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BACKGROUND: Rheumatoid arthritis (RA) is a chronic autoimmune disease with complex pathogenesis, including alterations in the gut microbiota. Gui Zhi Shao Yao Zhi Mu Decoction (GSZD), a traditional Chinese herbal formula, has shown efficacy in RA treatment, but its impact on intestinal microflora remains unclear. This study aimed to investigate the effects of GSZD combined with leflunomide on the gut microbiota of RA patients. METHODS: The study enrolled 48 RA patients who were randomly assigned to either a control group receiving leflunomide or a treatment group receiving GSZD combined with leflunomide for 12 weeks. Gut microbiota composition was analyzed pre- and post-intervention using 16S rDNA sequencing. Changes in microbial diversity, abundance, and metabolic functions were assessed. RESULTS: Post-treatment, both groups exhibited significant alterations in gut microbiota composition. GSZD combined with leflunomide led to an increased Bacteroidetes/Firmicutes ratio and a reduction in Actinobacteria compared to leflunomide alone. This was associated with beneficial shifts in microbial genera and metabolic pathways, suggesting improved gut health and systemic immune modulation. CONCLUSION: GSZD combined with leflunomide significantly modulates the gut microbiota in RA patients. This study provides insights into the mechanisms underlying the therapeutic effects of GSZD and highlights the potential of integrating traditional Chinese medicine with conventional treatments in managing RA.
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BACKGROUND: Organ fibrosis is a common endpoint of a variety of diseases. Many studies have shown that the pathogenesis of diabetic kidney disease (DKD) is related to the excessive activation of the Wnt/ß-catenin signaling pathway on podocytes, so the treatment of DKD starts from this signaling pathway. At the same time, DKD, as a metabolic disease, has many connections related to podocyte autophagy. OBJECTIVES: We experimented the effects of Mahuang Fuzi and Shenzhuo decoction (MFSD) which is the combination of Mahuang Fuzi decoction and Shenzhuo decoction in traditional Chinese medicine compounds used "The Golden Chamber" in high glucose-induced podocytes, determined whether this effect was related to Wnt/ß-catenin signaling pathway, and further investigated the relationship between this effect and autophagy. METHODS: The mice podocytes were stimulated by using 30 mmol/L of high glucose and serum containing MFSD or Wnt/ß-catenin signaling pathway inhibitor DKK1 (100 ng/ml) was used to intervene podocytes before high glucose stimulation. Podocyte injury-related proteins, Wnt/ß-catenin signaling pathway-related proteins, and autophagy-related proteins were detected by using western blotting and immunofluorescence analysis. RESULTS: Our results showed that DKK1 and MFSD treatment significantly upregulated the protein expressions of nephrin, podocin, podocalyxin, and podoplanin in high glucose-induced podocytes and downregulated the ß-catenin protein expression. Furthermore, the protein expressions of beclin1, LC3B, and P62 were also significantly increased in high glucose-induced podocytes. CONCLUSION: Our experiments confirmed that the destruction of podocytes in DKD is related to the excessive activation of Wnt/ß-catenin signaling pathway and the inhibition of autophagy after activation. MFSD treatment can inhibit the activation of Wnt/ß-catenin signaling pathway in podocytes stimulated by high glucose and helpful in reducing the podocyte injury. This protective mechanism can be related to the enhancement of podocyte autophagy by MFSD treatment.
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OBJECTIVE: To observe the curative effect of acupuncture intervention in reducing visceral fat content and secretary function in abdominal obesity patients. METHODS: A total of 73 cases of abdominal obesity patients were randomly divided into acupuncture group (n = 50) and control group (n = 23) according to the randomized block design. For patients of the acupuncture group, Zhongwan (CV 12), Tianshu (ST 25), Daheng (SP 15), Daimai (GB 26), Shuidao (ST 28), Waiguan (SJ 5) and Zulinqi (GB 41) were punctured with filiform needles, followed by electroacupuncture stimulation (2 Hz/100 Hz, 4-8 mA) of bilateral ST 25 and GB 26 for 20 min, once every other day for 8 weeks. In addition, the patients were also given with health education in every session of treatment. The patients of the control group were asked to receive health education including restraining wine or liquor and salt intake, stopping smoking, increasing physical activities, regular daily life habit, etc. The abdominal fat thickness was detected using a color Doppler ultrasonography, and serum visfatin level was assayed using ELISA. Additionally, the body weight, body mass index (BMI), waist circumstance (WC) and hip circumference (HC) were determind. RESULTS: After the treatment, the subcutaneous fat thickness levels including the subcutaneous fat at the mid-point between the xyphoid and the umbilicus (S1) and the right side of the umbilicus (S2), and serum visfatin content, WC and HC in both control and acupuncture groups, visceral fat at the mid-point between the xyphoid and the umbilicus (V1) and at the right side of the um- bilicus (V2), and antero-hepatic fat (AHF), perirenal fat (PRF) , and body weight and BMI in the acupuncture group were significantly reduced in comparison with pre-treatment in the same one group ( P<0.05, P<0.001), while the ultrasonic visceral fat index [UVI, = (V1 +V2)/(SI + S2)] of the control group was markedly increased (P<0.05). The S1, V1, V2, AHF, PRF and UVI levels, and BMI, WC and HC were significantly lower in the acupuncture group than in the control group (P<0.05, P<0.001). No statistical differences were found between the two groups in the S2, body weight and serum visfatin levels (P>0.05). CONCLUSION: Acupuncture therapy can effectively reduce the visceral fat content, being better than simple health education. Both acupuncture treatment and health education can decrease serum visfatin level, regulating visceral fat's secretion.
