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Wang H, Chu Z, Ni T, Chen D, Dai X, Jiang W, Sunagawa M, Liu Y. Effect and mechanism of aqueous extract of Chinese herbal prescription (TFK) in treating gout arthritis. JOURNAL OF ETHNOPHARMACOLOGY 2024; 321:117527. [PMID: 38056535 DOI: 10.1016/j.jep.2023.117527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE With the rapid development of China's economic level, great changes have taken place in people's diet structure, gout has become a common disease that puzzles people's health, seriously affects the realization of China's "Healthy China" strategic goal. Gouty arthritis (GA) is a common joint disease caused by chronic purine metabolism disorder. Currently, drugs used to treat GA are allopurinol and colchicine. However, these drugs can only temporarily relieve the clinical symptoms of GA with significant side effects. More and more basic and clinical studies have confirmed that Traditional Chinese medicine has definite curative effect on GA. AIM OF THE STUDY To elucidate the potential molecular mechanism of Tongfengkang (TFK) in the treatment of GA, and to provide experimental basis for the search and development of efficient and low-toxicity Chinese medicine for GA treatment. MATERIALS AND METHODS Aqueous extract of TFK (AETFK) were determined by liquid phase high resolution mass spectrometry and the possible effective constituents were screened out. Acute GA model rats were established to detect the anti-inflammatory and detumification effects of AETFK on GA and explore the potential mechanism. The effect of AETFK on serum uric acid and urinary uric acid levels in acute GA rats was determined by automatic biochemical analyzer, and the effect of AETFK on the expression of acute GA-related immunoinflammatory factors were determined by protein thermal fluorescence chip. The effect of AETFK on the concentration of neutrophils in the joint fluid of acute GA rats were determined by Reichs-Giemsa staining. The effect of AETFK on macrophage activation was detected by ELISA. In order to further investigate the mechanism of AETFK in the treatment of GA, a rat model of hyperuricemia was established to detect the effect of AETFK on the level of uric acid in hyperuricemia model rats. Biochemical indexes of liver and kidney and hematoxylin-eosin staining (HE) were used to evaluate the effects of AETFK on the organs, and to preliminatively evaluate the safety of ventilation confufang. RESULTS Compared with the model group, the joint swelling degree of GA rats in AETFK treatment group were significantly reduced, and the levels of blood uric acid and urine uric acid were also significantly decreased. Protein thermal fluorescence microarray results showed that the levels of gout - related inflammatory factors in GA rats in AETFK treatment group were significantly lower than those in control group. Reichsen-giemsa staining and ELISA showed that AETFK could reduce the activation of macrophages and the accumulation of neutrophils in the joint fluid. The results of liver and kidney biochemical indexes and HE staining showed that no obvious tissue damage was observed in the organs of rats treated with AETFK. CONCLUSIONS AETFK not only has significant anti-inflammatory effects on GA, but also can significantly reduce the level of blood uric acid in GA rats, without obvious toxic and side effects. These effects may be related to AETFK's inhibition of neutrophil enrichment and macrophage activation during early inflammation.
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Affiliation(s)
- Haibo Wang
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, China; The Key Laboratory of Syndrome Differentiation and Treatment of Gastric Cancer of the State Administration of Traditional Chinese Medicine, Yangzhou University, Yangzhou, 225001, China.
| | - Zewen Chu
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, China; The Key Laboratory of Syndrome Differentiation and Treatment of Gastric Cancer of the State Administration of Traditional Chinese Medicine, Yangzhou University, Yangzhou, 225001, China.
| | - Tengyang Ni
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, China; The Key Laboratory of Syndrome Differentiation and Treatment of Gastric Cancer of the State Administration of Traditional Chinese Medicine, Yangzhou University, Yangzhou, 225001, China.
| | - Dawei Chen
- Research Unit of Food Safety, Chinese Academy of Medical Sciences (No. 2019RU014), NHC Key Lab of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment (CFSA), Beijing, 100022, China.
| | - Xiaojun Dai
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, China.
| | - Wei Jiang
- College of Environmental Science & Engineering, Yangzhou University, Yangzhou, Jiangsu, 225127, China.
| | - Masataka Sunagawa
- Department of Physiology, School of Medicine, Showa University, Tokyo, 142, Japan.
| | - Yanqing Liu
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, China; The Key Laboratory of Syndrome Differentiation and Treatment of Gastric Cancer of the State Administration of Traditional Chinese Medicine, Yangzhou University, Yangzhou, 225001, China.
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Ten Klooster PM, Kraiss JT, Munters R, Vonkeman HE. Generalized pain hypersensitivity and associated factors in gout. Rheumatology (Oxford) 2021; 61:3640-3646. [PMID: 34919669 PMCID: PMC9434280 DOI: 10.1093/rheumatology/keab934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/13/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Previous studies have indicated that a sizeable proportion of patients with inflammatory arthritis present with features characteristic of central pain sensitization. However, this has not yet been examined in patients with gout. The objective of this study was to explore the presence of generalized pain hypersensitivity and associated factors in patients with diagnosed gout. METHODS A cross-sectional survey was performed in outpatients with crystal proven gout using the generalized pain questionnaire (GPQ) to screen for the presence of generalized pain hypersensitivity. Additional self-reported socio-demographic and medical information was collected and several patient-reported outcome measures were completed. Univariable logistic regressions and multivariable LASSO regression analysis with 10-fold cross-validation was used to explore relationships with patient characteristics, clinical features and PROMs. RESULTS Of the 97 included patients (84.5% male; mean ± standard deviation age: 68.9 ± 11.9 years), 20 patients (20.6%, 95% CI: 13.0-30.0) reported possible generalized pain hypersensitivity defined as a GPQ score ≥11 (range: 0-28; mean ± standard deviation GPQ: 6.3 ± 5.3). Lower age, concomitant fibromyalgia, and more experienced difficulties in performing their social role were independently associated with generalized pain hypersensitivity. Notably, use of urate lowering therapy was significantly lower in those with generalized pain hypersensitivity. CONCLUSIONS Generalized pain hypersensitivity appears to be quite common in gout, despite its more intermittent nature compared with other inflammatory arthritides. As this kind of pain does not respond well to regular treatment, screening for non-inflammatory pain may be important for improving pain management in gout.
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Affiliation(s)
- Peter M Ten Klooster
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Jannis T Kraiss
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Rik Munters
- Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente, Enschede, The Netherlands
| | - Harald E Vonkeman
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands.,Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente, Enschede, The Netherlands
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Holyer J, Garcia-Guillen A, Taylor WJ, Gaffo AL, Gott M, Slark J, Horne A, Su I, Dalbeth N, Stewart S. What Represents Treatment Efficacy in Long-term Studies of Gout Flare Prevention? An Interview Study of People With Gout. J Rheumatol 2021; 48:1871-1875. [PMID: 34470799 DOI: 10.3899/jrheum.210476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The patient experience of gout flares is multidimensional, with several contributing factors including pain intensity, duration, and frequency. There is currently no consistent method for reporting gout flare burden in long-term studies. This study aimed to determine which factors contribute to patient perceptions of treatment efficacy in long-term studies of gout flare prevention. METHODS This study involved face-to-face interviews with people with gout using visual representations of gout flare patterns. Participants were shown different flare scenarios over a hypothetical 6-month treatment period that portrayed varying flare frequency, pain intensity, and flare duration. The participants were asked to indicate and discuss which scenario they believed was most indicative of successful treatment over time. Quantitative data relating to the proportion of participants selecting each scenario were reported using descriptive statistics. A qualitative descriptive approach was used to code and categorize the data from the interview transcripts. RESULTS Twenty-two people with gout participated in the semistructured interviews. All 3 factors of pain intensity, flare duration, and flare frequency influenced participants' perception of treatment efficacy. However, a shorter flare duration was the most common indicator of successful treatment, with half of participants (n = 11, 50%) selecting the scenario with a shorter flare duration over those with less painful flares. CONCLUSION Flare duration, flare frequency, and pain severity are all taken into account by patients with gout when considering treatment efficacy over time. Long-term studies of gout should ideally capture all these factors to better represent patients' experience of treatment success.
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Affiliation(s)
- Jeremy Holyer
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrea Garcia-Guillen
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - William J Taylor
- W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Angelo L Gaffo
- A.L. Gaffo, MD, MSPH, FACP, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Merryn Gott
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Julia Slark
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Anne Horne
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Isabel Su
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Nicola Dalbeth
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Sarah Stewart
- J. Holyer, medical student, A. Garcia-Guillen, MD, M. Gott, PhD, J. Slark, PhD, A. Horne, MBChB, I. Su, BSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand;
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