[Xinfeng Capsule Improved Blood Stasis State of Rheumatoid Arthritis Patients Based on Actl/NF-KB Signaling Pathway: Mechanism and Effects].

Objective To observe the mechanism of Xingfeng Capsule (XFC) for improving blood stasis state in rheumatoid arthritis (RA) patients based on Actl/NF-κB signaling pathway. Methods Totally 76 RA patients were equally assigned to two groups by random digit table, the XFC group (XFC, 3 pills each time, three times per day) and the Leflunomide group (LEF, 10 mg each time, once per day). All patients were intervened for 3 successive months. Clinical efficacy of symptoms of Chinese medicine (CM) was assessed. Serum levels of interleukin-10 (IL-10) , IL-17, IL-6, NF-κB activator 1 (Actl), p50, p65, platelet activating factor ( PAF) , platelet activating factor acetyl hydrolase ( PAF-AH) were detected using ELISA. Symptoms of blood stasis syndrome (BSS) were also assessed. mRNA expressions of Act1, p50, and p65 were detected using fluorescent quantitative PCR. Protein expressions of p50 and p65 were detected using Western blot. Correlation analyses were performed in RA patients' peripheral blood coagulation indicators, total score of BSS, and IL-1 0, IL-6, IL-17, Act1 , p50, p65 using Spearman. Results The total effective rate was 89. 5% (34t38) in the XFC group, with no statistical difference as compared with that of the LEF group [94. 7% (36)38), P >0. 05]. Compared with before treatment in the same group, serum levels of D-dimer (DD) , fibrinogen (FBG) , platelet (PLT) , PAF, IL-17, and IL-6 all decreased, mRNA expressions and serum levels of Act1, p50, and p65 were lowered, protein expres- sions of p50 and p65 decreased, scores for each symptoms in BSS all decreased, serum levels of PAF- AH and IL-10 increased in the two groups after treatment (P <0. 05, P <0. 01). Compared with the LEF group, serum levels of DD, FBG, PLT, IL-17, and IL-6 decreased, mRNA expressions and serum levels of Act1 and p65 were lowered, protein expression of p65 decreased, scores for joint prickling pain, tongue proper, subcutaneous ecchymosis, and BSS total score all decreased in the XFC group (P < 0. 05, P <0. 01). Peripheral blood DD was positively correlated with IL-17, IL-6, Act1, and and p65, but negatively correlated with IL-10 (P <0. 05, P <0. 01). FBG was positively correlated with IL-6 (P <0. 05). PLT was positively correlated with IL-17 (P <0. 05). BSS total score was positively correlated with IL-6, Act1, and p65, but negatively correlated with IL-10 (P <0. 05, P <0. 01). PAF was positively correlated with IL-17, IL-6, Act1 , and p65 (P <0. 05, P <0. 01), while PAF-AH was negatively correlated with p50 (P <0. 05). Conclusion The pathogenesis of BSS in RA patients and the effects of XFC on blood stasis state might be closely correlated to the Act1/NF-KB signaling pathway.