Jie Shan-Shan, Sun Hui-Juan, Liu Jian-Xin, Gao Yan, Bai Dong, Zhu Liu-Luan, Zhao Hong-Yan, Zeng Hui, Ma Ya-Luan
The Institute of Basic Theory of Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
J Ethnopharmacol. 2023 Apr 6;305:116119. doi: 10.1016/j.jep.2022.116119. Epub 2022 Dec 31.
Rheumatoid arthritis (RA) is a common systemic autoimmune disease with high morbidity and disability rate. Currently, there is no effective allopathic treatment for RA, and most of the drugs provoke many adverse effects. Simiao Yong'an decoction (SMYAD) is a traditional Chinese prescription for the treatment of sore and gangrene caused by hot poison. With the development of pharmacology and clinical research, SMYAD has remarkable anti-inflammatory properties and has been used for RA treatments for years.
This study aimed to investigate the anti-arthritic effect of SMYAD and further explore the immunopharmacological mechanisms.
Arthritis was induced in DBA/1 mice by two-time immunizations. Collagen-induced rheumatoid arthritis (CIA) mice were divided into 4 groups: control, model, methotrexate (MTX), and SMYAD group (n = 6). The administration groups were given MTX (0.5 mg/kg/3 d) and SMYAD (4.5 g/kg/d) by gavage from day 14. The arthritis index (AI) score was evaluated every 3 days after the second immunization. Hematoxylin and eosin (H&E) staining, Safranin-O fast green staining, Trap staining, and Micro-CT were used to measure the histopathology injuries and bone destruction of joints. Granulocyte changes in the spleen, bone marrow, and period blood were analyzed by flow cytometry. The expression of inflammatory cytokines and chemokines in joints were detected by qRT-PCR. SMYAD-containing serum was obtained from SD rats gavaged with SMYAD. Neutrophils were isolated from peripheral blood and bone marrow for the in vitro experiments of transwell cell assay, apoptosis assay, reactive oxygen species (ROS) generation and neutrophil extracellular traps (NETs) formation.
SMYAD significantly relieved arthritis severity in CIA mice. The AI score was significantly decreased in the SMYAD group compared with the model group. Additionally, SMYAD alleviated inflammatory infiltration, cartilage damage, osteoclast formation, and bone damage in the ankle joints. In the flow cytometry assay, SMYAD significantly reduced granulocytes number in the spleen and bone marrow, while increased in peripheral blood. Furthermore, compared with the CIA group, SMYAD suppressed the mRNA levels of inflammatory factors including TNF-α, IL-1β, IL-6 and chemokines CXCL1, CXCL2, and IL-8 in the inflamed joints. In the in vitro studies, 20% SMYAD-containing serum effectively inhibited the migration of neutrophils, promoted neutrophils apoptosis, reduced ROS production and NETs formation.
Collectively, our results demonstrated that SMYAD effectively restrained arthritis in CIA mice by modulating neutrophil activities.
类风湿关节炎(RA)是一种常见的全身性自身免疫性疾病,发病率和致残率高。目前,针对RA尚无有效的对抗疗法,且大多数药物会引发诸多不良反应。四妙永安汤(SMYAD)是一种用于治疗热毒所致疮疡和坏疽的传统中药方剂。随着药理学和临床研究的发展,四妙永安汤具有显著的抗炎特性,并已用于RA治疗多年。
本研究旨在探讨四妙永安汤的抗关节炎作用,并进一步探究其免疫药理学机制。
通过两次免疫在DBA/1小鼠中诱导关节炎。将胶原诱导的类风湿性关节炎(CIA)小鼠分为4组:对照组、模型组、甲氨蝶呤(MTX)组和四妙永安汤组(n = 6)。从第14天起,给药组通过灌胃给予MTX(0.5mg/kg/3天)和四妙永安汤(4.5g/kg/天)。在第二次免疫后每3天评估关节炎指数(AI)评分。采用苏木精和伊红(H&E)染色、番红O固绿染色、抗酒石酸酸性磷酸酶染色(TRAP染色)和显微CT测量关节的组织病理学损伤和骨破坏。通过流式细胞术分析脾脏、骨髓和外周血中的粒细胞变化。采用qRT-PCR检测关节中炎性细胞因子和趋化因子的表达。含四妙永安汤的血清取自灌胃四妙永安汤的SD大鼠。从外周血和骨髓中分离中性粒细胞用于体外实验,包括Transwell细胞实验、凋亡实验、活性氧(ROS)生成和中性粒细胞胞外陷阱(NETs)形成实验。
四妙永安汤显著减轻了CIA小鼠的关节炎严重程度。与模型组相比,四妙永安汤组的AI评分显著降低。此外,四妙永安汤减轻了踝关节的炎症浸润、软骨损伤、破骨细胞形成和骨损伤。在流式细胞术检测中,四妙永安汤显著减少了脾脏和骨髓中的粒细胞数量,而外周血中的粒细胞数量增加。此外,与CIA组相比,四妙永安汤抑制了炎症关节中包括肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)等炎性因子以及趋化因子CXCL1、CXCL2和白细胞介素-8(IL-8)的mRNA水平。在体外研究中,含20%四妙永安汤的血清有效抑制了中性粒细胞的迁移,促进了中性粒细胞凋亡,减少了ROS生成和NETs形成。
总体而言,我们的结果表明四妙永安汤通过调节中性粒细胞活性有效抑制了CIA小鼠的关节炎。