Chen Kai, Chen Xiaoying, Huang Shuai, Zhou Lingling, Zhou Xueping, Lu Yan, Feng Zhe
The First Clinical Medical College, Nanjing University of Chinese Medicine, No.138 Xianlin Avenue, Nanjing, 210023, China.
College of Pharmacy, Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
Sci Rep. 2025 Jul 31;15(1):27960. doi: 10.1038/s41598-025-13241-7.
Tripterygium polyglycosides (TG), Triptolide (TP), and Celastrol (CEL), which are extracts from Tripterygium wilfordii Hook F (TwHF), are renowned for their anti-inflammatory and immunomodulatory properties in the treatment of rheumatoid arthritis (RA). However, a comprehensive systematic review and meta-analysis of preclinical evidence supporting the use of Tripterygium wilfordii extracts for RA has not yet been conducted. This study aimed to conduct a systematic review and meta-analysis to evaluate the therapeutic effects and potential underlying mechanisms of Tripterygium wilfordii extracts in CIA model of RA. Six electronic databases, including PubMed, Embase, Web of Science, Cochrane Library, Scopus, and Ovid, were searched from their inception to June 2024. The methodological quality was assessed via SYRCLE's risk of bias tool. Statistical analyses were performed using Stata 18.0 software and Review Manager 5.4.1 software. This study included 32 articles involving 568 animals. The results revealed that Tripterygium wilfordii extracts significantly reduced joint manifestations (arthritis index, paw swelling degree, and paw thickness); histopathological changes in joints (histopathological score, cartilage damage, bone destruction, synovial hyperplasia, pannus formation, and inflammatory cell infiltration); levels of related cytokines (TNF-α, IL-1β, IL-6, IL-23, IFN-γ, and IL-17); anti-type II collagen antibodies; and T-cell subsets (CD4 T cells, Th1 cells, and Th17 cells). Moreover, Tripterygium wilfordii extracts significantly increased the levels of relevant cytokines (IL-10, IL-4, and TGF-β) and the number of Treg cells compared with those in the control group. However, animal species and sex, extract category and dosage, and treatment duration were identified as important factors influencing the above results. Tripterygium wilfordii extracts (TG, TP and CEL) exhibit promising therapeutic effects and mechanisms in the treatment of RA. But the effect characteristics and mechanisms vary among different Tripterygium wilfordii extracts. These specific effects and mechanisms also vary depending on the treatment duration and dosage.
雷公藤多苷（TG）、雷公藤甲素（TP）和雷公藤红素（CEL）是从雷公藤（Tripterygium wilfordii Hook F，TwHF）中提取的成分，它们在治疗类风湿关节炎（RA）方面的抗炎和免疫调节特性广为人知。然而，尚未对支持使用雷公藤提取物治疗RA的临床前证据进行全面的系统评价和荟萃分析。本研究旨在进行系统评价和荟萃分析，以评估雷公藤提取物在RA的胶原诱导性关节炎（CIA）模型中的治疗效果及潜在机制。检索了六个电子数据库，包括PubMed、Embase、Web of Science、Cochrane图书馆、Scopus和Ovid，检索时间从建库至2024年6月。采用SYRCLE偏倚风险工具评估方法学质量。使用Stata 18.0软件和Review Manager 5.4.1软件进行统计分析。本研究纳入32篇文章，涉及568只动物。结果显示，雷公藤提取物显著降低了关节表现（关节炎指数、爪肿胀程度和爪厚度）；关节的组织病理学变化（组织病理学评分、软骨损伤、骨破坏、滑膜增生、血管翳形成和炎性细胞浸润）；相关细胞因子（TNF-α、IL-1β、IL-6、IL-23、IFN-γ和IL-17）的水平；抗II型胶原抗体；以及T细胞亚群（CD4 T细胞、Th1细胞和Th17细胞）。此外，与对照组相比，雷公藤提取物显著提高了相关细胞因子（IL-10、IL-4和TGF-β）的水平以及调节性T细胞的数量。然而，动物种类和性别、提取物类别和剂量以及治疗持续时间被确定为影响上述结果的重要因素。雷公藤提取物（TG、TP和CEL）在治疗RA方面显示出有前景的治疗效果和机制。但不同的雷公藤提取物的作用特点和机制有所不同。这些具体作用和机制也因治疗持续时间和剂量而异。
