[Treatment of Rheumatoid Arthritis by Hebi Recipe: an Efficacy Observation].

OBJECTIVE: To observe the auxiliary efficacy and safety of Hebi Recipe (HR)in treating early rheumatoid arthritis (RA). METHODS: Totally 63 early RA patients with Gan-Pi disharmony were randomly assigned to the treatment group [32 cases, treated by HR (one dose per day, taken in two portions for 24 successive weeks) plus Methotrexate (MTX)] and the control group (31 cases, treated by MTX alone). The dosage of MTX was increased from 7.5 mg to 12.5 mg, once per week, 24 weeks as one course of treatment. Efficacy for Chinese medical syndromes, American College of Rheumatology 20 (ACR20) improvement rate, disease activity score in 28 joints (DAS28), laboratory related indices [ESR, rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide (CCP)], and related ultrasonic inspection items (synovium thickness, synovium blood flow classification, effusion of joint), and adverse reactions were observed. RESULTS: The total effective rate (83.9%, 26/31 cases) and ACR20 improvement rate (74.2%, 23/31 cases) were higher in the treatment group than in the control group [60.7% (17/28 cases), 46.4% (13/28 cases); P < 0.05]. Compared with before treatment in the same group, DAS28 score, ESR, RF, CRP, CCP, synovium thickness, synovium blood flow classification, effusion of joint all decreased in the two groups after treatment (P < 0.01, P < 0.05). Compared with the control group after treatment, ACR20 improvement rate, DAS28 score, ESR, RF, CRP, CCP, synovium thickness, synovium blood flow classification, effusion of joint all decreased in the treatment group (P < 0.01, P < 0.05). Liver dysfunction occurred in 1 case of the treatment group. One leucopenia and 2 liver dysfunction occurred in the control group. CONCLUSION: HR could effectively improve joints and systemic symptoms of early RA patients with Gan-Pi disharmony.

Antioxidant activity and hepatoprotective effect of a polysaccharide from Bei Chaihu (Bupleurum chinense DC).

Chinese medicine plays a pivotal role in hepatoprotective treatment. In the present study, a water-soluble polysaccharide fraction (WBCP) was fractioned from the roots of Bupleurum chinense and purified by DEAE-cellulose and Surperdex 200 HR chromatography. The physicochemical properties, antioxidative and hepatoprotective activities of WBCP were evaluated in a rat model of hepatic injury caused by d-galactosamine (GalN). Hepatoprotective effect was evaluated by measuring aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) activities in the plasma of mice. Antioxidant activity was evaluated by measuring biochemical parameters in the mouse liver homogenate, such as glutathione reductase (GR), γ-glutamylcysteine synthetase (GCS), glutathione S-transferase (GST) and superoxide dismutase (SOD) activities, as well as glutathione (GSH) and thiobarbituric acid reactive substances (TBARS) levels. The results showed the oral administration of WBCP could significantly reduce the activity of AST, ALT, ALP and LDH, indicating that WBCP possesses hepatoprotective activity. Furthermore, there was general a statistically significant increase in the activities of GSH, GR, GCS, GST and SOD, and a loss in TBARS in the liver of WBCP-treated group compared with the control group. In addition, the elevated levels of pro-inflammatory cytokine tumour necrosis factor-alpha (TNF-α) in the serum of the experimental animals was significantly returned by WBCP treatment at the dose of 400 mg/kg. These results clearly demonstrated that WBCP possess promising hepatoprotective effects against GalN-induced liver damage, which may be mediated through augmentation of antioxidant defenses.

Intravenous injection of mesenchymal stem cells is effective in treating liver fibrosis.

AIM: To compare the influence of different transplant sites in bone marrow mesenchymal stem cell (MSC)-based therapy for liver fibrosis. METHODS: MSCs isolated from Sprague Dawley (SD) rats were induced into hepatocyte-like cells. Liver fibrosis in SD rats was induced with carbon tetrachloride. Following hepatocyte induction in vitro, 4',6-diamidino-2-phenylindole (DAPI)-labeled MSCs were transplanted by intravenous, intrahepatic, and intraperitoneal injection. Histopathological staining, immunohistochemistry, and biochemical analysis were used to compare the morphological and functional liver regeneration among different MSC injection modalities. The expression differences of interleukins, growth factor, extracellular matrix, matrix metalloproteinases, and tissue inhibitor of metalloproteinase were examined by real-time reverse transcription-polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay (ELISA). RESULTS: Four days after exposure to hepatocyte differentiation medium, MSCs that did not express hepatocyte markers could express α-fetoprotein, albumin, and cytokeratin 18. The results of histopathological staining, immunohistochemistry, and biochemical analysis indicated that intravenous injection is more effective at rescuing liver failure than other injection modalities. DAPI-labeled cells were found around liver lobules in all three injection site groups, but the intravenous group had the highest number of cells. PCR and ELISA analysis indicated that interleukin-10 (IL-10) was highest in the intravenous group, whereas il1ß, il6, tnfα and tgfß, which can be regulated by IL10 and are promoters of liver fibrosis, were significantly lower than in the other groups. CONCLUSION: MSC administration is able to protect against liver fibrosis. Intravenous injection is the most favorable treatment modality through promotion of IL10 expression.