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Kariyawasam HH, Leandro M, Dziadzio M, Robinson DS, Lund VJ, Gane SB. Chronic Rhinosinusitis With Nasal Polyps In Patients With Aspirin Sensitivity-Mycophenolate Mofetil as an Effective Steroid-Sparing Agent. JAMA Otolaryngol Head Neck Surg 2020; 147:2771314. [PMID: 33030525 DOI: 10.1001/jamaoto.2020.3401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Affiliation(s)
- Harsha H Kariyawasam
- Rhinology Section, Royal National ENT Hospital, London, United Kingdom
- University College London Hospital NHS Foundation Trust,, London, United Kingdom
- University College London, London, United Kingdom
| | - Maria Leandro
- University College London Hospital NHS Foundation Trust,, London, United Kingdom
- University College London, London, United Kingdom
| | - Magdalena Dziadzio
- Rhinology Section, Royal National ENT Hospital, London, United Kingdom
- University College London Hospital NHS Foundation Trust,, London, United Kingdom
- University College London, London, United Kingdom
| | - Douglas S Robinson
- University College London Hospital NHS Foundation Trust,, London, United Kingdom
- University College London, London, United Kingdom
| | - Valerie J Lund
- Rhinology Section, Royal National ENT Hospital, London, United Kingdom
- University College London, London, United Kingdom
| | - Simon B Gane
- Rhinology Section, Royal National ENT Hospital, London, United Kingdom
- University College London Hospital NHS Foundation Trust,, London, United Kingdom
- University College London, London, United Kingdom
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Yuan K, Li X, Lu Q, Zhu Q, Jiang H, Wang T, Huang G, Xu A. Application and Mechanisms of Triptolide in the Treatment of Inflammatory Diseases-A Review. Front Pharmacol 2019; 10:1469. [PMID: 31866868 PMCID: PMC6908995 DOI: 10.3389/fphar.2019.01469] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 11/13/2019] [Indexed: 12/19/2022] Open
Abstract
Bioactive compounds from medicinal plants with anti-inflammatory and immunosuppressive effects have been emerging as important sources of drugs for the treatment of inflammatory disorders. Triptolide, a diterpene triepoxide, is a pharmacologically active compound isolated from Tripterygium wilfordii Hook F (TwHF) that is used as a remedy for inflammatory and autoimmune diseases. As the most promising bioactive compound obtained from TwHF, triptolide has attracted considerable interest recently, especially for its potent anti-inflammatory and immunosuppressive activities. Over the past few years, an increasing number of studies have been published emphasizing the value of triptolide in the treatment of diverse inflammatory disorders. Here, we systematically review the mechanism of action and the therapeutic properties of triptolide in various inflammatory diseases according to different systematic organs, including lupus nephritis, inflammatory bowel disease, asthma, and rheumatoid arthritis with pubmed and Embase. Based on this review, potential research strategies might contribute to the clinical application of triptolide in the future.
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Affiliation(s)
- Kai Yuan
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaohong Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Qingyi Lu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Qingqing Zhu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Haixu Jiang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Ting Wang
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Guangrui Huang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Anlong Xu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.,State Key Laboratory of Biocontrol, Department of Biochemistry, School of Life Sciences, Sun Yat-Sen (Zhongshan) University, Guangzhou, China
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Liu L, Wang LP, He S, Ma Y. Immune Homeostasis: Effects of Chinese Herbal Formulae and Herb-Derived Compounds on Allergic Asthma in Different Experimental Models. Chin J Integr Med 2018; 24:390-398. [PMID: 29752613 DOI: 10.1007/s11655-018-2836-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Indexed: 12/18/2022]
Abstract
Allergic asthma is thought to arise from an imbalance of immune regulation, which is characterized by the production of large quantities of IgE antibodies by B cells and a decrease of the interferon-γ/interleukin-4 (Th1/Th2) ratio. Certain immunomodulatory components and Chinese herbal formulae have been used in traditional herbal medicine for thousands of years. However, there are few studies performing evidence-based Chinese medicine (CM) research on the mechanisms and effificacy of these drugs in allergic asthma. This review aims to explore the roles of Chinese herbal formulae and herb-derived compounds in experimental research models of allergic asthma. We screened published modern CM research results on the experimental effects of Chinese herbal formulae and herb-derived bioactive compounds for allergic asthma and their possible underlying mechanisms in English language articles from the PubMed and the Google Scholar databases with the keywords allergic asthma, experimental model and Chinese herbal medicine. We found 22 Chinese herb species and 31 herb-derived anti-asthmatic compounds as well as 12 Chinese herbal formulae which showed a reduction of airway hyperresponsiveness, allergen-specifific immunoglobulin E, inflflammatory cell infifiltration and a regulation of Th1 and Th2 cytokines in vivo, in vitro and ex vivo, respectively. Chinese herbal formulae and herbderived bioactive compounds exhibit immunomodulatory, anti-inflflammatory and anti-asthma activities in different experimental models and their various mechanisms of action are being investigated in modern CM research with genomics, proteomics and metabolomics technologies, which will lead to a new era in the development of new drug discovery for allergic asthma in CM.
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Affiliation(s)
- Lu Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.,University Course of Traditional Chinese Medicine, Medical University of Vienna, A-1090, Vienna, Austria
| | - Lin-Peng Wang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Shan He
- Molecular Research in Traditional Chinese Medicine Group, Department of Pathophysiology and Allergy Research, Vienna General Hospital, Medical University of Vienna, A-1090, Vienna, Austria
| | - Yan Ma
- University Course of Traditional Chinese Medicine, Medical University of Vienna, A-1090, Vienna, Austria. .,Molecular Research in Traditional Chinese Medicine Group, Department of Pathophysiology and Allergy Research, Vienna General Hospital, Medical University of Vienna, A-1090, Vienna, Austria.
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Wei D, Huang Z. Anti-inflammatory effects of triptolide in LPS-induced acute lung injury in mice. Inflammation 2015; 37:1307-16. [PMID: 24706025 DOI: 10.1007/s10753-014-9858-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Triptolide is one of the main active components of Chinese herb Tripterygium wilfordii Hook F, which has been demonstrated to have anti-inflammatory properties. The aim of this study was to investigate the effects of triptolide on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and to clarify the possible mechanisms. Mice were administered intranasally with LPS to induce lung injury. Triptolide was administered intraperitoneally 1 h before LPS challenge. Triptolide-treated mice exhibited significantly reduced leukocyte, myeloperoxidase (MPO) activity, edema of the lung, as well as TNF-α, IL-1β, and IL-6 production in the bronchoalveolar lavage fluid compared with LPS-treated mice. Additionally, Western blot analysis showed that triptolide inhibited the phosphorylation of inhibitor-kappa B kinase-alpha (IκB-α), p65, nuclear factor kappa B (NF-κB), p38, extracellular receptor kinase (ERK), and Jun N-terminal kinase (JNK) and the expression of Toll-like receptor 4 (TLR4) caused by LPS. In conclusion, our results suggested that the promising anti-inflammatory mechanism of triptolide may be that triptolide activates peroxisome proliferation-activated receptor gamma (PPAR-γ), thereby attenuating an LPS-induced inflammatory response. Triptolide may be a promising potential therapeutic reagent for ALI treatment.
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Affiliation(s)
- Dong Wei
- College of Veterinary Medicine, Hebei North University, South Diamond Road, Gaoxin District, 075000, Zhangjiakou, People's Republic of China,
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Chen M, Lv Z, Zhang W, Huang L, Lin X, Shi J, Zhang W, Liang R, Jiang S. Triptolide suppresses airway goblet cell hyperplasia and Muc5ac expression via NF-κB in a murine model of asthma. Mol Immunol 2014; 64:99-105. [PMID: 25466609 DOI: 10.1016/j.molimm.2014.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 11/03/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND We have reported that triptolide inhibited pulmonary inflammation in patients with steroid-resistant asthma. In the present study, we investigated whether suppresses airway remodeling and goblet cell hyperplasia, studied the mechanism of triptolide on mucin5ac (Muc5ac) expression in a murine model of asthma. METHODS BALB/c mice were sensitized to intraperitoneal ovalbumin (OVA) followed by repetitive ovalbumin challenge for 6 weeks. Treatments included triptolide (40 μg/kg) and dexamethasone (2mg/kg). The area of bronchial airway (WAt/Pbm), smooth muscle (WAm/Pbm) and mucus index were assessed 24h after the final OVA challenge. Levels of Muc5ac were assessed by ELISA, immunohistology and real-time PCR. Western blot was performed to analyze the phosphorylation of NF-κB p65. RESULTS Triptolide and dexamethasone significantly reduced allergen-induced increases in the thickness of bronchial airway, smooth muscle and goblet cell hyperplasia. Levels of lung Muc5ac and Muc5ac mRNA were significantly reduced in mice treated with triptolide and dexamethasone. Phosphorylation of NF-κB p65 was significantly reduced in mice treated with triptolide and dexamethasone. CONCLUSION Triptolide may inhibit airway goblet cell hyperplasia and Muc5ac expression in asthmatic mice via NF-κB. It may be a potential drug for the treatment of patients with severe asthma.
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Affiliation(s)
- Ming Chen
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China
| | - Zhiqiang Lv
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China
| | - Wei Zhang
- Department of Geratology, The Second People's Hospital of Shenzhen, Shenzhen 518000, China
| | - Linjie Huang
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China
| | - Xiaoling Lin
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China
| | - Jianting Shi
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China
| | - Wei Zhang
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China
| | - Ruiyun Liang
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China
| | - Shanping Jiang
- Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory Disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120, China.
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Dai S, Yin K, Yao X, Zhou L. Inhibition of interleukin-13 gene expression by triptolide in activated T lymphocytes. Respirology 2014; 18:1249-55. [PMID: 23796028 DOI: 10.1111/resp.12145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 04/01/2013] [Accepted: 04/28/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Triptolide, a type of diterpenoid, is the active compound of Tripterygium wilfordii; it plays roles in anti-inflammatory and immune response regulation. Our objective was to investigate the mechanism of the inhibitory effect of triptolide on interleukin-13 (IL-13) gene expression in activated T lymphocytes. Understanding the molecular mechanism by which triptolide exerts a therapeutic function may be useful in developing a pharmaceutical treatment for asthma. METHODS Peripheral blood mononuclear cells (PBMC) and Hut-78 cells were stimulated with anti-CD3/CD28 with or without co-incubation with triptolide. The alteration of IL-13 messenger RNA (mRNA), expression and protein level were analysed using real-time reverse transcription polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay, respectively. The intracellular distribution profile of transcription factor GATA3 and nuclear factor of activated T cells (NFAT1) were analysed by Western blotting. The binding rates of GATA3 and NFAT1 to the promoter sequence of IL-13 were analysed by chromatin immunoprecipitation (ChIP) PCR. RESULTS In PBMC, the release of IL-13 was dependent on anti-CD3/CD28 stimulation. Its release could be inhibited by triptolide at the concentration of 500 nmol. In Hut-78 cells, IL-13 mRNA and protein expression were increased with anti-CD3/CD28 stimulation and significantly inhibited by incubation with 28 nmol triptolide. This concentration of triptolide also significantly inhibited the nuclear translocation of GATA3 and NFAT1 reducing the binding rate to the IL-13 gene promoter. CONCLUSIONS Triptolide inhibits IL-13 gene transcription and protein expression by inhibiting GATA3 and NFAT1 nuclear translocation and their binding rates to the IL-13 gene promoter region.
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Affiliation(s)
- Shanlin Dai
- Department of Respiratory Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Xu X, Xiong M, Xu Y, Su Y, Zou P, Zhou H. Triptolide attenuates idiopathic pneumonia syndrome in a mouse bone marrow transplantation model by down-regulation of IL-17. Int Immunopharmacol 2012; 14:704-9. [DOI: 10.1016/j.intimp.2012.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 08/19/2012] [Accepted: 09/21/2012] [Indexed: 10/27/2022]
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Söllner J, Mayer P, Heinzel A, Fechete R, Siehs C, Oberbauer R, Mayer B. Synthetic lethality for linking the mycophenolate mofetil mode of action with molecular disease and drug profiles. MOLECULAR BIOSYSTEMS 2012; 8:3197-207. [DOI: 10.1039/c2mb25256b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chen M, Lv Z, Jiang S. The effects of triptolide on airway remodelling and transforming growth factor-β₁/Smad signalling pathway in ovalbumin-sensitized mice. Immunology 2011; 132:376-84. [PMID: 21214541 DOI: 10.1111/j.1365-2567.2010.03392.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Airway remodelling contributes to increased morbidity and mortality in asthma. We have reported that triptolide, the major component responsible for the immunosuppressive and anti-inflammatory effects of Tripterygium wilfordii Hook F, inhibited pulmonary inflammation in patients with steroid-resistant asthma. In the present study, we investigated whether triptolide inhibits airway remodelling in a mouse asthma model and observed the effects of triptolide on the transforming growth factor-β₁ (TGF-β₁)/Smad pathway in ovalbumin (OVA)-sensitized mice. BALB/c mice were sensitized to intraperitoneal OVA followed by repetitive OVA challenge for 8 weeks. Treatments included triptolide (40 μg/kg) and dexamethasone (2 mg/kg). The area of bronchial airway (WAt/basement membrane perimeter) and smooth muscle (WAm/basement membrane perimeter), mucus index and collagen area were assessed 24 hr after the final OVA challenge. Levels of TGF-β(1) were assessed by immunohistology and ELISA, levels of TGF-β(1) mRNA were measured by RT-PCR, and levels of pSmad2/3 and Smad7 were assessed by Western blot. Triptolide and dexamethasone significantly reduced allergen-induced increases in the thickness of bronchial airway and smooth muscle, mucous gland hypertrophy, goblet cell hyperplasia and collagen deposition. Levels of lung TGF-β(1) , TGF-β(1) mRNA and pSmad2/3 were significantly reduced in mice treated with triptolide and dexamethasone, and this was associated with a significant increase in levels of Smad7. Triptolide may function as an inhibitor of asthma airway remodelling. It may be a potential drug for the treatment of patients with a severe asthma airway.
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Affiliation(s)
- Ming Chen
- Department of Respiratory Medicine, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Hoyle GW, Hoyle CI, Chen J, Chang W, Williams RW, Rando RJ. Identification of triptolide, a natural diterpenoid compound, as an inhibitor of lung inflammation. Am J Physiol Lung Cell Mol Physiol 2010; 298:L830-6. [PMID: 20348278 DOI: 10.1152/ajplung.00014.2010] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Inflammation is associated with various pulmonary diseases and contributes to the pathogenesis of acute lung injury. We previously identified a proinflammatory signaling pathway triggered by G protein-coupled receptors (GPCRs) in which stimulation of G(q)-coupled GPCRs results in activation of the transcription factor NF-kappaB. Because damage to the lung causes the release of multiple mediators acting through G(q)-coupled GPCRs, this signaling pathway is likely to contribute to inflammatory processes in the injured lung. In an effort to identify novel inhibitors of lung inflammation, the National Institutes of Health Clinical Collection, a library of 446 compounds, was screened for inhibitory activity toward production of IL-8 induced by stimulation of the G(q)-coupled tachykinin 1 receptor with substance P in A549 cells. Twenty-eight compounds that significantly inhibited substance P-induced IL-8 production were identified. The most potent inhibitor was triptolide, a diterpenoid compound from Tripterygium wilfordii Hook F, a vine used in traditional Chinese medicine for the treatment of autoimmune diseases. Triptolide inhibited IL-8 production induced by substance P with an IC(50) of 2.3 x 10(-8) M and inhibited NF-kappaB activation in response to an agonist of the protease-activated receptor 2 with an IC(50) of 1.4 x 10(-8) M. Anti-inflammatory effects of triptolide were assessed in vivo using a chlorine gas lung injury model in mice. Triptolide inhibited neutrophilic inflammation and the production of KC (Cxcl1) in the lungs of chlorine-exposed mice. The results demonstrate that triptolide exhibits anti-inflammatory activity in cultured lung cells and in an in vivo model of acute lung injury.
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Affiliation(s)
- Gary W Hoyle
- Department of Environmental and Occupational Health Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY 40202, USA.
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Zhang Y, Ma X. Triptolide inhibits IL-12/IL-23 expression in APCs via CCAAT/enhancer-binding protein alpha. THE JOURNAL OF IMMUNOLOGY 2010; 184:3866-77. [PMID: 20194724 DOI: 10.4049/jimmunol.0903417] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Triptolide is a biologically active component purified from Chinese herbal plant Tripterygium wilfordii Hook F. It is widely used in East Asia for treatment of systemic lupus erythematosus, rheumatoid arthritis, nephritis, Bechect's disease, psoriasis, atopic dermatitis, and asthma. However, its immunological mechanisms are poorly understood. IL-12 and IL-23 are closely related heterodimeric cytokines that share the common subunit p40. They are produced by APCs and are key factors in the generation and effector functions of Th1 and Th17 cells, respectively. They have been strongly implicated in the pathogenesis of several autoimmune disorders. In this study, we investigated the molecular mechanism whereby triptolide inhibits the expression of the p40 gene in APCs. We demonstrate that triptolide does so at the transcriptional level in part through targeting CCAAT/enhancer-binding protein-alpha (C/EBPalpha), which directly interacts with the p40 promoter and inhibits its transcription in inflammatory macrophages. Triptolide can activate the transcription of C/EBPalpha, and phosphorylation of Ser21 and Thr222/226 critical for C/EBPalpha inhibition of p40. Further, activation of C/EBPalpha by triptolide is dependent on upstream kinases ERK1/2 and Akt-GSK3beta. This study provides mechanistic insights into the immunomodulatory capacity of triptolide and has strong implications for its therapeutic applications in autoimmune diseases.
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Affiliation(s)
- Yan Zhang
- Department of Microbiology and Immunology, Weill Medical College, eill Graduate School of Medical Sciences, Cornell University, New York, NY 10065, USA
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Kapoor S. Clinical Applications of the Immunomodulatory Properties of Triptolide besides in Arthritis. Scand J Immunol 2009; 69:468. [DOI: 10.1111/j.1365-3083.2009.02239.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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