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Shen S, Wan A, Wang Y, Liu L, Yao Y, Weng J, Zhu T, Yang Q, Yan Q. Flexible microneedles incorporating gold nanorods and tacrolimus for effective synergistic photothermal-chemotherapy of rheumatoid arthritis. Int J Biol Macromol 2024; 276:133797. [PMID: 38992523 DOI: 10.1016/j.ijbiomac.2024.133797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 11/24/2023] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
Transdermal drug delivery systems for rheumatoid arthritis (RA) have garnered substantial attention due to their great potential to overcome limitations observed in conventional oral or injection strategies, including limited selectivity and adverse effects on extra-articular tissues. Microneedles (MNs) appear to be highly desirable carriers for transdermal drug delivery of RA. However, microneedles typically are unable to keep up with the flexibility of joints, which decreases the effectiveness of administration. In this study, we developed a flexible microneedles (FMNs) delivery system. And gelatin was employed for the fabrication of flexible backings for microneedles owing to its excellent ductility and biocompatibility. We achieved synergisticphotothermal-chemotherapy of RA by incorporating the chemical drug Tacrolimus (TAC) and the photothermal agent gold nanorods (AuNRs) into dissolving microneedles. Results showed a high mechanical strength of the proposed FMNs. In the animal model of adjuvant-induced arthritis (AA), it is indicated that the prepared FMNs inhibited the expression of related inflammatory cytokines such as IL-1ß and TNF-α while enhancing bone repair and other related factors. Thus, the combination therapy of FMNs-mediated hyperthermia and chemotherapy can serve as a novel and synergistic treatment option for RA.
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Affiliation(s)
- Shulin Shen
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Aiqun Wan
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Yan Wang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Linxiao Liu
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Yao Yao
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Jiaqi Weng
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Institute of Laser Advanced Manufacturing, Zhejiang University of Technology, Hangzhou, Zhejiang 310023, PR China; College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310023, PR China
| | - Tong Zhu
- School of Education and English, Faculty of Humanities and Social Sciences, University of Nottingham, Ningbo, Zhejiang 315199, PR China
| | - Qingliang Yang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Qinying Yan
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China.
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Boman R, Penkala S, Chan RHM, Joshua F, Cheung RTH. Ultrasound imaging of the dorsalis pedis artery as an early indicator of the precursory changes for rheumatoid vasculitis: A case series. Australas J Ultrasound Med 2024; 27:42-48. [PMID: 38434542 PMCID: PMC10902827 DOI: 10.1002/ajum.12373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Introduction Clinical verification of rheumatoid vasculitis (RV) persists as a mid-to-late diagnosis with medical imaging or biopsy. Early and subclinical presentations of RV, in particular, can remain underdiagnosed in the absence of adequate diagnostic testing. In this study, the research demonstrated the precursory changes for RV in patients with rheumatoid arthritis (RA) using non-invasive ultrasound imaging of a peripheral vessel. Method Six participants were recruited: three participants with (RA) and three age- and gender-matched healthy controls. All participants completed a Foot Health Survey Questionnaire (FHSQ), and participants with RA completed a Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5). Bilateral B-mode and Doppler ultrasound of the dorsalis pedis artery (DPA) was performed. The degree of inflammation, lumen and artery diameters, lumen diameter-to-artery diameter ratio and peak systolic velocity in the proximal DPA were compared between the two groups. Results The mean RADAI-5 score (5.4 ± 0.8 out of 10) indicated moderate disease activity amongst participants with RA. Inflammation was observed in the DPA wall in all participants with RA, compared to no inflammation observed in the control group (Friedmans two-way analysis: χ2 = 15.733, P = 0.003). Differences between groups for inflammation, lumen diameter and lumen diameter-to-artery diameter ratio were found (P < 0.034), without differences for artery diameter and peak systolic velocity (P > 0.605). DPA wall inflammation did not correlate with FHSQ scores (r = -0.770, P = 0.073). Conclusion Despite moderate RA disease activity, this is the first study to demonstrate the use of ultrasound to observe inflammation in small vessel disease. Our findings suggest ultrasound imaging may be a viable screening tool to demonstrate arterial wall inflammation, indicating the precursory changes of RV.
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Affiliation(s)
- Robyn Boman
- School of Health SciencesWestern Sydney UniversityCampbelltownNew South WalesAustralia
| | - Stefania Penkala
- School of Health SciencesWestern Sydney UniversityCampbelltownNew South WalesAustralia
- Translational Health Research InstituteWestern Sydney UniversityCampbelltownNew South WalesAustralia
| | - Rosa H. M. Chan
- Department of Electrical EngineeringCity University of Hong KongHong KongHong Kong
| | - Fredrick Joshua
- Faculty of Medicine and Health SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Roy Tsz Hei Cheung
- School of Health SciencesWestern Sydney UniversityCampbelltownNew South WalesAustralia
- Translational Health Research InstituteWestern Sydney UniversityCampbelltownNew South WalesAustralia
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Wen J, Liu J, Wan L, Xin L, Sun Y, Wang F. The effect of long-term traditional Chinese medicine treatment on extra-articular lesions of rheumatoid arthritis patients based on propensity score matching: A retrospective cohort study. Heliyon 2024; 10:e23147. [PMID: 38187299 PMCID: PMC10770526 DOI: 10.1016/j.heliyon.2023.e23147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Objective To explore the efficacy of long-term traditional Chinese medicine (TCM) treatment on the occurrence of extra-articular lesions in rheumatoid arthritis (RA) patients. Methods Our retrospective cohort study included patients diagnosed with RA between January 2018 to December 2019. Patients were divided into TCM treatment group and control group according to whether they received TCM treatment for more than three months. Propensity score matching (PSM) was used to balance covariates between groups. The occurrence time of extra-articular lesions, including interstitial lung disease, Sjögren's syndrome, and anemia, was calculated for both groups after PSM. Additionally, clinical indicators that may affect the occurrence of extra-articular lesions in RA were included in Cox multivariate regression analysis to explore prognostic factors related to RA. Results A total of 883 RA patients were initially included in our study, with 481 in the TCM treatment group and 279 in the control group. TCM treatment improved all clinical indicators of RA patients, and there was a higher degree of support, confidence, and lift between TCM treatment and the improvement of clinical indicators. There was no significant difference in the rate of extra-articular lesions occurrence between the two groups. After PSM, the median occurrence time of interstitial lung disease, Sjögren's syndrome and anemia in the TCM treatment group were 30.767, 21.370 and 31.970 months, respectively. While in the control group, it was 15.911, 14.667 and 11.825 months, respectively. Cox multivariate regression analysis indicated that TCM treatment was a protective factor for the occurrence of extra-articular lesions in RA, while abnormally high level of IgG was an independent factor for interstitial lung disease and C4 was an independent factor for Sjögren's syndrome. Moreover, a longer duration of TCM usage was associated with a later occurrence of extra-articular lesions. Conclusion Long-term TCM treatment not only positively affects the occurrence time of extra-articular lesions in RA patients, but also helps reduce the risk of extra-articular lesions occurrence. TCM can be applied flexibly throughout the treatment process for RA patients.
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Affiliation(s)
- Jianting Wen
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, Anhui Province, China
- Institute of Rheumatology, Anhui Academy of Chinese Medicine, Hefei, 230012, Anhui Province, China
- Key Laboratory of Xin'an Medicine of the Ministry of Education, Anhui University of Chinese Medicine, Hefei, Anhui, 230038, China
| | - Jian Liu
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, Anhui Province, China
- Institute of Rheumatology, Anhui Academy of Chinese Medicine, Hefei, 230012, Anhui Province, China
- Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Lei Wan
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, Anhui Province, China
- Institute of Rheumatology, Anhui Academy of Chinese Medicine, Hefei, 230012, Anhui Province, China
- Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Ling Xin
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, Anhui Province, China
- Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Yue Sun
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, Anhui Province, China
- Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
| | - Fanfan Wang
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, Anhui Province, China
- Anhui Province Key Laboratory of Modern Chinese Medicine Department of Internal Medicine Application Foundation Research and Development, Hefei, 230031, Anhui, China
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Wang F, Liu J, Fang Y, Wen J, He M, Han Q, Li X. Hypercoagulability in Rheumatoid Arthritis: A Bibliometric Analysis and Retrospective Data Mining Study. ACS OMEGA 2023; 8:48522-48534. [PMID: 38144152 PMCID: PMC10734003 DOI: 10.1021/acsomega.3c08460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic systemic inflammation, leading to joint deformities and functional loss. RA progression is accompanied by abnormalities in the coagulation-fibrinolysis system, clinically manifested as a hypercoagulable state. However, there are currently no bibliometrics or visualization analysis in this field. OBJECTIVE The present study aims to reveal the knowledge structure, research status, and research trends related to hypercoagulability in RA through bibliometric analysis and to evaluate the utility of inflammatory and coagulation markers in RA disease activity through retrospective data mining. METHODS English articles and reviews on RA hypercoagulability published from 2010 to 2023 were extracted from the Web of Science Core Collection (WoSCC) database on March 1, 2023. VOSviewer and CiteSpace software were used for knowledge mapping analysis of the included papers in terms of countries/regions, institutions, journals, authors, keywords, research hotspots, and frontiers. A retrospective analysis was conducted on the general information on RA patients. The demographic and clinical indicators of all participants were collected to determine the correlation of inflammatory and coagulation markers with the Chinese patient-reported activity index for rheumatoid arthritis (CPRI-RA). RESULTS A total of 957 papers were retrieved. The United States was the most productive country in this field and had the highest h-index, and the most prolific institution was the Karolinska Institute. The Annals of the Rheumatic Diseases was the journal with the most publications, and KLARESKOG L. was the most productive author. From keyword analysis, it could be seen that "inflammation", "activation", "disease-activity", and "risk" had long been the focuses of RA hypercoagulability research. "Criteria", "validation", "coagulation", "target", and "anemia" were the latest popular keywords in the past 5 years. Retrospective data mining revealed that the levels of inflammation (RF, ESR, and CRP) and coagulation (PLT and DD) were significantly increased in RA patients. FBG, CRP, and ESR were significantly correlated with CPRI-RA. Additionally, ESR, CRP, and FBG were identified as independent risk factors for CPRI-RA. CONCLUSION The mechanism and application of hypercoagulability in RA have been research hotspots in recent years. Inflammation and coagulation markers are independent risk factors for CPRI-RA.
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Affiliation(s)
- Fanfan Wang
- The
First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui 230038, China
- The
First Clinical Medical College, Anhui University
of Chinese Medicine, Hefei, Anhui 230038, China
| | - Jian Liu
- The
First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui 230038, China
| | - Yanyan Fang
- Department
of Clinical Data Center, The First Affiliated
Hospital of Anhui University of Chinese Medicine, Hefei, Anhui 230038, China
| | - Jianting Wen
- The
First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui 230038, China
| | - Mingyu He
- The
First Clinical Medical College, Anhui University
of Chinese Medicine, Hefei, Anhui 230038, China
| | - Qi Han
- The
First Clinical Medical College, Anhui University
of Chinese Medicine, Hefei, Anhui 230038, China
| | - Xu Li
- The
First Clinical Medical College, Anhui University
of Chinese Medicine, Hefei, Anhui 230038, China
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王 帆, 刘 健, 方 妍, 文 建, 贺 明, 韩 琦, 李 旭. [Traditional Chinese medicine may reduce the risk of readmission in patients with rheumatoid arthritis complicated with elevated platelet count: a matched cohort study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2023; 43:1548-1557. [PMID: 37814869 PMCID: PMC10563093 DOI: 10.12122/j.issn.1673-4254.2023.09.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE To evaluate the association of traditional Chinese medicine (TCM) treatment with the risk of readmission in patients with rheumatoid arthritis (RA) complicated with elevated platelet count. METHODS We retrospectively collected the data of inpatients diagnosed with RA in our hospital from 2013 to 2021. The patients with elevated platelet count receiving TCM treatment were matched to those without TCM treatment using propensity score matching at the 1∶1 ratio, and the confounding factors were adjusted including gender, age, Chinese patent medicine, and external application. A Cox proportional hazard model was used to evaluate the hazard ratio (HR) of the risk of readmission, and a Kaplan-Meier curve was generated to assess the incidence of readmission in these patients. RESULTS A total of 1176 RA patients with elevated platelet count were included in this study, including 842 patients in the TCM group and 334 patients in the non-TCM group, and after 1∶1 propensity score matching, 334 patients were included in each group. The Cox proportional hazards model showed that the readmission rate was significantly lower in TCM group than in non-TCM group (HR=0.59, 95% CI: 0.48-0.73, P<0.001), and TCM was a protective factor against readmission in RA patients with elevated platelet count. Kaplan-Meier curves demonstrated that long-term use of TCM helped to decrease the risk of readmission (Log-rank P<0.001). Association rules showed that the use of several Chinese herbal medicines and the Chinese patent medicine Xinfeng Capsule had a strong correlation with improvement of such clinical indicators as rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein. CONCLUSION In RA patients with elevated platelet count, the use of TCM, as a protective factor against readmission, is strongly associated with a lowered risk of readmission with a long-term association.
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Affiliation(s)
- 帆帆 王
- />安徽中医药大学第一附属医院,安徽 合肥 230031First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - 健 刘
- />安徽中医药大学第一附属医院,安徽 合肥 230031First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - 妍妍 方
- />安徽中医药大学第一附属医院,安徽 合肥 230031First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - 建庭 文
- />安徽中医药大学第一附属医院,安徽 合肥 230031First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - 明玉 贺
- />安徽中医药大学第一附属医院,安徽 合肥 230031First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - 琦 韩
- />安徽中医药大学第一附属医院,安徽 合肥 230031First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
| | - 旭 李
- />安徽中医药大学第一附属医院,安徽 合肥 230031First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China
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Wang F, Liu J, Fang Y, Li X, He M, Han Q. Traditional Chinese medicine may be associated with a reduced risk of recurrent exacerbation in patients with rheumatoid arthritis: A matched cohort study based on 1383 individuals. Heliyon 2023; 9:e15054. [PMID: 37095982 PMCID: PMC10121797 DOI: 10.1016/j.heliyon.2023.e15054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 04/26/2023] Open
Abstract
Ethnopharmacological relevance This study determines whether traditional Chinese medicine (TCM) treatment is associated with the risk of recurrent exacerbation in patients with rheumatoid arthritis (RA). Materials and methods In this retrospective study, we selected 1383 patients who were diagnosed with RA between 2013 and 2021 from the medical record information management system of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine. Then, patients were classified into TCM users and non-TCM users. Gender, age, recurrent exacerbation, TCM, death, surgery, organ lesions, Chinese patent medicine, external medicine, and non-steroidal anti-inflammatory drugs were adjusted one TCM user-to-one non-TCM user with propensity score matching to reduce selection bias and confusion using propensity score matching (PSM). A Cox regression model was used to compare the hazard ratio of the risk of recurrent exacerbation and the Kaplan Meier curve of recurrent exacerbation proportion between the two groups. Results Most of the tested clinical indicators in this study improved in patients, which was correlated with the use of TCM, with a statistical significance. TCM was preferred in female and younger (<58 years old) patients with RA. Of note, recurrent exacerbation was observed in more than 850 (61.461%) RA patients. The results of the Cox proportional hazard model showed TCM as a protective factor for the recurrent exacerbation of RA patients (HR = 50%, 95% CI = 0.65-0.92, P < 0.01). Kaplan Meier curves demonstrated that the survival rate of TCM users was higher than that of non-TCM users (log-rank P < 0.01). Conclusion Conclusively, the use of TCM may be related to a lower risk of recurrent exacerbation in RA patients. These findings provide evidence for the recommendation of TCM treatment for RA patients.
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Effect of Siegesbeckiae Herba on Immune-inflammation of Rheumatoid Arthritis: Data Mining and Network Pharmacology. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Wang R, Ji CL, Feng DD, Wu YJ, Li Y, Olatunji OJ, Yu LJ, Zuo J. Consumption of Saturated Fatty Acids-Rich Lard Benefits Recovery of Experimental Arthritis by Activating PPAR-γ. Mol Nutr Food Res 2023; 67:e2200429. [PMID: 36433679 DOI: 10.1002/mnfr.202200429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/15/2022] [Indexed: 11/27/2022]
Abstract
SCOPE This study investigates the impacts of lard and related fatty acids intake on rheumatoid arthritis (RA) animal models. METHOD AND RESULTS Collagen-induced arthritis (CIA) and adjuvant-induced arthritis (AIA) are induced in SD rats and C57 BL/6 mice respectively, which are fed by lard-rich diet (LRD) for 42 days with intake restriction or not. AIA SD rats are treated by representative fatty acids for 30 days. Body weight, arthritis score, and metabolic profile are periodically recorded. Monocyte distribution, cytokine/metabolites levels, gene expression, and tissue damages are investigated by flow cytometry, ELISA, colorimetry, PCR, and histological methods. After being treated by fatty acids in vitro, THP-1 monocytes and the corresponding medium are collected for ELISA, PCR, immunoblotting, and reporter gene assays. Irrespective of intake amounts, LRD decreases inflammatory cytokines and inhibits glycolysis in all rheumatic rodents. Furthermore, it alters monocyte distribution and promotes PPAR-γ expression in AIA mice. Overall evidences show that both saturated (SF) and unsaturated fatty acids (USF) from lard can attenuate inflammation by activating PPAR-γ. Silencing PPAR-γ abrogates their anti-inflammatory effects in vitro. Besides, SF can stimulate TLR4/NF-κB pathway. CONCLUSION Lard consumption is beneficial for active inflammatory arthritis recovery. Even SF can activate PPAR-γ and consequently attenuate inflammation.
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Affiliation(s)
- Rui Wang
- Xin'an Medicine Research Center, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, 241000, China
| | - Cong-Lan Ji
- School of Pharmacy, Anhui College of Traditional Chinese Medicine, Wuhu, Anhui, 241000, China
| | - Dan-Dan Feng
- Department of Rheumatology, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, 241000, China
| | - Yi-Jin Wu
- Research Center of Integration of Traditional Chinese and Western Medicine, Wannan Medical College, Wuhu, 241000, China
| | - Yan Li
- Xin'an Medicine Research Center, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, 241000, China
| | - Opeyemi Joshua Olatunji
- Traditional Thai Medical Research and Innovation Center, Faculty of Traditional Thai Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand
| | - Li-Jun Yu
- Research Center of Integration of Traditional Chinese and Western Medicine, Wannan Medical College, Wuhu, 241000, China
| | - Jian Zuo
- Xin'an Medicine Research Center, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, 241000, China.,Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution, Wannan Medical College, Wuhu, 241000, China.,Anhui Provincial Engineering Laboratory for Screening and Re-evaluation of Active Compounds of Herbal Medicines in Southern Anhui, Wuhu, 241000, China
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Liu L, Chen H, Jiang T, He D. MicroRNA-106b Overexpression Suppresses Synovial Inflammation and Alleviates Synovial Damage in Patients with Rheumatoid Arthritis. Mod Rheumatol 2021; 32:1054-1063. [PMID: 34850088 DOI: 10.1093/mr/roab108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/25/2021] [Accepted: 11/08/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To explore the effect of miR-106b on synovial inflammation and damage in rheumatoid arthritis (RA) patients, and further to investigate its possible mechanism. METHODS : Quantitative real-time polymerase chain reaction (qRT-PCR), immunofluorescence, in situ hybridization and immunohistochemistry assay were separately used to verify the levels of miR-106b and cytokines in the synovial tissues of patients with RA or osteoarthritis (OA). Pearson correlation analysis was conducted to examine the bivariate relationship between miR-106b and cytokines or RANKL. Following the isolation and culture of fibroblast-like synoviocytes (FLS), the cells were transfected with lentivirus-mediated miR-106b mimic, miR-106b inhibitor, and negative control miR-106b mimic, respectively. Thereafter, cell proliferation was measured by Cell Counting Kit-8 assay, and cell invasion and migration capacity was assessed by Transwell assay. Furthermore, concentration and expression of cytokines were separately detected by Enzyme linked immunosorbent assay and Western blot. RESULTS Compared with osteoarthritis, validation by qRT-PCR showed that RA patients had a lower level of miR-106b and higher levels of receptor activator of nuclear factor-κ B ligand (RANKL), tumor necrosis factor-a (TNF-a) and interleukin-6 (IL-6). Additionally, the scatter plot showed that the relative transcription of miR-106b level was negatively correlated to the level of TNF-a, IL-6, and RNKAL in the synovial tissues of both RA and OA patients (All P<0.05). Furthermore, miR-106b overexpression suppressed cell proliferation, migration and invasion capacity of human RA-FLS. CONCLUSIONS miR-106b overexpression suppresses synovial inflammation and alleviates synovial damage, thus it may be served as a potential therapeutic target for RA patients.
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Affiliation(s)
- Linchen Liu
- Department of Rheumatology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing China
| | - Haiyan Chen
- Department of Rheumatology, Shanghai Guanghua Hospital of Integrated Traditional and Western Medicine, Shanghai China
| | - Ting Jiang
- Department of Rheumatology, Shanghai Guanghua Hospital of Integrated Traditional and Western Medicine, Shanghai China
| | - Dongyi He
- Arthritis Institute of Integrated Traditional and Western Medicine, Shanghai Chinese Medicine Research Institute, Shanghai, China
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Hao J, Chen Y, Yu Y. Circular RNA circ_0008360 Inhibits the Proliferation, Migration, and Inflammation and Promotes Apoptosis of Fibroblast-Like Synoviocytes by Regulating miR-135b-5p/HDAC4 Axis in Rheumatoid Arthritis. Inflammation 2021; 45:196-211. [PMID: 34462830 DOI: 10.1007/s10753-021-01538-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/09/2021] [Indexed: 12/31/2022]
Abstract
Circular RNAs (circRNAs) have been demonstrated to play crucial roles in the development and progression of many diseases, including rheumatoid arthritis (RA). However, the functions and molecular mechanism of circ_0008360 in RA remain unclear. Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to determine the expression of circ_0008360, microRNA-135b-5p (miR-135b-5p), and histone deacetylase 4 (HDAC4). Cell Counting Kit-8 (CCK-8) assay, wound healing assay, and flow cytometry analysis were performed to assess cell proliferation, migration, and apoptosis, respectively. Inflammatory response was evaluated by enzyme-linked immunosorbent assay (ELISA). The interaction between miR-135b-5p and circ_0008360 or HDAC4 was predicted by bioinformatics analysis and verified by dual-luciferase reporter and RNA Immunoprecipitation (RIP) and RNA pull-down assays. Western blot assay was used to detect the protein expression of HDAC4 and proliferating cell nuclear antigen (PCNA). The expression of circ_0008360 was downregulated in RA synovial tissues and RA fibroblast-like synoviocytes (RA-FLSs). Circ_0008360 suppressed the proliferation, migration, and inflammation and promoted apoptosis of RA-FLSs, and circ_0008360 knockdown showed opposite effects. Moreover, miR-135b-5p was a direct target of circ_0008360, and miR-135b-5p could reverse the effects of circ_0008360 on proliferation, migration, inflammation, and apoptosis in RA-FLSs. Furthermore, HDAC4 was a downstream target of miR-135b-5p, and miR-135b-5p accelerated the proliferation, migration, and inflammation and suppressed apoptosis of RA-FLSs by targeting HDAC4. In addition, circ_0008360 positively regulated HDAC4 expression by sponging miR-135b-5p. Circ_0008360 inhibited the proliferation, migration, and inflammation and facilitated apoptosis of RA-FLSs by sponging miR-135b-5p and upregulating HDAC4, providing a potential target for prevention and treatment of RA.
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Affiliation(s)
- Jinying Hao
- Department of Rheumatology, Heping Hospital Affiliated To Changzhi Medical College, Changzhi, Shanxi, China
| | - Yan Chen
- Department of Rheumatology, Zao Zhuang Hospitai of Zao Zhuang Mining Group, Shandong, Zaozhuang, China
| | - Yunxiang Yu
- Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, No.32, South Renmin Road, Shiyan, 442000, Hubei, China. .,Department of Orthopedics, Taihe Hospital, Hubei University of Medicine, No.32, South Renmin Road, Hubei, 442000, Shiyan, China.
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Tian F, Wen Z, Li J, Luo X, Deng L, Zhang L, He J, Yao F, Liao Z. Cost-effectiveness of Anbainuo plus methotrexate compared to conventional disease-modifying antirheumatic drugs for rheumatoid arthritis patients in China. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1165. [PMID: 34430606 PMCID: PMC8350709 DOI: 10.21037/atm-21-3132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/15/2021] [Indexed: 12/15/2022]
Abstract
Background This study aimed to evaluate the cost-effectiveness of Anbainuo (ABN) plus methotrexate (MTX) vs. conventional disease-modifying antirheumatic drugs (cDMARDs) in Chinese rheumatoid arthritis (RA) patients. Methods A total of 90 RA patients who underwent ABN + MTX [assigned as ABN + MTX group (n=47)] or cDMARDs [assigned as control group (n=43)] treatment were analyzed. Disease activity was assessed at baseline (M0), 3rd month (M3), 6th month (M6), and 12th month (M12) after treatment. Drug, other medical, indirect, and total costs were calculated. Then, pharmacoeconomic analyses were performed with the threshold of cost-effectiveness set as 3 times of the mean gross domestic product (GDP) per capita in China during the study period. Results Treatment response rate was similar between the 2 groups, while disease remission and low disease activity (LDA) rates were increased in the ABN + MTX group compared to control group. Drug cost, other medical costs, and total cost were higher in the ABN + MTX group than control group, while indirect cost was similar between the 2 groups. Meanwhile, the quality-adjusted life-years (QALY) in ABN + MTX group and control group were 0.72 and 0.48 years, respectively. The incremental cost-effectiveness ratios (ICER) of ABN + MTX group compared to control group among the entire participant cohort, moderate-disease-activity participants, and severe-disease-activity participants were ¥135,486.7, ¥146,450.4, and ¥124,987.2/QALY, respectively, which were all below the cost-effectiveness threshold. Further sensitivity analyses revealed that the cost-effectiveness of ABN + MTX vs. cDMARDs was relatively robust, while among all the indexes, ABN price and Health Assessment Questionnaire Disability Index (HAQ-DI) score change for the ABN + MTX group affected ICER most. Conclusions Treatment with ABN + MTX offers acceptable cost-effectiveness compared to cDMARDs treatment in Chinese RA patients.
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Affiliation(s)
- Feng Tian
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Zhenhua Wen
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Jingyang Li
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Xiaowen Luo
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Li Deng
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Liang Zhang
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Jingyun He
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Fangling Yao
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
| | - Zheng Liao
- Department of Rheumatology and Immunology, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China
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Sun J, Dai S, Zhang L, Feng Y, Yu X, Zhang Z. Investigating the safety and compliance of using csDMARDs in rheumatoid arthritis treatment through face-to-face interviews: a cross-sectional study in China. Clin Rheumatol 2021; 40:1789-1798. [PMID: 33058034 PMCID: PMC8102276 DOI: 10.1007/s10067-020-05458-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/06/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023]
Abstract
Rheumatoid arthritis (RA) significantly impacts the health of Chinese patients. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) are used as the standard treatment for patients with RA. However, Chinese patients with RA have reported poor compliance with csDMARDs. This study aims to better understand the safety and compliance of using csDMARDs in RA treatment. Face-to-face interviews were conducted by questionnaires on safety and compliance of csDMARDs in 400 patients with RA and 100 rheumatologists from 13 cities in China. Rheumatologists were from Tier 3 Class A hospitals with independent rheumatology departments, who admitted more than 30 patients with RA per week. All patients were diagnosed for > 3 months before the survey and had been treated with csDMARDs for > 3 months. The incidence of adverse events (AEs) that attributed to csDMARDs estimated by rheumatologists was lower than that reported by patients for all four prescribed csDMARDs. Also, types of common AEs in rheumatologist's perception differed from those in the patient's report. Only 86% (116/135) of patients claimed they notified their rheumatologist about AEs, and 40.8% (150/368) of patients did not strictly adhere to their prescribed treatment. Reasons why patients were not compliant with their treatment, other than AEs, included symptoms being less severe, travel, and busy working life/business trips. This study revealed gaps in perceptions of csDMARDs-related AEs and medication adherence between rheumatologists and patients. These findings suggested adequate doctor-patient communications, and considerations of multiple real-world situations may improve adherence in the treatment of RA patients. Key Points • This study identified gaps in rheumatologists' perception of the prevalence and type of AEs experienced by their patients, which could potentially help them improve their patients' compliance with treatment.
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Affiliation(s)
- Jiaying Sun
- Department of Rheumatology and Immunology, First Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang, China
| | - Siming Dai
- Department of Rheumatology and Immunology, First Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang, China
| | - Ling Zhang
- Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, China
| | - Yajing Feng
- Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, China
| | - Xin Yu
- Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, China
| | - Zhiyi Zhang
- Department of Rheumatology and Immunology, First Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang, China.
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Sun L, Tu J, Chen X, Dai M, Xia X, Liu C, Zhou Y. JNK pathway-associated phosphatase associates with rheumatoid arthritis risk, disease activity, and its longitudinal elevation relates to etanercept treatment response. J Clin Lab Anal 2021; 35:e23709. [PMID: 33547838 PMCID: PMC8059732 DOI: 10.1002/jcla.23709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 12/29/2022] Open
Abstract
Background This study aimed to investigate the relationship of serum JNK pathway‐associated phosphatase (JKAP) expression with rheumatoid arthritis (RA) risk and clinical features, also to explore the longitudinal change of JKAP during etanercept treatment and its relationship with etanercept treatment response in RA patients. Methods A total of 87 RA patients and 44 healthy controls (HCs) were enrolled; then, their JKAP expression in serum was determined by enzyme‐linked immunosorbent assay (ELISA). Among 87 RA patients, 42 cases further received the 24‐week etanercept treatment; then, their JKAP level in serum (detected by ELISA) and clinical response (evaluated by disease activity score in 28 joints (DAS28) score) were evaluated at week 4 (W4), week 12 (W12), and week 24 (W24) after initiation of etanercept treatment. Results JKAP expression was decreased in RA patients compared to HCs, which disclosed a good predictive value for RA risk. JKAP expression was negatively associated with tender joint count, swollen joint count, erythrocyte sedimentation rate, C‐reactive protein, and DAS28 in RA patients, respectively. For RA patients who received 24‐week etanercept treatment, their clinical response rate was 0.0%, 33.3%, 50.0%, and 69% at W0, W4, W12, and W24, respectively. Importantly, JKAP was gradually increased during etanercept treatment, whose longitudinal elevation positively related to etanercept treatment response in RA patients. Conclusion Circulating JKAP links with decreased RA risk and mild disease activity, whose longitudinal elevation positively relates to etanercept treatment response.
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Affiliation(s)
- Li Sun
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jianxin Tu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaowei Chen
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meijie Dai
- Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoru Xia
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Cailong Liu
- Department of Orthopaedic Sports Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yan Zhou
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Lin N, Zhang YQ, Jiang Q, Liu W, Liu J, Huang QC, Wu KY, Tu SH, Zhou ZS, Chen WH, Li XX, Ding Y, Fang YF, Liu JP, Li ZB, He DY, Chen YL, Lou YQ, Tao QW, Wang QW, Jin YH, Liao X, Li TX, Wang XY. Clinical Practice Guideline for Tripterygium Glycosides/ Tripterygium wilfordii Tablets in the Treatment of Rheumatoid Arthritis. Front Pharmacol 2021; 11:608703. [PMID: 33519474 PMCID: PMC7845140 DOI: 10.3389/fphar.2020.608703] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
Tripterygium wilfordii Hook F (TwHF) is one of the most commonly used and effective traditional Chinese herbal medicines against rheumatoid arthritis (RA). Both Tripterygium Glycoside Tablets (TGT) and Tripterygium wilfordii Tablets (TWT) are the representative TwHF-based agents enrolled into the 2019 edition of Medicine Catalog for National Basic Medical Insurance, Injury Insurance, and Maternity Insurance. However, individual differences in TGT/TWT response across patients usually exist in the process of treating RA, implying that the clinical application of the two agents may not be standardized leading to the ineffective treatment and the risk of side effects. Growing evidence show that the bioactive constituents of TwHF may often have toxicity, the package insert of TGT and TWT may not be described in detail, and the therapeutic windows of the two agents are narrow. Thus, it is an urgent task to develop a standardized clinical practice guideline for TGT and TWT in the treatment of RA. In the current study, a group of clinical experts of traditional Chinese medicine and Western medicine in the research field of rheumatism diseases, pharmacists, and methodologists of evidence-based medicine were invited to select the clinical questions, to determine the levels of the evidence and the strength of the recommendations, and to develop the recommendations and good practice points. The guideline is formed based on the combination of clinical research evidence and expert experience (evidence-based, consensus, supplemented by experience). The clinical problems which are supported by clinical evidence may form recommendations, and the clinical problems without clinical evidence may form experts' suggestions. Both recommendations and experts' suggestions in this guideline summarized the clinical indications, usage, dosage, combined medication, and safety of TGT and TWT against RA systematically and comprehensively, which may offer a professional guidance in the context of the clinical application of the two TwHF-based agents.
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Affiliation(s)
- Na Lin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan-Qiong Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Quan Jiang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jian Liu
- First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Qing-Chun Huang
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Kuan-Yu Wu
- Second People's Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Sheng-Hao Tu
- Tongji Hospital Affiliated to Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
| | - Zu-Shan Zhou
- Department of Honghu, Hubei Province Hospital of Traditional Chinese Medicine, Honghu, China
| | - Wei-Heng Chen
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Xia Li
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ying Ding
- First Affiliated Hospital of the Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Yong-Fei Fang
- Southwest Hospital, Army Medical University, Chongqing, China
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhen-Bin Li
- Bethune International Peace Hospital, People's Liberation Army, Shijiazhuang, China
| | - Dong-Yi He
- Shanghai Guanghua Hospital of Integrated Traditional and Western Medicine, Shanghai, China
| | - Yao-Long Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | | | | | - Qing-Wen Wang
- Shenzhen Hospital, Peking University, Shenzhen, China
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xing Liao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tai-Xian Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao-Yue Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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Effect of Moxibustion on the Serum Levels of MMP-1, MMP-3, and VEGF in Patients with Rheumatoid Arthritis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7150605. [PMID: 33014110 PMCID: PMC7519456 DOI: 10.1155/2020/7150605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/18/2020] [Accepted: 09/04/2020] [Indexed: 11/23/2022]
Abstract
Background Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease, which will eventually lead to joints deformity and functional damage. The aim of this research is to evaluate the effect of moxibustion on the serum indicators related to bone and cartilage metabolism, matrix metalloproteinase 1 (MMP-1), matrix metalloproteinase 3 (MMP-3), and vascular endothelial growth factor (VEGF) in patients with RA and to explore the mechanism of moxibustion in the treatment of RA. Methods We recruited 70 RA patients who met the inclusion criteria, and they were randomly divided into two groups, a treatment group and a control group in equal ratio. The control group took methotrexate, folate, or leflunomide orally, while the treatment group received methotrexate, folate, or leflunomide orally and moxibustion at ST36 (Zusanli), BL23 (Shen shu), and Ashi points. We compared the clinical symptoms, RA serological disease markers and serum contents of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), MMP-1, MMP-3, and VEGF of RA patients before and after treatment. Results (1) The clinical symptoms and RA serological disease markers of the two groups improved after treatment (P < 0.05), while the clinical symptoms of the treatment group were significantly improved in comparison with the control group (P < 0.05). (2) The levels of IL-1β, TNF-α, and VEGF decreased in both groups after treatment (P < 0.05), but the treatment group was significantly decreased compared with the control group (P < 0.05). (3) There were significant differences in MMP-1 and MMP-3 contents after treatment in the treatment group (P < 0.05, P < 0.05), while there were no significant differences in the control group (P > 0.05, P > 0.05). Above all, the contents of IL-1β, TNF-α, MMP-1, MMP-3, and VEGF in the treatment group decreased more significantly than those in the control group (P < 0.05). Conclusion The improvement effect of moxibustion on the clinical symptoms of RA patients may be related to influence on the contents of IL-1β, TNF-α, MMP-1, MMP-3, and VEGF, and moxibustion may play a potential role in bone protection.
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Xu XL, Shu GF, Wang XJ, Qi J, Jin FY, Shen QY, Ying XY, Ji JS, Du YZ. Sialic acid-modified chitosan oligosaccharide-based biphasic calcium phosphate promote synergetic bone formation in rheumatoid arthritis therapy. J Control Release 2020; 323:578-590. [PMID: 32376462 DOI: 10.1016/j.jconrel.2020.04.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/30/2020] [Accepted: 04/29/2020] [Indexed: 12/16/2022]
Abstract
Therapeutic goals for rheumatoid arthritis (RA) consist of inhibiting the inflammatory response and repairing the damaged bone/cartilage. Tissue engineering could achieve both goals, however, it was hindered due to the lack of biologically relevant tissue complexity, limitation in covering the entire polyarthritis lesions and requirement of extra surgical implantation. Integrating nanotechnologies into clinically sized implants represents a major opportunity to overcome these problems. Herein, we designed a sialic acid (SA)-modified chitosan oligosaccharide-based biphasic calcium phosphate (BCP), a biomimetic nanoplatform that could load with methotrexate. We found that SA modification could not only improve the accumulation of the designed organic-inorganic nanoplatform in arthritic paws (34.38% higher than those without SA modification at 48 h), but also cooperate with BCP to exert synergetic mineralization of calcium phosphate, allowing more osteoblasts to attach, proliferate and differentiate. The more differentiated osteoblasts produced 4.46-fold type I collagen and 2.60-fold osteoprotegerin compared to the control group. Besides, the disassembled nanorods released chitosan oligosaccharide-based micelles, revealing a cartilage-protective effect by reducing the loss of glycosaminoglycan. All these improvements contributed to the light inflammatory response and reduced destruction on cartilage/bone. The findings provide a novel strategy for RA therapy via nanometer-scale dimension mimicking the natural tissues.
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Affiliation(s)
- Xiao-Ling Xu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Gao-Feng Shu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China; Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, Lishui 323000, PR China
| | - Xiao-Juan Wang
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Jing Qi
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Fei-Yang Jin
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Qi-Ying Shen
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China
| | - Xiao-Ying Ying
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China.
| | - Jian-Song Ji
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Hospital of Zhejiang University, Lishui 323000, PR China.
| | - Yong-Zhong Du
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, PR China.
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Hou HB, Cao B, Shi SM, Huo AX, Liu YH. Total knee arthroplasty for treatment of rheumatoid arthritis: A protocol for a systematic review of randomized controlled trial. Medicine (Baltimore) 2019; 98:e16558. [PMID: 31348279 PMCID: PMC6708675 DOI: 10.1097/md.0000000000016558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a very tricky orthopedic condition. If it can not be treated fairly well, it may greatly affect quality of life in patients with RA, and even can cause disability. Total knee arthroplasty (TKA) has reported to treat patients with RA effectively. However, no study has systematically explored its efficacy and complications for patients with RA. METHODS Seven databases will be searched from their inceptions to the present without any language restrictions: MEDICINE, EMBASE, Cochrane Library, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. Two authors will carry out all study selection, data extraction, and risk of bias assessment independently. RESULTS The primary outcome of joint pain will be measured by any pain scales, such as visual analogue scale. The secondary outcomes will include joint function, quality of life, and postoperative adverse events. The joint function will be measured by The Western Ontario and McMaster Universities Arthritis Index, Knee Injury and Osteoarthritis Outcome Score, or other relevant scales. The quality of life will be assessed by the 36-Item Short Form Health Survey or any related tools. In addition, postoperative adverse events will also be analyzed. CONCLUSIONS The findings of this study will summarize the latest existing evidence on the efficacy and safety of TKA for patients with RA. ETHICS AND DISSEMINATION This study does not need ethical approval, because it will not analyze individual data. The results of this study are expected to be disseminated at peer-reviewed journals. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019133274.
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Affiliation(s)
| | - Bo Cao
- Department of Joint Surgery
| | | | - Ai-xin Huo
- Department of Immunology and Rheumatology, Yanan University Affiliated Hospital, Yan’an, China
| | - Yu-hong Liu
- Department of Immunology and Rheumatology, Yanan University Affiliated Hospital, Yan’an, China
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Li ZG, Liu Y, Xu HJ, Chen ZW, Bao CD, Gu JR, Zhao DB, An Y, Hwang LJ, Wang L, Kremer J, Wu QZ. Efficacy and Safety of Tofacitinib in Chinese Patients with Rheumatoid Arthritis. Chin Med J (Engl) 2019; 131:2683-2692. [PMID: 30425195 PMCID: PMC6247584 DOI: 10.4103/0366-6999.245157] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). This study assessed the efficacy and safety of tofacitinib in Chinese patients with RA enrolled in Phase 3 and long-term extension (LTE) studies. Methods: ORAL Sync was a 1-year, randomized, placebo-controlled, Phase 3 trial. Patients received tofacitinib 5 or 10 mg twice daily (BID) or placebo advanced to tofacitinib 5 or 10 mg BID at 3 or 6 months. All patients remained on ≥1 background conventional synthetic disease-modifying antirheumatic drug. ORAL Sequel is an open-label LTE study (data-cut: March 2015; data collection and analyses were ongoing, and study database was not locked at the time of analysis; study was closed in 2017). Efficacy outcomes: American College of Rheumatology (ACR) 20/50/70 response rates and Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-4 [ESR]). Patient- and physician-reported outcomes: Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient and Physician Global Assessment of Arthritis, and pain (visual analog scale). Safety was assessed throughout. Results: ORAL Sync included 218 patients; 192 were subsequently enrolled into ORAL Sequel. In ORAL Sync, more patients achieved ACR20 (tofacitinib 5 mg BID, 67.4%; 10 mg BID, 70.6%; placebo, 34.1%) and DAS28-4 (ESR) <2.6 (tofacitinib 5 mg BID, 7.1%; 10 mg BID, 13.1%; placebo, 2.3%) with tofacitinib versus placebo at Month 6. Mean changes from baseline in HAQ-DI were greater with tofacitinib versus placebo at Month 6. In ORAL Sequel, efficacy was consistent to Month 48. Incidence rates for adverse events of special interest in tofacitinib-treated patients were similar to the global population. Conclusions: Tofacitinib significantly reduced signs/symptoms and improved physical function and quality of life in Chinese patients with moderate-to-severely active RA up to Month 48. The safety profile was consistent with the global population. Clinical Trial Identifier: NCT00856544 and NCT00413699.
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Affiliation(s)
- Zhan-Guo Li
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - Yi Liu
- Department of Rheumatology and Immunology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Hu-Ji Xu
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai 200003, China
| | - Zhi-Wei Chen
- Department of Rheumatology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Chun-De Bao
- Department of Rheumatology, Shanghai Renji Hospital, Shanghai 200000, China
| | - Jie-Ruo Gu
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China
| | - Dong-Bao Zhao
- Department of Rheumatology and Immunology, Changhai Hospital of Shanghai, Shanghai 200433, China
| | - Yuan An
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - Lie-Ju Hwang
- Statistician, Pfizer Inc, New York, NY 10017, USA (at the time of analysis)
| | - Lisy Wang
- Clinician, Pfizer Inc, Groton, CT 06340, USA
| | - Joel Kremer
- Center for Rheumatology, Albany Medical College, Albany, NY 12208, USA
| | - Qi-Zhe Wu
- Medical, Pfizer Inc, Beijing 100010, China
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Zhao J, Zhan T, Zhu J, Fan M, Huang Q, Ren H, Wu J, Yu Q, Lin J, Ouyang Q, An S, Yang M. Long-term prognosis and quality of life in patients with early rheumatoid arthritis treated according to the 2015 ACR guideline (LELAND): protocol for a multicentre prospective observational study in Southern China. BMJ Open 2018; 8:e023798. [PMID: 30446575 PMCID: PMC6252632 DOI: 10.1136/bmjopen-2018-023798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a chronic systemic disease and one of the most disabling diseases for patients. The American College of Rheumatology (ACR) issued a new guideline in 2015 for the treatment of RA based on the treat-to-target strategy to achieve better outcomes. This study will focus on the real-world rates of remission and low disease activity of patients with early RA in China, who will be treated according to the 2015 ACR guideline. Additionally, factors influencing treat-to-target outcomes will be analysed, and long-term prognosis and quality of life will be assessed. METHOD AND ANALYSIS Two-hundred patients with early RA will be enrolled, treated and followed up once every 3 months for 48 months. These patients should fulfil the 2010 RA classification criteria of the ACR/European League Against Rheumatism with a disease course of no more than 6 months and should also fulfil other eligibility criteria. The patients will be treated following the 2015 ACR guideline. Their disease activity will be assessed, and they will be instructed to complete several questionnaires once every 3 months. The primary outcomes are the Disease Activity Score on 28 joints and Health Assessment Questionnaire Disability Index. The secondary outcome variables are the Simplified Disease Activity Index, Clinical Disease Activity Index and Routine Assessment of Patient Index Data 3 results, imaging data and personal medical costs. The data will be analysed using appropriate statistical analyses. ETHICS AND DISSEMINATION This research was approved by the Nanfang Hospital Ethics Committee (NFEC-2017-192). The results of the study will be published in international peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03508713; Pre-results.
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Affiliation(s)
- Jinjun Zhao
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Taihe Zhan
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junqing Zhu
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Meida Fan
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qin Huang
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Ren
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Wu
- Department of Rheumatology and Clinical Immunology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Qinghong Yu
- Department of Rheumatology and Clinical Immunology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jingli Lin
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qingqing Ouyang
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shengli An
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Min Yang
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Patton T, Hu H, Luan L, Yang K, Li SC. Mapping between HAQ-DI and EQ-5D-5L in a Chinese patient population. Qual Life Res 2018; 27:2815-2822. [PMID: 29974382 PMCID: PMC6208580 DOI: 10.1007/s11136-018-1925-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES In order to address the current deficiency of health utility evidence relevant for economic evaluations involving treatments for rheumatoid arthritis (RA) in the Chinese setting, this study aims to develop a mapping algorithm linking the Health Assessment Questionnaire (HAQ) and EQ-5D-5L in a Chinese population of patients with RA. METHODS An estimation sample was obtained from a cross-sectional study that collected HAQ, the pain Visual Analogue Scale, and EQ-5D-5L in RA patients in two tertiary referral hospitals in China. Mapping algorithms were derived in this study using two alternative regression methods: the beta regression and a multivariate ordered probit regression. The internal validity of the mapping algorithms was assessed in each case by calculating predictive performance using a bootstrapping procedure. RESULTS Of the several algorithms developed using these data, predictive performance was shown to be better when VAS pain was included as a predictor and when the multivariate ordered probit regression method was used, rather than the beta regression method. The algorithms developed were shown to be comparable, in terms of predictive performance, to existing mapping studies despite the small sample size of the estimation data. CONCLUSION It is hoped that the availability of these algorithms will facilitate the development of cost-effectiveness studies evaluating RA treatments in the Chinese health care setting.
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Affiliation(s)
- Thomas Patton
- Centre for Health Economics, University of York, York, YO10 5DD, UK.
| | - Hao Hu
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Luan Luan
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Keqin Yang
- Department of Rheumatology, Taizhou No. 4 Renmin Hospital, Taizhou, Jiangsu, China
| | - Shu-Chuen Li
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
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Huang QC, Wang MJ, Chen XM, Yu WL, Chu YL, He XH, Huang RY. Can active components of licorice, glycyrrhizin and glycyrrhetinic acid, lick rheumatoid arthritis? Oncotarget 2016; 7:1193-202. [PMID: 26498361 PMCID: PMC4811453 DOI: 10.18632/oncotarget.6200] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/09/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This review stated the possible application of the active components of licorice, glycyrrhizin (GL) and glycyrrhetinic acid (GA), in rheumatoid arthritis (RA) treatment based on the cyclooxygenase (COX)-2/thromboxane A2 (TxA2) pathway. METHODS The extensive literature from inception to July 2015 was searched in PubMed central, and relevant reports were identified according to the purpose of this study. RESULTS The active components of licorice GL and GA exert the potential anti-inflammatory effects through, at least in part, suppressing COX-2 and its downstream product TxA2. Additionally, the COX-2/TxA2 pathway, an auto-regulatory feedback loop, has been recently found to be a crucial mechanism underlying the pathogenesis of RA. However, TxA2 is neither the pharmacological target of non-steroidal anti-inflammatory drugs (NSAIDs) nor the target of disease modifying anti-rheumatic drugs (DMARDs), and the limitations and side effects of those drugs may be, at least in part, attributable to lack of the effects on the COX-2/TxA2 pathway. Therefore, GL and GA capable of targeting this pathway hold the potential as a novel add-on therapy in therapeutic strategy, which is supported by several bench experiments. CONCLUSIONS The active components of licorice, GL and GA, could not only potentiate the therapeutic effects but also decrease the adverse effects of NSAIDs or DMARDs through suppressing the COX-2/TxA2 pathway during treatment course of RA.
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Affiliation(s)
- Qing-Chun Huang
- Department of Rheumatology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Mao-Jie Wang
- Central Laboratory, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Xiu-Min Chen
- Department of Rheumatology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Wan-Lin Yu
- Central Laboratory, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Yong-Liang Chu
- Department of Rheumatology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Xiao-Hong He
- Department of Rheumatology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Run-Yue Huang
- Department of Rheumatology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
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Guo XH, Shao L, Li J, Mao YJ, Zhang LL, Song Q. Association of TLR-4 regulatory variants (rs41426344 and rs7873784) with rheumatoid arthritis in a Chinese population. EUR J INFLAMM 2016. [DOI: 10.1177/1721727x16660559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Toll-like receptors (TLRs) play a key role in both innate and adaptive immunity. The role of TLR-4 in various autoimmune disorders has been well documented. Variations in the TLR-4 gene have been linked with susceptibility to rheumatoid arthritis (RA). In the present report, we conducted a hospital-based case-control study to investigate whether common polymorphisms in the TLR-4 gene are associated with susceptibility/resistance to development of RA in a Chinese population. A total of six single nucleotide polymorphisms (Asp299Gly, Thr399Ile, rs10759932, rs41426344, rs11536889, and rs7873784) were genotyped by PCR-RFLP in 250 RA patients and 248 healthy controls. Distribution of genotypes and alleles in RA and controls were compared by Fisher’s exact test. The prevalence of minor allele, heterozygous and homozygous mutants for rs41426344 polymorphism were more frequent in RA patients compared to healthy controls (C: P <0.0001, OR = 5.51 [3.37–8.99]; GC: P <0.0001, OR = 7.38 [4.10–13.29]; CC: P = 0.01, OR = 4.73 [1.28–17.47]). Similarly, the frequencies of CC genotype and C allele of rs7873784 polymorphism were significantly higher in RA than healthy controls ([GC: P = 0.008, OR = 1.77 [1.16–2.70]; C: P = 0.01, OR = 1.61 (1.11–2.34]). However, genotypes and alleles distribution of rs10759932 and rs11536889 were comparable in both clinical categories. Similar to earlier observations, all participants were wild type for TLR-4 codon polymorphisms (Asp299Gly and Thr399Ile). In conclusion, TLR-4 (rs41426344 and rs7873784) variants are associated with susceptibility to development of RA in a Chinese population.
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Affiliation(s)
- Xiang-hua Guo
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Li Shao
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Jian Li
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Yu-jing Mao
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Li-li Zhang
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Qin Song
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
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Li S, Wu Z, Li L, Liu X. Interleukin-6 (IL-6) Receptor Antagonist Protects Against Rheumatoid Arthritis. Med Sci Monit 2016; 22:2113-8. [PMID: 27322646 PMCID: PMC4920098 DOI: 10.12659/msm.896355] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background The aim of this study was to investigate the protective effect of interleukin-6 (IL-6) receptor antagonist tocilizumab (TCZ) on rheumatoid arthritis (RA) and its related mechanism. Material/Methods Thirty RA patients receiving long-term methotrexate therapy at moderate and severe active stages were selected and treated with TCZ 8 mg/kg/time iv gtt intravenously guttae every 4 weeks. Peripheral blood was extracted before and 24 weeks after TCZ treatment. Peripheral blood mononuclear cells (PBMC) were collected by density gradient centrifugation. Flow cytometry was used to detect the ratio of CD4 naïve T cells and CD4 memory T cells, Th17 cells, and Treg cells in PBMC. DAS28 score, CRP, RF, and CCP levels in patients were evaluated. Results Compared with before treatment, IL-6 receptor antagonist TCZ significantly improved patients’ condition, including DAS28 score, CRP, RF, and CCP levels (P<0.01). Furthermore, TCZ obviously upregulated CD4 naïve T cells proportion and decreased CD4 memory T cells ratio (P<0.01). TCZ also markedly reduced the proportion of Th17 cells and increased the proportion of Treg cells (P<0.01). Conclusions TCZ can treat RA patients through regulating the ratio of CD4 naïve T cells, CD4 memory T cells, Th17 cells, and Treg cells in PBMC.
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Affiliation(s)
- Songsong Li
- Department of Rheumatism, Tianjin People's Hospital of Nankai University, Tianjin, China (mainland)
| | - Zhenzhou Wu
- College of Life Sciences, Nankai University, Tianjin, China (mainland)
| | - Ling Li
- Department of Rheumatism, Tianjin People's Hospital of Nankai University, Tianjin, China (mainland)
| | - Xuehua Liu
- Department of Rheumatism, Tianjin People's Hospital of Nankai University, Tianjin, China (mainland)
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Liang QQ, Shi Q, Wood RW, Xing LP, Wang YJ. Peri-articular lymphatic system and "Bi" theory of Chinese medicine in the pathogenesis and treatment of arthritis. Chin J Integr Med 2015; 21:648-55. [PMID: 26432788 DOI: 10.1007/s11655-015-2305-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Indexed: 12/11/2022]
Abstract
Rheumatoid arthritis (RA) and osteoarthritis (OA) are the two most common joint diseases, and they have characterization of synovial inflammation and cartilage destruction, associated with the accumulation of numerous catabolic mediators and inflammatory cells in the synovial space and surrounding soft tissues. How these factors are cleared and if the "clearance" process contributes to pathogenesis of arthritis are not known. Recently, we found the existence of the peri-articular lymphatic system in mouse joints. The blockade of lymphangiogenesis and lymphatic draining function accelerates while stimulation of lymphatic function attenuates the severity of joint tissue lesions in mouse models of RA and OA. More importantly, we noticed the similarity between the dysfunction of lymphatic drainage in arthritic joints and "Bi" theory of Chinese medicine (CM), and demonstrated that several Bi disease-treated herbal drugs directly affect the function of lymphatic endothelial cells. Here we review the advances about the interactions between joint inflammation and changes in the peri-articular lymphatic system and discuss our view of linking "Bi" theory of CM to lymphatic dysfunction in arthritis.
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Affiliation(s)
- Qian-Qian Liang
- Department of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Qi Shi
- Department of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Ronald W Wood
- Department of Obstetrics and Gynecology, Urology, and Neurobiology and Anatomy, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Lian-Ping Xing
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA. .,Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Yong-Jun Wang
- Department of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
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