01). Results of Western blot showed, when compared with the blank control group, protein activities of NF-kappaB/P65 and NF-kappaB/P50 were significantly enhanced in the model group (P < 0.01). Compared with the model group, protein activities of NF-kappaB/P65 and NF-kappaB/P50 significantly decreased in high and middle dose JJR groups and the tripterygium control group (P < 0.05, P < 0.01). All indices mentioned above were higher in the low dose JJR group than in the tripterygium control group (P < 0.05, P < 0.01). CONCLUSION: JJR could lower the expression of serum IL-17 in CIA model rats, and inhibit protein activities of NF-kappaB/P65 and NF-kappaB/P50.