Effectiveness and safety of tripterygium glycosides tablet for lupus nephritis: a systematic review and Meta-analysis.

OBJECTIVE: To investigate the effectiveness and safety of tripterygium glycosides (TG) tablet for the treatment of Lupus nephritis (LN). METHODS: Several databases were systematically searched including PubMed, Embase, Cochrane, Wiley, China National Knowledge Infrastructure Database, SinoMed and Wanfang Library till June 20, 2020. Revman5.3 was utilized to analyze the data according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. RESULTS: In total, 8 randomized controlled trials involving 583 participants were identified. Meta-analyses showed that, compared with glucocorticoids (GC) alone, the combination with TG tablet provided a statistically significant improvement in total remission (TR) ( = 1.27, 95% : 1.08-1.50, = 0.004), complete remission (CR) ( = 1.61, 95% : 1.05-2.47, = 0.03) and C3 levels ( = 0.27, 95% : 0.14-0.39, < 0.000 1), C4 levels ( = 0.12, 95% : 0.07-0.17, < 0.000 01). No significant differences were seen in TR, CR, proteinuria, serum creatinine, C3 and C4 (TR: = 1.00, 95% : 0.87-1.16, = 0.95; CR: = 1.10, 95% : 0.78-1.56, = 0.58; proteinuria levels: = -0.06, 95% : -0.13 to 0.01, = 0.10; serum creatinine levels: = -0.01, 95%: -7.36 to 7.35, = 1.00; C3 levels: = 0.01, 95%: -0.06 to 0.07, = 0.84; C4 levels: = -0.01, 95%: -0.03 to 0.01, = 0.49) between azathioprine (AZA) / leflomit (LEF) + GC and TG tablet + GC. Adverse events (hepatic dysfunction, nausea, vomitting) showed no statistical differences between the TG tablet + GC group and the GC group. There were more new onset of irregular menstruation in the TG tablet + GC group than those in the AZA + GC ( = 3.57, 95% : 1.40-9.11, = 0.008) /LEF+ GC ( = 6.69, 95% : 2.42-18.46, = 0.000 2) group, but leucopenia lower than those in AZA + GC group ( = 0.38, 95% : 0.17-0.85, = 0.02) and alopecia ( = 0.14, 95% : 0.03-0.77, = 0.02) and rash ( = 0.09, 95% : 0.01-0.69, = 0.02) lower than those in LEF + GC group. CONCLUSIONS: This review indicates that TG tablet maybe effective in LN treatment. Nevertheless, adverse events cannot be ignored. Large sample, multi-center, high-quality clinical studies are needed to verify the exact effects and safety of TG tablet in treatment of LN.

Analysis of Traditional Chinese Medical Syndrome Patterns of Psoriatic Arthritis Patients in Related Reports Issued in Recent 35 Years / 广州中医药大学学报

Objective An analysis was carried out for the reports of traditional Chinese medical syndrome patterns of psoriatic arthritis (PsA) patients in related reports issued in the recent 35 years, thus to explore the characteristics of syndrome patterns of PsA patients and to supply evidence for the syndrome classification. Methods Electronic retrieval was performed in the reports of PsA syndrome analysis issued in the Chinese medical journals from the year of 1979 to 2013. Traditional Chinese medical syndrome information of PsA patients was extracted from the reports, and then was standardized and classified. SPSS 17.0 software was applied for the analysis of occurrence frequency of syndromes, syndrome elements, tongue and pulse states. Results A total of 84 reports were obtained, and 26 reports met the inclusion criteria. In the 26 included reports, 10 kinds of tongue texture, 15 kinds of tongue fur and 22 kinds of pulse states were present. After the standardization of the syndromes, a total of 39 syndrome patterns were obtained. After combination of the similar syndromes, 14 syndromes were included into the analysis. In the 14 included syndrome patterns, the leading 5 patterns were wind-damp heat arthralgia, wind-heat with blood dryness, excessive heat toxin, wind-cold damp arthralgia, and liver-kidney deficiency. Fourteen syndrome elements were extracted from the syndromes, and 9 were included into the analysis after combination of the similar syndrome elements. The top syndrome elements were heat, phlegm-dampness, wind, dryness, deficiency, and blood stasis. Conclusion The syndrome patterns of PsA patients are various, and the syndrome elements of cold, heat, phlegm-dampness, wind, dryness, and blood stasis play an important role in the pathogenesis of PsA.

Thromboxane A2 receptor induces proliferation of rheumatoid arthritis synovial cells by up-regulation of cyclooxygenase-2 / 中国病理生理杂志

AIM:To examine the effects of thromboxane A 2 receptor ( TXA2 R) , the downstream product of cy-clooxygenase-2 (COX-2), on the proliferative ability and COX-2 expression in rheumatoid arthritis (RA) synovial cells. METHODS:The effects of TXA2 R antagonist SQ29548 and agonist U46619 on the proliferation of RA synovial cell line MH7A were detected by MTS cell proliferation assay , and their effects on COX-2 mRNA expression in MH7A cells were al-so examined by real-time PCR.In addition, the possible effect of U46619 on the proliferation of MH7A cells, when COX-2 was knocked down by siRNA , was determined by BrdU cell proliferation assay .RESULTS:SQ29548 inhibited the cell proliferation and the mRNA level of COX-2 while U46619 enhanced them.Moreover, U46619 reconstitute the proliferative ability of MH7A cells to some extent that inhibited by COX-2 siRNA.CONCLUSION: In RA synovial cells, TXA2R is able to control COX-2 expression, while it also mediates the effects of COX-2, suggesting that TXA2R might be an ideal candidate for RA treatment .

Comparison of the expression profile of apoptosis-associated genes in rheumatoid arthritis and osteoarthritis.

The purpose of this study was to employ microarray analysis to evaluate differential gene expression in synovial tissue samples obtained from patients with rheumatoid arthritis (RA) or osteoarthritis (OA) to study the expression profile of apoptosis-associated genes in these tissues. Four samples were obtained from RA-affected patients and three from osteoarthritis patients. After total RNA was extracted from synovial tissue, the RNA was processed using two-cycle target labeling, followed by hybridization and scanning procedure. The GeneChip Human Genome U133 Plus 2.0 containing 900471 gene loci was used and eight genes associated with apoptosis were identified with a selected p value<0.05 and a twofold change in expression in rheumatoid samples compared to osteoarthritis tissues. Anti-apoptotic genes were generally upregulated whereas apoptotic genes were downregulated suggesting that these genes may play a role in the pathogenesis of RA. Furthermore, these genes may serve as novel therapeutic targets for the treatment of RA.

Effect of Tongbiling on VEGF mRNA Expression in Rheumatoid Arthritis Synovial Cell / 中国中医药信息杂志

Objective To study effect of Tongbiling (TBL) on VEGF mRNA expression in RA synovlcytes cultured in vitro and explore its mechanism. Method Synovial cells from the knee joint in patient with RA were digested, divided and separately cultured after arthroscopy. Blank controls:DMEM culture containing 10% FBS in saline;Low-dose admission group of TBL:DMEM culture containing 10% FBS in 50 mg/L TBL;High-dose admission of TBL:DMEM culture containing 10% FBS in 200 mg/L TBL. RNA were distilled. Expression of VEGF mRNA were detected with RT-PCR. Result Compared with control group, expression of VEGF mRNA in low and high-dose admission groups of TBL both decreased (P

Tongbiling for interleukin 2 and its receptor o-chain in vivo and in vitro / 中国组织工程研究

BACKGROUND: Tongbiling is the modified guizhi shaoyao zhimu tang (Decoction of Cinnamon Twig, Peony and Anemarrhena) recorded in Synopsis of Prescriptions of the Golden Chamber. It has been used for rheumatoid arthritis(RA) for more than ten years. Here is the experimental study on effects of tongbiling on interleukin 2(IL-2) and its α-chain, IL-2Rα(CD25), to explain the mechanism of tongbiling in regulating the cellular immunity and resisting RA From the aspects of in vivo and in vitro.OBJECTIVE: To study the effect of tongbiling on IL-2 in collagen introduced arthritis of rats and the influence of total base of tongbiling on expression of IL2-Rα (CD25).DESIGN: A totally randomized and controlled experimental study based on the experimental animalsSETTING: Department of Jinkui of a university and the center of organ transplantation and immunity of another university.MATERIALS: The experiment was carried out from April to July 2001 in the Central Laboratory of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. The 36 Wistar rats, clean degree, male,bought from the Animal Experimental Center of Medical College of Sun Yat-sen University, certificate No. 2000A050, weighted(110 ± 20) g, were divided into 6 groups with 6 in each: normal group, model group, methotrexate (MTX) high dosage group, MTX low dosage group, tongbiling high dosage group, and tongbiling small dosage group.METHODS: The experiment in vivo was done with the modeled rats of collagen-induced arthritis. The foot swelling was measured with volume method, the cells of primary synovium cultured, and the upper clear fluid of culture fluid tested with radioimmunoassay to observe the effect of tongbiling on synovial IL-2. The experiment in vitro was done in the way of separating the lymphocytes, giving extraneous stimulation with phorbol 12, 13-dibutyrate (PDB) or concanavalin A(ConA), using bicolor immunofluorescence labeling, testing with flow cytometer to observe the influence of total base of tongbiling on the expression of CD3 +, CD25 +.MAIN OUTCOME MEASURES: The influence of tongbiling on the foot swelling and synovial IL-2 of rats with collagen-induced arthritis.RESULTS: In the experiment in vivo, the high dosage of tongbiling could relieve obviously the foot swelling, compared with MTX, there was no remarkable difference ( P ＞ 0.05) . Both high and low dosage of tongbiling could inhibit the synthesis of synovial IL-2 ( P ＜ 0.01 ). In the experiment in vitro, the total base of tongbiling could extremely inhibit the expression of CD3 +, CD25 + stimulated by ConA, but not effective for that stimulated by PDB plus ionomycin.CONCLUSION: Tongbiling can inhibit the IL-2 synthesis and the signal transduction of IL-2Rα (CD25) activated by ConA, relieving the inflammation of local joint. It provides an experimental evidence for the application of tongbiling in the treatment of RA.

Effects of Tongbiling Prescription in Counteracting Cartilage Destruction in Rats with Collagen-induced Arthritis / 广州中医药大学学报

[Objective] To observe the effects of Tongbiling (TBL) prescription in counteracting cartilage destruction in rats with rheumatoid arthritis (RA). [Methods] Collagen-induced arthritis (CIA) rat models were established to observe the therapeutic effects of TBL. After a short-term treatment, expressions of tumor necrosis factor (TNF - a) and transforming growth factor (TGF- P) in cartilage tissue of model group, methotrenxate (MTX) tablets group and Radix Tripterygii Wilfordii (RTW) preparation group were examined by immunohistochemical semi-quantitative assessment method. [ Results ] The number of chondrocytes with positive TNF - a expression was lower and the chondrocytes were stained lighter in normal group than those in model group and low-dose MTX group ( P

Effect of vascular endothelial growth factor on angiogenesis and its regulation / 第二军医大学学报

Vascular endothelial growth factor(VEGF) is a kind of protein facilitating the angiogenesis,which can combine with its special receptor. The 2 major functions of VEGF are:(1) accelerate the proliferation of endothelial cells,leading to the formation of new vessels;(2) up regulation of the vessels permeability.The activity of the VEGF is regulated by various factors at different levels,such as: hypoxia, oncogene,the cytokine, the intercellular matrix, etc .The biological character and role of VEGF were summarized in this article with special emphasis on VEGF function and regulation.