Prevention and treatment of inflammatory arthritis with traditional Chinese medicine: Underlying mechanisms based on cell and molecular targets

Asarum heterotropoides F. schmidt attenuates osteoarthritis via multi-target anti-inflammatory actions: A network pharmacology and experimental validation

ETHNOPHARMACOLOGICAL RELEVANCE

Asarum heterotropoides F. Schmidt (ARR) has a well-documented history of traditional use in East Asia for musculoskeletal pain disorders, including osteoarthritis (OA), attributed to its significant anti-inflammatory properties. While preliminary studies suggest potential anti-inflammatory effects, conclusive evidence regarding the ability of ARRs to modulate the multiple inflammatory pathologies involved in OA pathogenesis is currently lacking.

AIM OF THE STUDY

This study aimed to experimentally evaluate the effects of ARR extract on pain, cartilage integrity, and inflammatory responses using in vitro and in vivo models relevant to OA, guided by initial computational predictions.

MATERIALS AND METHODS

Active ingredients of ARRs were retrieved from four databases and screened using SwissADME for ADME predictions. Disease targets were combined with OA-related genes from GEO microarray database. The intersecting genes underwent protein-protein interaction construction, GO, and KEGG enrichment analysis. A compound-target-pathway network was constructed using Cytoscape and was validated via molecular docking. Pain-relieving, functional, and chondroprotective effects were assessed in vivo using acetic acid-induced peripheral pain mice and monosodium iodoacetate (MIA)-induced osteoarthritis rat models. Furthermore, anti-inflammatory properties were explored by evaluating serum cartilage tissue and lipopolysaccharide-stimulated RAW 264.7 cells.

RESULTS

Network pharmacology analysis elucidated five principal active constituents of ARR (cryptopine, 5-[2-(2-hydroxyphenyl)ethyl]-2,3-dimethoxy-phenol, 5-[2-(3-hydroxyphenyl)ethyl]-2-methoxybenzene-1,3-diol, naringenin, resorstatin) alongside 22 putative herbal targets. Molecular docking analyses revealed strong binding affinities (-8 to -9.4 kcal/mol) of these constituents towards principal target proteins. Functional GO and KEGG enrichment analyses indicated that ARR exerts its effects potentially involving pathways associated with cancer, fluid shear stress, and atherosclerosis. In vivo assessments demonstrated significant mitigation of pain, functional deficits, and cartilage degradation by ARR within an MIA-induced osteoarthritis model. Molecular dynamics simulations validated stable interactions between the primary compounds and their designated target proteins. The therapeutic efficacy of ARR was characterized by dose-dependent suppression of diverse inflammatory mediators (IL-1β, IL-6, TNF-α), matrix metalloproteinases (MMP-1, -3, -8, -13), and signaling pathways including CCND1, CDK2, IKBKB, HIF1A, BDKRB1, SIRT1, MAPK8, and NLRP3 within both RAW264.7 cells and articular cartilage tissue.

CONCLUSIONS

This investigation demonstrates that ARR exerts pain alleviation, functional enhancement, and chondroprotective effects in osteoarthritis via multi-target anti-inflammatory actions. Integrating network pharmacology, molecular docking, animal models, and cellular experiments, this study comprehensively elucidated the multifaceted anti-inflammatory mechanisms attributed to ARR. These findings collectively provide a crucial foundation for understanding the potential therapeutic efficacy and operative mechanisms of ARR for osteoarthritis management.

3,4-Dihydroxybenzoic acid methyl ester from Vespa velutina auraria Smith against rheumatoid arthritis via modulating the apoptosis and inflammation through NF-κB pathway

In Yunnan, Vespa velutina auraria Smith is used in production of wasp wine, which is employed for treating rheumatoid arthritis (RA). From compounds extracted from Vespa velutina auraria Smith, 3,4-dihydroxybenzoic acid methyl ester (DBME) showed the most effective anti-inflammatory response in RAW264.7 cells according to our prior investigation. This research was designed to investigate how DBME affects RA. RA rat model and inflammatory model of MH7A cell were employed to determine the effects of DBME on RA. DBME was able to reduce paw swelling, bone damage, and changes in histopathological sections in CIA rats in vivo. Furthermore, DBME lowered the levels of tumor necrosis factor-α (TNF-α), immunoglobulin G (IgG), C-C motif chemokine ligand 5 (CCL5), prostaglandin E2 (PGE-2), interleukin-17 (IL-17), and IL-1β, while enhancing the rate of apoptosis in synovial tissue cells of RA rats. Experiments conducted in vitro demonstrated that DBME decreased the concentrations of matrix metalloproteinase 3 (MMP3), IL-1β, CCL5 and IL-6, and promoted the apoptosis in TNF-α-stimulated MH7A cells. Moreover, DBME decreased the ratios of p-P65 to P65 and phosphorylated inhibitor kappa B α (p-IκBα) to IκBα in TNF-α-stimulated MH7A cells. This indicated that DBME may have anti-inflammatory and pro-apoptotic effects in RA via NF-κB pathway.

Functional metabolomics combined with network pharmacology reveals the mechanism of alleviating rheumatoid arthritis with Yiyi Fuzi powder

ETHNOPHARMACOLOGICAL RELEVANCE

Yiyi Fuzi powder (YYFZ) is a composite formulation consisting of Fuzi and Coix lacryma-jobi seeds. The synergistic application of these exhibits notable anti-inflammatory properties, playing a crucial role in the management of rheumatoid arthritis (RA). However, the therapeutic advantages and potential mechanism of YYFZ in the treatment of RA are still unclear.

AIM OF THE STUDY

The purpose of this study is to find functional metabolites by metabolomics technology, and to investigate the mechanism of functional metabolites mediating RA inflammation on the basis of collagen-induced arthritis rat fibroblast-like synovial cells (CIA-FLS) model, and to explore the pharmacodynamic material basis of YYFZ.

MATERIALS AND METHODS

Utilizing untargeted metabolomics in conjunction with UPLC-Q-TOF/MS and GC-MS, we identified potential functional metabolites of YYFZ. In vitro experiments were conducted to determine pyroptosis-related proteins via Western blot, q-PCR and immunofluorescence, thereby exploring functional metabolic pathways. Subsequently, network pharmacology and molecular docking techniques were employed to evaluate the mode of action and mechanisms of "effective components-key targets", elucidating the active components of YYFZ.

RESULTS

Using untargeted metabolomics, 18 differential metabolites were identified, with palmitic acid (PA) showing high correlation as a potential functional metabolite. MTT experiments revealed that 300 μM PA inhibited CIA-FLS by 50%. Further analysis through in vitro experiments indicated that PA promotes inflammatory factor expression via NLRP3/Caspase-1/GSDMD-N/IL-1β mediated pyroptosis. Network pharmacology and molecular docking of 26 in vitro YYFZ components identified benzoylaconine (BAC), benzoylmesaconine (BMA) and benzoylhypacoitine (BHA) as potential active components. In vitro experiments revealed that these components reduce RA inflammation by targeting pyroptosis.

CONCLUSION

PA, a functional metabolite, can promote RA inflammatory factors by inducing pyroptosis of NLRP3/Caspase1/GSDMD-N/IL-1β. BAC, BMA and BHA derived from YYFZ have demonstrated efficacy in mitigating the inflammatory damage induced by the functional metabolite PA, suggesting their potential as therapeutic agents for RA. These findings offer valuable insights for the development of targeted therapies for RA and underscore the clinical applicability of YYFZ.

Crosstalk between kidney and bones: New perspective for modulating osteoporosis

Growing evidence indicates an interesting interplay between kidney and bone. The pathophysiological condition of the skeletal system is intricately associated with the normal functioning of the kidneys. This relationship is modulated by various factors, including calcium and phosphate, 1-α-hydroxylase, erythropoietin (EPO), klotho, fibroblast growth factor 23 (FGF23), bone morphogenetic protein-7 (BMP-7), and extracellular vesicles (EVs). These interactions are notably evident in conditions such as chronic kidney disease with bone mineral density (CKD-BMD), renal osteodystrophy (ROD), and osteoporosis (OP). Furthermore, innovative methodologies such as cell co-culture, organ-on-a-chip, single-cell sequencing, and spatial transcriptomics are highlighted as instrumental in advancing the study of inter-organ interactions. This review, grounded in the pathogenesis, diagnostic and therapeutic modalities, and pharmacological treatments of OP, synthesizes evidence from molecular biology to clinical perspectives. It aims to establish a foundation for the development of more complex and physiologically relevant in vitro models and to propose potential therapeutic strategies.

Natural polysaccharide-based nanodrug delivery systems for targeted treatment of rheumatoid arthritis: A review

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent inflammation of the joints, leading to pain, disability, and systemic complications. Conventional treatments often exhibit limitations, including adverse effects and suboptimal bioavailability. To address these challenges, natural polysaccharides-mediated nano drug delivery is a promising vehicle for RA management. This review explores the potential of natural polysaccharides in RA, including chitosan, cellulose, albumin, hyaluronic acid, polylactic acid, alginate, etc. Their biodegradable and biocompatible nature renders them ideal nanomaterials for RA applications. These properties facilitate targeted delivery, improved cellular uptake, and sustained release of therapeutic agents, enhancing their pharmacological effects while minimizing systemic toxicity. Recent advances in nanotechnology have enabled the formulations of polysaccharides that can encapsulate a range of therapeutic agents, including conventional anti-inflammatory drugs and novel biologics. The review also highlights various formulation strategies to optimize the physicochemical properties of polysaccharide-based nano drug delivery systems, including surface modification and combinatorial therapies. Overall, natural polysaccharides represent a versatile and effective approach for developing innovative nano drug delivery systems, offering a promising strategy for the effective treatment of rheumatoid arthritis.

Mahonia bealei (Fort.) Carr. Leaf extract modulates the TLR2/MyD88/NF-κB signaling pathway to inhibit PGN-induced inflammation in RAW264.7 cells

ETHNOPHARMACOLOGICAL RELEVANCE

Mahonia bealei (Fort.) Carr. (M. bealei) is a traditional Chinese medicinal plant and one of the herbs used by the Hmong people. It has been recorded in the most recent editions of the Chinese Pharmacopoeia as well as in Hmong medicinal works such as Hmong Pharmacopoeia, for its ability to clear away heat, dry up dampness, and to remove fire and toxins. Currently, the plant is widely cultivated in China, Japan, Mexico, the United States, and Europe, and it appears to be naturalized in the eastern United States. Our earlier research demonstrated that M. bealei leaf extract (MBE) effectively reduced inflammation in xylene-induced ear swelling in mice and cotton ball granuloma in rats. The unclear specific anti-inflammatory mechanism necessitated further investigation in this study.

AIM OF THE STUDY

The aim of this study was to investigate the mechanism of anti-inflammatory effects of MBE on PGN-stimulated RAW264.7 macrophages through the TLR2/MyD88/NF-κB signaling pathway.

METHODS

Firstly, M. bealei leaf extract (MBE) was obtained by ultrasonic synergistic high-speed homogenization extraction. The main active components in MBE were determined by UPLC-Q-TOF-MS/MS and the interaction of the main components with TLR2 was verified by molecular docking technique. Then, PGN-induced RAW264.7 cells were used to establish an inflammation model, and then the administration concentration of MBE and the modeling concentration of PGN were determined by the CCK-8 method, and the protective effect of MBE on PGN-induced cellular inflammation was evaluated. Meanwhile, the effect of MBE on the morphology of RAW264.7 cells was observed by scanning electron microscopy. The effect of MBE on the focal death of RAW264.7 cells was determined by flow cytometry. Subsequently, NO levels were measured using the Griess method, while PGE2, TNF-α, IL-1β, IL-6, and IL-10 concentrations were assessed via ELISA. ROS levels were determined by fluorescent staining in each group of cells. The expression levels of TLR2, MyD88, IκB, IKK, and NF-κB in the TLR2/MyD88/NF-κB pathway were analyzed using RT-qPCR for mRNA and Western blot for protein.

RESULTS

Nineteen major components were detected from MBE by UPLC-Q-TOF-MS/MS, and 10 of them with higher relative abundance were selected for molecular docking with TLR2, respectively, and all of them showed low binding energies and good stability. MBE was shown to be effective in ameliorating the PGN-induced inflammatory condition of RAW264.7 cells, as demonstrated by the CCK-8 method, scanning electron microscopy, and flow cytometry. MBE effectively suppressed the release of inflammatory cytokines NO, PGE2, TNF-α, IL-1β, and IL-6, while enhancing IL-10 production. The RT-qPCR and Western Blot analyses demonstrated that MBE could decreased the mRNA and protein levels of TLR2 and MyD88, suppressed the phosphorylation of IκB, NF-κB, and IKK, and consequently inhibited the TLR2/MyD88/NF-κB signaling pathway.

CONCLUSION

The present study showed that MBE effectively inhibited PGN-induced inflammation and ameliorated cell injury in RAW264.7 cells. This may be attributed to its inhibition of the TLR/MyD88/NF-κB pathway, which further regulates the release of downstream related inflammatory factors and exerts anti-inflammatory effects. These findings also suggest the potential of M. bealei as a natural drug for the treatment of inflammation-related diseases.

Maxing Yigan formula promotes cartilage regeneration by regulating chondrocyte autophagy in osteoarthritis

Maxing Yigan formula (MYF) is a traditional Chinese medicine (TCM) prescription used for the treatment of OA for decades in China. However, the mechanism remains unknown. In this study, we developed a MYF-incorporated collagen sponge (MYF@CS) and investigated its cartilage regeneration effect and the underlying mechanism. In vitro experiments revealed that MYF significantly promoted cell viability, proliferation, and autophagy of OA chondrocytes. Furthermore, MYF@CS significantly enhanced chondrogenesis and cartilage regeneration, as assessed by macroscopic observation, the International Cartilage Repair Society (ICRS) visual histological score, and histological examination. Our findings suggest that MYF@CS could represent a significant therapeutic strategy for the treatment of OA.

Regulating Rheumatoid Arthritis From the Perspective of Metabolomics: A Comprehensive Review

Rheumatoid arthritis (RA) is a severe inflammatory autoimmune disease with metabolic changes. RA patients have abnormalities in glycolysis, amino acid metabolism, choline metabolism, and fatty acid synthesis. The differential metabolites in individuals of RA patients and animal models were explored to find the potential biomarkers for the risk prediction, diagnosis, and prognosis of RA in the perspective of metabolism. Moreover, we discussed the changes of related metabolites after treatment with anti-rheumatic drugs, Traditional Chinese Medicine (TCM) and potential metabolites for the treatment of RA to explore promising metabolites. In addition, the immunological mechanism of TCM in the treatment of RA from the perspective of metabolism was also clarified. For the perspectives of research and application of the beneficial metabolites in clinic, relevant technologies and focuses for the future studies in the field have been proposed accordingly.

Clinical features of inflammatory arthritis in daily practice-China's perspective

OBJECTIVE

This study aimed to analyze and compare the proportion of patients with different types of inflammatory arthritis and investigate the clinical characteristics, including symptoms and signs, medication choices, and disease activity, in the daily clinical practice of China.

METHODS

Patients with inflammatory arthritis were recruited from 16 Grade-A tertiary hospitals between August 2021 and April 2022. The medical profiles, encompassing sociodemographic characteristics, clinical and laboratory date, were collected.

RESULTS

This study included 2,693 patients with arthritis, with rheumatoid arthritis (RA) accounting for the highest proportion (50.50%). Significant differences were observed in terms of age, gender, body mass index (BMI), disease duration, smoking and family history among patients with different types of inflammatory arthritis. Physical activity and cold exposure were identified as the main predisposing factors for RA, psoriatic arthritis (PsA), osteoarthritis (OA), and ankylosing spondylitis (AS), while alcohol consumption was the most common inducing factor for gout. Hypertension and hyperlipidemia were the primary concomitant diseases in RA, OA, and AS, whereas hyperuricemia and hypertension were mainly associated with gout, psoriasis and diabetes were the most common comorbidities in PsA. Peripheral joints were predominantly affected in PsA, RA, OA, and gout, while axial joints were mainly affected in AS. Methotrexate and leflunomide were the main therapeutic drugs for RA, while biologics were commonly prescribed for PsA and AS. OA and gout patients mainly utilized nonsteroidal anti-inflammatory drugs (NSAIDs).

CONCLUSION

Patients with different types of inflammatory arthritis exhibited varying predisposing factors, joint inflammation, concomitant diseases, and medication choices, highlighting the importance of individualized approaches in the clinic. Key Points • 2,693 patients classified and diagnosed with inflammatory arthritis were recruited in this study from 16 Grade-A tertiary hospitals in China between August 2021 and April 2022. • This study analyzed and compared the proportion of patients with different types of arthritis in routine clinical practice in China. • Joint inflammation, comorbidities, and medication choices were assessed among patients with the most common types of arthritis in this study. • This study also provided some epidemiologically relevant information about inflammatory arthritis patients in China.

Norwogonin Attenuates Inflammatory Osteolysis and Collagen-Induced Arthritis via Modulating Redox Signalling and Calcium Oscillations

Norwogonin is a flavonoid extraction derived from Scutellaria baicalensis. However, its potential mechanisms in the context of rheumatoid arthritis (RA) are unclear. This study investigates the specific effects and associated targets of Norwogonin in RA-related inflammatory osteolysis. Network pharmacology was conducted to analyse the core targets and signalling pathways of Norwogonin in RA. In vitro experiments were carried out to explore the actual effects of Norwogonin on osteoclast behaviours and related signalling mechanisms. In vivo studies further validated the therapeutic effect of Norwogonin in collagen-induced arthritis (CIA) mice. The network pharmacological analysis identified 18 shared targets between Norwogonin and RA, indicating a connection with inflammatory response and oxidoreductase activity. For biological validations, the results of in vitro experiments revealed 160 μM of Norwogonin inhibited LPS-driven osteoclast differentiation and function. The qPCR assay and Western blot analysis also disclosed consistently diminished changes to osteoclastic marker genes and proteins due to Norwogonin treatment, including those for osteoclast differentiation (Traf6, Tnfrsf11a and Nfatc1), fusion (Atp6v0d2, Dcstamp and Ocstamp) and function (Mmp9, Ctsk and Acp5). Further mechanism study revealed Norwogonin suppressed LPS-driven ROS production and calcium (Ca2+) oscillations. Also, intraperitoneal injection of 30 mg/kg Norwogonin every other day successfully mitigated clinical arthritis progression and attenuated bone destruction in the CIA model. Our study scrutinises Norwogonin's therapeutic prospects in treating RA and illustrates its inhibitory effects and potential mechanism within LPS-induced osteoclastogenesis and CIA mice, providing a basis for further translational research on Norwogonin in the treatment of RA-related inflammatory osteolysis.

Amentoflavone Induces Ferroptosis to Alleviate Proliferation, Migration, Invasion and Inflammation in Rheumatoid Arthritis Fibroblast-like Synoviocytes by Inhibiting PIN1

Rheumatoid arthritis (RA) is a systemic autoimmune disease that is prevalent worldwide and seriously threatens human health. RA-fibroblast-like synoviocytes (FLS) play important roles in almost all aspects of RA progression. This study aimed to study the effect of Amentoflavone (AMF), a polyphenol compound derived from extracts of Selaginella tamariscina, on the abnormal biological behaviors of RA-FLS. The immortalized human RA-FLS cell line (MH7A) was treated with AMF or transfected with small interfering RNAs (siRNAs) targeting peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (PIN1). Then, cell viability was detected by CCK-8 assay. EDU staining, wound healing and transwell assays were employed to measure the capacities of MH7A cell proliferation, migration and invasion. The levels of inflammatory factors were assessed using ELISA kits. Additionally, ferroptosis was analyzed by detecting Fe2+ content, lipid reactive oxygen species (ROS) level and expression of ferroptosis-related proteins. Pull-down assay was employed to verify the targeted binding of AMF to PIN1. Further, PIN1 overexpression or ferroptosis inhibitor Ferrostatin-1 (Fer-1) addition was conducted to elucidate the regulatory mechanism of AMF on PIN1 and ferroptosis. Results revealed that AMF intervention or PIN1 knockdown inhibited the proliferation, migration, invasion and inflammation in MH7A cells. AMF facilitated lipid peroxidation and ferroptosis in MH7A cells. Moreover, AMF targeted inhibition of PIN1 expression, and PIN1 overexpression restored the promoting effect of AMF on lipid peroxidation and ferroptosis in MH7A cells. Besides, Fer-1 reversed the impacts of AMF on the abnormal biological behaviors of MH7A cells. In summary, AMF induced ferroptosis to inhibit the proliferation, migration, invasion and inflammation in RA-FLS by inhibiting PIN1, providing a promising candidate for RA treatment.

Exploring the benefits and prescribing informations of combining East Asian herbal medicine with conventional medicine in the treatment of rheumatoid arthritis: A systematic review and multifaceted analysis of 415 randomized controlled trials

BACKGROUND

Notwithstanding progress in conventional medicine (CM), the management of rheumatoid arthritis (RA) continues to be problematic due to factors such as limited patient response to treatment and restricted medication access. This study aimed to evaluate the extent to which East Asian herbal medicine with CM combination therapy (EACM) provides additional benefits in effectiveness and safety.

METHODS

We conducted a comprehensive search across 11 databases in English, Chinese, Korean, and Japanese for randomized controlled trials. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the American College of Rheumatology (ACR) 20/50/70 Response Criteria and the incidence of adverse events (AEI) as primary outcomes. This meta-analysis was performed using a random-effects model. The quality of each study was assessed according to the RoB 2. Of the 1036 full-text articles screened, 415 were included in the review.

RESULTS

This review included data from 37,839 participants. EACM was associated with higher ACR responses: ACR 20 (RR: 1.2332; 95 % CI: 1.1852-1.2831, p < 0.0001), ACR 50 (RR: 1.3782; 95 % CI: 1.2936-1.4684, p < 0.0001), and ACR 70 (RR: 1.7084; 95 % CI: 1.5555-1.8762, p < 0.0001), as well as a favorable AEI (OR: 0.3977; 95 % CI: 0.3476-0.4551, p < 0.0001), indicating both better efficacy and safety compared to CM alone. These patterns were consistent across eight secondary outcomes measuring pain, inflammation, and disease activity in RA. Subgroup analyses showed that EACM's effects were independent of the control CM type. Through a comprehensive analysis of a polyherbal prescription dataset, we identified 18 key herbs and 16 significant combination rules, further supported by relevant preclinical evidence. These herbs and synergistic herbal combinations were anticipated to be the most pharmacologically influential in contributing to the meta-analysis outcomes, as substantiated by analytical metrics including network topology and intricate association pattern evaluations.

CONCLUSIONS

The findings suggest that EACM may serve as a valuable complementary strategy for RA patients insufficiently managed by CM alone. In particular, given that the ACR index integrates multiple aspects of RA patients, the results are expected to provide valuable complementary decision support for the management of RA patients who do not respond well to CM therapy, both for medical and economic reasons. Additionally, the key herbs derived through the multifaceted analysis, which actively reflect clinicians' implicit preferences for prescribing EACMs, may serve as important hypotheses for further research and clinical application. However, additional qualitative and quantitative improvements in research are needed for more definitive conclusions. Further analysis of the herbal prescriptions presented in this study will provide valuable direction for future research.

Exploring the molecular mechanism of Epimedium for the treatment of ankylosing spondylitis based on network pharmacology, molecular docking, and molecular dynamics simulations

Ankylosing spondylitis (AS) is a rheumatic disease that causes inflammation and bone formation in the spine. Despite significant advances in treatment, adverse side effects have triggered research into natural compounds. Epimedium (EP) is a traditional Chinese herb with a variety of pharmacological activities, including antirheumatic, anti-inflammatory, and immunomodulatory activities; however, its direct effects on AS treatment and the underlying molecular mechanisms have not been systematically studied. Thus, here, we used network pharmacology, molecular docking, and molecular dynamics simulations to explore the targets of EP for treating AS. We constructed an interaction network to elucidate the complex relationship between EP and AS. Sixteen active ingredients in EP were screened; 80 potential targets were identified. In particular, 8-(3-methylbut-2-enyl)-2-phenylchromone, anhydroicaritin, and luteolin were the core components and TNF, IL-6, IL-1β, MMP9, and PTGS2 were the core targets. The GO and KEGG analyses indicated that EP may modulate multiple biological processes and pathways, including the AGE-RAGE, TNF, NF-κB/MAPK, and TLR signaling pathways, for AS treatment. Molecular docking and molecular dynamics simulations showed good affinity between the active components and core targets of EP, with stable binding within 100 nanoseconds. In particular, 8-(3-methylbut-2-enyl)-2-phenylchromone possessed the highest free energy of binding to PTGS2 and TNF (-115.575 and - 87.676 kcal/mol, respectively). Thus, EP may affect AS through multiple pathways, including the alleviation of inflammation, oxidative stress, and immune responses. In summary, we identified the active components and potential targets of EP, highlighting new strategies for the further experimental validation and exploration of lead compounds for treating AS.

Integrating lipid metabolomics, serum medicinal chemistry, network pharmacology and experimental validation to explore the mechanism of Sanmiao wan in the treatment of rheumatoid arthritis

ETHNOPHARMACOLOGICAL RELEVANCE

Rheumatoid arthritis (RA) is a common autoimmune disease with a high clinical morbidity and leads to persistent chronic inflammation. Sanmiao wan is a classic formula for the treatment of RA, and the results of clinical and experimental studies have shown its therapeutic effect on RA. However, its mechanism of action remains unclear.

AIM OF THE STUDY

The aim of this study was to evaluate the effect of Sanmiao wan on RA rats and to further explore its protective mechanism.

MATERIALS AND METHODS

Research was conducted using RA models induced by Freund's adjuvant complete, and the degree of arthritis, bone destruction, histopathological and clinical chemical indexes of RA model rats were used to evaluate the animal model and the therapeutic effect of Sanmiao wan. A combination of lipid metabolomics, serum medicinal chemistry, network pharmacology, molecular docking and experimental validation was used to systematically elucidate the potential mechanism of action of Sanmiao wan in the treatment of RA.

RESULT

Pharmacodynamic results showed that Sanmiao reduced joint swelling and improved immunity, and the results of non-targeted lipid metabolomics showed a total of 6 lipid core markers, which were hypothesised to play a therapeutic role in RA by modulating the glycerophospholipid metabolism and sphingolipid metabolism pathways. Using serum medicinal chemistry, we identified 19 blood components and predicted the targets related to RA, and combined with network pharmacology, we screened a total of 59 components and disease-cross-cutting targets, and the enrichment analysis and network pharmacology and KEGG results indicated that the core targets were TNF, IL6, MMP3, and the key metabolic pathways were TNF signaling pathway, lipid and The key metabolic pathways are TNF signaling pathway, lipid and atherosclerosis, rheumatoid arthritis, IL-17 signaling pathway and sphingolipid signaling pathway, etc. It was verified by molecular docking and ELISA experiments that palmatine, cyasterone, atractylenolide I, atractylenolide III, wogonoside, wogonin, phellodendrine, and berberine in Sanmiao could reduce the activity of these targets, thereby inhibiting the expression of inflammatory factors TNF-α, IL6, IL17, RF, MMP3, STAT3.

CONCLUSIONS

Sanmiao has a good therapeutic effect on RA, and for the first time, it was found that its potential mechanism of action may be to treat RA by decreasing the activities of TNF, IL6, MMP3 and modulating glycerophospholipid metabolism and sphingolipid metabolism.It provides a solid basis for the clinical application of Sanmiao wan.

Systematic insight into the dual COX-2/5-LOX inhibitory mechanism of Duhuo Jisheng decoction for treatment of osteoarthritis based on in silico and bioassay

ETHNOPHARMACOLOGICAL RELEVANCE

Traditional Chinese medicine (TCM) is frequently used to treat osteoarthritis (OA). Duhuo Jisheng decoction (DHJSD), a Chinese patent medicine, was commonly used Chinese herbal formula for the treatment of OA. In Western medicine, dual inhibition of cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) enzyme has been proved to be a promising strategy to treat inflammatory diseases with reduced side effects.

AIM OF THE STUDY

To elucidate the dual action mechanism of DHJSD targeting COX-2 and 5-LOX against OA.

MATERIALS AND METHODS

DHJSD, containing 1495 compounds was screened using a virtual screening approach based on molecular docking. The inhibitory effect of hit compounds against COX-2 and 5-LOX was validated using enzyme-based assays. In vitro, rat chondrocytes were treated with IL-1β (10 ng/mL) for 24 h to induce OA model in vitro. The chondrocyte viability was evaluated using an CCK-8 assay. ELISA was used to detect inflammatory factors expression. Immunofluorescence was used to assess the expression level of collagen II and MMP-13. In addition, a rat cartilage explants culture model was established, and safranin O and HE staining analysis were carried to assess cartilage matrix degradation and cartilage damage, respectively. In vivo, carrageenan-induced paw edema assay was used to examine anti-inflammatory activity, and the gastric ulcerogenic effect was further detected. Finally, Molecular dynamics simulations and binding free energy analysis were carried to explore the binding mechanism.

RESULTS

13 compounds from DHJSD were identified as promising candidates by a virtual screening approach. Among these candidates, three hits 7,4'-dimethoxyisoflavone, genistein, and fraxetin displayed dual inhibition of COX-2 and 5-LOX. Further in vitro assay indicated that 7,4'-dimethoxyisoflavone, genistein, and fraxetin could inhibit PGE2, LTB4, TNF-α, IL-6, or NO production in IL-1β-induced chondrocytes. In addition, the three compounds reduced IL-1β-induced degradation of collagen II and expression of MMP-13 in rat chondrocytes. The results of anti-inflammatory activity of the three compounds in vivo showed that the highest anti-inflammatory activity with edema inhibition percentages of 50.00%, 56.00%, and 51.00% after 3 h, respectively. Moreover, it was found that 7,4'-dimethoxyisoflavone, genistein, and fraxetin have a superior gastric safety profile comparable to indomethacin. Finally, molecular dynamics simulations, binding free energy analysis, and detailed interaction mode demonstrated that 7,4'-dimethoxyisoflavone, genistein, and fraxetin interacted well with both COX-2 and 5-LOX.

CONCLUSIONS

7,4'-dimethoxyisoflavone, genistein, and fraxetin from DHJSD with excellent anti-inflammatory effects and no gastric ulceration effects, which helps to explain the dual action mechanism and potential material basis of DHJSD in treating OA and provide evidence to support DHJSD's clinical use.

Uncovering the mechanisms of Zhubi decoction against rheumatoid arthritis through an integrated study of network pharmacology, metabolomics, and intestinal flora

ETHNOPHARMACOLOGICAL RELEVANCE

Zhubi Decoction (ZBD) is a modified formulation derived from the classic traditional Chinese medicine prescription "Er-Xian Decoction" documented in the esteemed "Clinical Manual of Chinese Medical Prescription". While the utilization of ZBD has exhibited promising clinical outcomes in treating rheumatoid arthritis (RA), the precise bioactive chemical constituents and the underlying mechanisms involved in its therapeutic efficacy remain to be comprehensively determined.

AIM OF THE STUDY

This study aims to systematically examine ZBD's pharmacological effects and molecular mechanisms for RA alleviation.

MATERIALS AND METHODS

Utilizing the collagen-induced arthritis (CIA) rat model, we comprehensively evaluated the anti-rheumatoid arthritis effects of ZBD in vivo through various indices, such as paw edema, arthritis index, ankle diameter, inflammatory cytokine levels, pathological conditions, and micro-CT analysis. The UPLC-MS/MS technique was utilized to analyze the compounds of ZBD. The potential therapeutic targets and signaling pathways of ZBD in the management of RA were predicted using network pharmacology. To analyze comprehensive metabolic profiles and identify underlying metabolic pathways, we conducted a serum-based widely targeted metabolomics analysis utilizing LC-MS technology. Key targets and predicted pathways were further validated using immunofluorescent staining, which integrated findings from serum metabolomics and network pharmacology analysis. Additionally, we analyzed the gut microbiota composition in rats employing 16 S rDNA sequencing and investigated the effects of ZBD on the microbiota of CIA rats through bioinformatics and statistical methods.

RESULTS

ZBD exhibited remarkable efficacy in alleviating RA symptoms in CIA rats without notable side effects. This included reduced paw redness and swelling, minimized joint damage, improved the histopathology of cartilage and synovium, mitigated the inflammatory state, and lowered serum concentrations of cytokines TNF-α, IL-1β and IL-6. Notably, the effectiveness of ZBD was comparable to MTX. Network pharmacology analysis revealed inflammation and immunity-related signaling pathways, such as PI3K/AKT, MAPK, IL-17, and TNF signaling pathways, as vital mediators in the effectual mechanisms of ZBD. Immunofluorescence analysis validated ZBD's ability to inhibit PI3K/AKT pathway proteins. Serum metabolomics studies revealed that ZBD modulates 170 differential metabolites, partially restored disrupted metabolic profiles in CIA rats. With a notable impact on amino acids and their metabolites, and lipids and lipid-like molecules. Integrated analysis of metabolomics and network pharmacology identified 6 pivotal metabolite pathways and 3 crucial targets: PTGS2, GSTP1, and ALDH2. Additionally, 16 S rDNA sequencing illuminated that ZBD mitigated gut microbiota dysbiosis in the CIA group, highlighting key genera such as Ligilactobacillus, Prevotella_9, unclassified_Bacilli, and unclassified_rumen_bacterium_JW32. Correlation analysis disclosed a significant link between 47 distinct metabolites and specific bacterial species.

CONCLUSION

ZBD is a safe and efficacious TCM formulation, demonstrates efficacy in treating RA through its multi-component, multi-target, and multi-pathway mechanisms. The regulation of inflammation and immunity-related signaling pathways constitutes a crucial mechanism of ZBD's efficacy. Furthermore, ZBD modulates host metabolism and intestinal flora. The integrated analysis presents experimental evidence of ZBD for the management of RA.

M13, an anthraquinone compound isolated from Morinda officinalis alleviates the progression of the osteoarthritis via the regulation of STAT3

BACKGROUND

Osteoarthritis (OA) is characterized by the progressive deterioration of articular cartilage, leading to joint pain and functional impairment. OA severely impacts quality of life and presents a substantial societal burden. Currently, effective treatment options remain limited. Morinda officinalis (MO), a traditional Chinese herb, is commonly used to treat rheumatoid arthritis and alleviate joint pain. M13, an anthraquinone extracted from MO, has shown significant anti-inflammatory properties, making it a promising candidate for the treatment of OA. However, its role in inhibiting OA progression and the mechanisms involved remain poorly understood.

PURPOSE

The objective of this study is to examine the impact of M13 on osteoarthritis and uncover the mechanisms.

METHODS

The effects of M13 on OA were assessed using TNF-α induced chondrocyte models and mice with destabilization of the medial meniscus (DMM). Celecoxib was used as a positive control. We evaluated the expression of factors related to chondrocyte degeneration and inflammation through qRT-PCR, immunoblotting, and immunofluorescence. Chondrocyte viability was measured using CCK-8 assays, EdU staining, and flow cytometry. Molecular docking, molecular dynamics simulations and isothermal titration calorimetry (ITC) were performed to evaluate the binding efficacy of target proteins. Additionally, the therapeutic effects of M13 in OA mice were confirmed through in vivo experiments.

RESULTS

In primary murine chondrocytes, M13 rescued TNF-α-induced matrix degradation and loss of vitality while suppressing ROS generation. Mechanistically, STAT3 was identified as a target protein of M13, through which M13 mitigated OA by inhibiting the STAT3 signaling pathway. Further in vivo experiments demonstrated that M13 reduced the scores of the Osteoarthritis Research Society International (OARSI), alleviating cartilage impairment. M13 enhanced levels of collagen II and aggrecan in cartilage tissue while decreasing the amounts of cartilage-degrading proteins ADAMTS-5 and MMP13.

CONCLUSION

This is the first study to validate that M13 mitigates the inflammation and damage in cartilage tissue by blocking the STAT3 signaling pathway. These findings hold promise for enhancing innovative clinical interventions targeting OA.

Kunduan Yimu Decoction affected Th17/Treg balance through microRNA-124 to improve rheumatoid arthritis pathology

BACKGROUND

Rheumatoid arthritis (RA) is an autoimmune condition characterized by inflammation and the deterioration of joints. Current treatments often have side effects, highlighting the need for safer options. This study investigates the therapeutic effects of Kunduan Yimu Decoction (KDYMD) on RA, focusing on the role of miR-124 in regulating Th17/Treg differentiation.

METHODS

PBMCs from RA patients were analyzed before and after KDYMD treatment. RT-qPCR was used to measure the miR-124 expressions. Flow cytometry was used to assess the ratios of Th17 to Treg cells. ELISA was used to quantify the cytokine concentrations. The effects of KDYMD on JAK2/STAT3 signaling were evaluated by western blot analysis. A CIA mouse model was used to validate the in vivo effects of KDYMD.

RESULTS

MiR-124 expression was significantly upregulated in PBMCs of RA patients after KDYMD treatment. This upregulation was associated with increased Tip60 and Foxp3 expression and decreased RORγt expression. In the cytokine analysis, IL-1, IL-6, and IL-17A were decreased, and IL-10 and TGF- were increased after treatment. Flow cytometry showed a restoration of the Th17/Treg balance, with a decrease in Th17 and an increase in Treg cells. In vivo, KDYMD treatment ameliorated ankle swelling and arthritis index in CIA mice, comparable to methotrexate (MTX). In addition, KDYMD modulated JAK2/STAT3 signaling and enhanced anti-inflammatory responses.

CONCLUSIONS

KDYMD exerts significant anti-inflammatory effects in RA by upregulating miR-124, which in turn regulates Th17/Treg differentiation and modulates JAK2/STAT3 signaling. A novel mechanism involving miR-124 and immune cell balance suggests KDYMD could be a promising therapeutic agent for RA.

Efficacy and safety of integrated traditional Chinese and Western medicine for rheumatoid arthritis-interstitial lung disease: A systematic review and meta-analysis

Objective

To systematically evaluate the efficacy and safety of integrated traditional Chinese and Western medicine(TCM-WM) for the treatment of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).

Materials and methods

An independent search of electronic databases (PubMed, Excerpta Medica Database, Cochrane Central Register of Controlled Trials, OVID Medline, China National Knowledge Infrastructure, WanFang Data, VIP Data databases, and China Biology Medicine disc) from inception to June 25, 2024 was performed to identify studies treating RA-ILD that used combined Chinese and Western medicine treatment compared to Western medicine. Two researchers independently audited each article, and the quality was assessed using the Cochrane Risk of Bias Assessment Tool 2 and the modified Jadad. Meta-analyses were performed using Review Manager 5.4 and Stata 16.0 software to analyze data. Sample certainty and conclusiveness of evidence were assessed using the Grading of Recommendations Assessment, Development, and Evaluation Profiler (GRADEPRO) and trial sequential analysis(TSA) 0.9.5.10 beta.

Results

Eighteen randomised controlled trials (RCT), including 1353 patients, were abstracted. Integrated traditional Chinese and Western medicine was significantly more effective than Western medicine in improving lung function in patients with rheumatoid arthritis-associated interstitial lung disease, including forced vital capacity (FVC) (Standardized Mean Difference (SMD) = 1.44, 95 % CI 0.93 to 1.95, P < 0.00001), diffusion capacity for carbon monoxide of the lung (DLCO) (SMD = 1.20, 95 % CI: 0.57 to 1.84, P = 0.0002), and total lung capacity (TLC) (SMD = 1.29, 95 % CI: 0.81 to 1.76, P < 0.00001). There were significant differences between the two groups in the reduced high-resolution Computed Tomography scores (Mean Difference(MD) = -1.92, 95 % CI: 2.73 to -1.10, P < 0.00001). Significantly reduced inflammatory markers, combined Chinese and Western medical treatments for RA-ILD were substantially better than Western treatments, including erythrocyte sedimentation rate(ESR) (MD = -7.89, 95 % CI: 12.40 to -3.39, P < 0.00001), C-reactive protein(CRP) (MD = -4.75, 95 % CI: 8.61 to -1.34, P = 0.006), rheumatoid factor(RF) (MD = -41.76, 95 % CI: 66.95 to -16.56, P = 0.001). Combination therapy improved clinical effectiveness (odds ratio (OR) = 3.69, 95 % CI: 2.68 to 5.07, P < 0.00001). Simultaneously, trial sequential analysis indicated that the results demonstrating the superiority of integrated traditional Chinese and Western medicine over Western medicine alone in the treatment of rheumatoid arthritis-associated interstitial lung disease are robust.

Conclusion

Current evidence shows that combined traditional Chinese medicine is effective and safe for rheumatoid arthritis-associated interstitial lung disease compared with Western medicine alone. The sample size for inclusion concerns may require the inclusion of more randomised trials in the future to validate our results.

Photo-physical characterizations and evaluation of in-vitro antioxidant, anti-inflammatory and antidiabetic potentials of green synthesized ackee (Blighia sapida) selenium nano-particles

BACKGROUND

Green synthesized nanoparticles have recently gained significant medicinal applications and oftentimes outperform their green sources. Selenium is of fundamental importance to human health, stemming from its distinctive physicochemical properties, such as antioxidant activity, inhibition of Lipid peroxidation, stabilization of membrane proteins, maintenance of membrane fluidity and modulation of cell signaling. Though reports have shown some therapeutic potential of Ackee plant parts such as antioxidant, anti-inflammatory, antimicrobial, neuroprotective, very few scientific proofs still exist in support of these effects.

METHODS

This study synthesized selenium nanoparticles (Se-NPs) from crude methanolic extracts of Ackee leaves (AKL) and Ackee arils (AKA), examined the photo-physical characteristics of the Se-NPs and determined the in-vitro antioxidant, antidiabetic, and anti-inflammatory potentials of AKL, AKA, and their Se-NPs using established protocols.

RESULTS

In both leaves and arils Se-NPs: UV spectroscopy revealed a qualitative absorbance at 310 nm; FTIR indicated multiple vibrations around 4000 cm-1- 400 cm-1; SEM images of 5 µm principally showed consistent size distribution of amorphous and granular shape at a magnification of 10,000X; while EDS spectra strongly confirm the presence of atomic Se compound at 30 kV. Various antioxidant activities assays carried out showed a range of approximately 4 to 60 times higher activities of the AKL, AKA, and Se-NPs than Ascorbic acid-the standard drug used. Furthermore, appreciable activities of more than 50% were obtained for alpha-amylase and alpha-glucosidase inhibitory activities, along with highly significant activities of haemoglobin glycosylation, glucose uptake, membrane stabilization, anti-arthritic, anti-haemolysis activities, when AKL, AKA, and Se-NPs were compared with standard drugs.

CONCLUSION

Encouraging the development and utilization of AKL, AKA, and Se-NPs will provide tremendous therapeutic efficacy and bioavailability approaches towards the management of diabetes, inflammation, and other oxidative stress-related diseases.

Therapeutic Potential of Bee and Wasp Venom in Anti-Arthritic Treatment: A Review

Arthritis has a high global prevalence. During the early ancient human era, bee (Apis) venom therapy was employed in Egypt, Greece, and China to alleviate ailments such as arthritis and neuralgia. In addition, bee venom has long been used as a traditional medicine for immune-related diseases in Korea. Wasp (Vespa) venom is a folk medicine of the Jingpo people in Yunnan, China, and has been widely used to treat rheumatoid arthritis. In spite of this, the underlying mechanisms of bee and wasp venoms for the treatment of arthritis are yet to be fully understood. In recent years, researchers have investigated the potential anti-arthritic properties of bee and wasp venoms. Studies have shown that both bee and wasp venom can improve swelling, pain, and inflammation caused by arthritis. The difference is that bee venom reduces arthritis damage to bone and cartilage by inhibiting the IRAK2/TAK1/NF-κB signaling pathway, NF-κB signaling pathway, and JAK/STAT signaling pathway, as well as decreasing osteoclastogenesis by inhibiting the RANKL/RANK signaling pathway. Wasp venom, on the other hand, regulates synovial cell apoptosis via the Bax/Bcl-2 signaling pathway, inhibits the JAK/STAT signaling pathway to reduce inflammation production, and also ameliorates joint inflammation by regulating redox balance and iron death in synovial cells. This review provides a detailed overview of the various types of arthritis and their current therapeutic approaches; additionally, it comprehensively analyzes the therapeutic properties of bee venom, wasp venom, or venom components used as anti-arthritic drugs and explores their mechanisms of action in anti-arthritic therapy.

Inhibitory Effects of Reynoutria japonica Houtt. on Pain and Cartilage Breakdown in Osteoarthritis Based on Its Multifaceted Anti-Inflammatory Activity: An In Vivo and In Vitro Approach

In the past 30 years, the number of years lived with disability due to osteoarthritis (OA) has doubled, making it an increasing global health burden. To address this issue, interventions that inhibit the progressive pathology driven by age-related low-grade inflammation, the primary mechanism of OA, are being actively pursued. Recent investigations have focused on modulating the age-related low-grade inflammatory pathology of this disease as a therapeutic target. However, no agent has successfully halted the disease's progression or reversed its irreversible course. Reynoutria japonica Houtt. (RJ), a promising East Asian herbal medicine, has been utilized for several diseases due to its potent anti-inflammatory activity. This study aims to determine RJ's capacity to inhibit OA symptoms and associated inflammation, exploring its potential for further development. In vivo and in vitro experiments demonstrated RJ's anti-OA activity and modulation of multifaceted inflammatory targets. RJ significantly inhibited pain, gait deterioration, and cartilage destruction in a monosodium iodoacetate-induced OA rat model, with its analgesic effect further confirmed in an acetic acid-induced writhing model. RJ exhibited consistent anti-inflammatory activity against multiple targets in serum and cartilage of the OA rat model and lipopolysaccharide-induced RAW 264.7 cells. The inhibition of inflammatory cytokines, including interleukin-1β, interleukin-6, matrix metalloproteinase-13, tumor necrosis factor-α, and nitric oxide synthase 2, suggests that RJ's alleviation of OA manifestations relates to its multifaceted anti-inflammatory activity. These results indicate that RJ merits further investigation as a disease-modifying drug candidate targeting OA's inflammatory pathology. To further characterize the pharmacological properties of RJ, future studies with expanded designs are warranted.

Investigating the Anti-Inflammatory, Analgesic, and Chondroprotective Effects of Gynostemma pentaphyllum (Thunb.) Makino in Osteoarthritis: An In Vitro and In Vivo Study

Osteoarthritis (OA) is an age-related disease characterized by inflammation, pain, articular cartilage damage, synovitis, and irreversible disability. Gynostemma pentaphyllum (Thunb.) Makino (GP), a herbal medicine traditionally used in East Asia for its anti-inflammatory properties, was investigated for its potential to modulate OA pathology and symptoms. This study evaluated GP's efficacy in inhibiting pain, functional decline, and cartilage destruction in monosodium iodoacetate-induced OA and acetic acid-induced writhing models. Additionally, the effects of GP on OA-related inflammatory targets were assessed via mRNA and protein expression in rat knee cartilage and lipopolysaccharide-induced RAW 264.7 cells. The GP group demonstrated significant pain relief, functional improvement, and cartilage protection. Notably, GP inhibited key inflammatory mediators, including interleukin (IL)-1β, IL-6, matrix metalloproteinases (MMP)-3 and MMP-13, cyclooxygenase-2, and prostaglandin E receptor 2, surpassing the effects of active controls. These findings suggest that GP is a promising candidate for disease-modifying OA drugs and warrants further comprehensive studies.

Intra-articular injection of modified citrus pectin and hyaluronate gel induces synergistic effects in treating osteoarthritis

We previously found that modified citrus pectin (MCP), an inhibitor of pro-inflammatory factor Galectin-3 (Gal-3), has significant anti-inflammatory and chondroprotective effects. In this study, a hyaluronate (HA) gel-based sustained release system of MCP (MCP-HA) was developed as an anti-inflammatory agent for chronic inflammation for osteoarthritis (OA) treatment. The MCP-HA gel was injected into the knee joint cavities of OA rabbit models induced by anterior cruciate ligament transection (ACLT) or modified Hulth method once a week for five weeks. We found that MCP-HA could improve the symptoms and signs of OA, protect articular cartilage from degeneration, suppress synovial inflammation, and therefore alleviate OA progression. Proteomic analysis of the synovial fluid obtained from the knee joints of OA rabbits revealed that MCP-HA synergistically regulated the levels of multiple inflammatory mediators and proteins involved in metabolic pathways. Taken together, our results demonstrate that the MCP-HA shows a synergistic effect of HA and MCP by modulating both inflammation and metabolic processes, thereby alleviating OA progression. The MCP-HA sustained release system has promising potential for long-term use in OA treatment.

Regulation of bone homeostasis: signaling pathways and therapeutic targets

As a highly dynamic tissue, bone is continuously rebuilt throughout life. Both bone formation by osteoblasts and bone resorption by osteoclasts constitute bone reconstruction homeostasis. The equilibrium of bone homeostasis is governed by many complicated signaling pathways that weave together to form an intricate network. These pathways coordinate the meticulous processes of bone formation and resorption, ensuring the structural integrity and dynamic vitality of the skeletal system. Dysregulation of the bone homeostatic regulatory signaling network contributes to the development and progression of many skeletal diseases. Significantly, imbalanced bone homeostasis further disrupts the signaling network and triggers a cascade reaction that exacerbates disease progression and engenders a deleterious cycle. Here, we summarize the influence of signaling pathways on bone homeostasis, elucidating the interplay and crosstalk among them. Additionally, we review the mechanisms underpinning bone homeostatic imbalances across diverse disease landscapes, highlighting current and prospective therapeutic targets and clinical drugs. We hope that this review will contribute to a holistic understanding of the signaling pathways and molecular mechanisms sustaining bone homeostasis, which are promising to contribute to further research on bone homeostasis and shed light on the development of targeted drugs.

Pain Relief, Functional Recovery, and Chondroprotective Effects of Angelica gigas Nakai in Osteoarthritis Due to Its Anti-Inflammatory Property: An In Vitro and In Vivo Study

Osteoarthritis (OA), characterized by chronic pain and joint degradation, is a progressive joint disease primarily induced by age-related systemic inflammation. Angelica gigas Nakai (AG), a medicinal plant widely used in East Asia, exhibits promising results for such conditions. This study aimed to evaluate the potential of AG as a drug candidate for modulating the multifaceted pathology of OA based on its anti-inflammatory properties. We evaluated the efficacy of AG in pain relief, functional improvement, and cartilage erosion delay using monosodium iodoacetate-induced OA rats and acetic acid-induced writhing mice, along with its anti-inflammatory effects on multiple targets in the serum and cartilage of in vivo models and lipopolysaccharide-stimulated RAW 264.7 cells. In vivo experiments demonstrated significant analgesic and chondroprotective effects of AG, along with functional recovery, in model animals compared with the active controls. AG dose-dependently modulated inflammatory OA pathology-related targets, including interleukin-1β, tumor necrosis factor-α, matrix metalloproteinase-13, and cyclooxygenase-2, both in vitro and in vivo. In conclusion, AG could be a potential drug candidate for modulating the multifaceted pathology of OA. Nevertheless, further comprehensive investigations, involving a broader range of compounds, pathologies, and mechanisms, are warranted to validate these findings.

Cartilage protective and anti-edema effects of JTF in osteoarthritis via inhibiting NCOA4-HMGB1-driven ferroptosis and aquaporin dysregulation

BACKGROUND

Preventing joint edema is crucial in halting osteoarthritis (OA) progression. Growing clinical evidence indicate that Jianpi-Tongluo Formula (JTF) may have a promising anti-edema effect. However, the therapeutic properties of JTF and the underlying mechanisms remains unclear.

MATERIALS AND METHODS

An OA rat model was established and employed to evaluate pharmacological effects of JTF in vivo based on dynamic histopathologic assessments and micro-CT observations. Then, OA-related genes and potential targets of JTF were identified through clinical transcriptomic data analysis and "disease gene-drug target" network analysis, which were verified by a series of in vivo experiments.

RESULTS

JTF administration effectively reduced pain and joint edema, inhibited matrix degradation, chondrocyte apoptosis, and aquaporin expression in OA rats. Notably, JTF dose-dependently reversed damage-associated molecular patterns and inflammatory factor upregulation. Mechanically, our "disease gene-drug target" network analysis indicated that the NCOA4-HMGB1-GSK3B-AQPs axis, implicated in ferroptosis and aquaporin dysregulation, may be potentially served as a target of JTF against OA. Accordingly, JTF mitigated NCOA4, HMGB1, and GSK3B expression, oxidative stress, and iron metabolism aberrations in OA rats. Furthermore, JTF treatment significantly attenuated the aberrant upregulation of AQP1, AQP3, and AQP4 proteins observed in cartilage tissues of OA rats.

CONCLUSION

Our data reveal for the first time that JTF may exert cartilage protective and anti-edema effects in osteoarthritis therapy by inhibiting NCOA4-HMGB1-driven ferroptosis and aquaporin dysregulation.

The protective effect of natural medicines in rheumatoid arthritis via inhibit angiogenesis

Rheumatoid arthritis is a chronic immunological disease leading to the progressive bone and joint destruction. Angiogenesis, accompanied by synovial hyperplasia and inflammation underlies joint destruction. Delaying or even blocking synovial angiogenesis has emerged as an important target of RA treatment. Natural medicines has a long history of treating RA, and numerous reports have suggested that natural medicines have a strong inhibitory activity on synovial angiogenesis, thereby improving the progression of RA. Natural medicines could regulate the following signaling pathways: HIF/VEGF/ANG, PI3K/Akt pathway, MAPKs pathway, NF-κB pathway, PPARγ pathway, JAK2/STAT3 pathway, etc., thereby inhibiting angiogenesis. Tripterygium wilfordii Hook. f. (TwHF), sinomenine, and total glucoside of Paeonia lactiflora Pall. Are currently the most representative of all natural products worthy of development and utilization. In this paper, the main factors affecting angiogenesis were discussed and different types of natural medicines that inhibit angiogenesis were systematically summarized. Their specific anti-angiogenesis mechanisms are also reviewed which aiming to provide new perspective and options for the management of RA by targeting angiogenesis.

Anti-Inflammatory, Analgesic, Functional Improvement, and Chondroprotective Effects of Erigeron breviscapus (Vant.) Hand.-Mazz. Extract in Osteoarthritis: An In Vivo and In Vitro Study

Osteoarthritis (OA) is a degenerative bone disease characterized by inflammation as a primary pathology and currently lacks therapeutic interventions to impede its progression. Erigeron breviscapus (Vant.) Hand.-Mazz. (EB) is an east Asian herbal medicine with a long history of use and a wide range of confirmed efficacy against cardiovascular and central nervous system diseases. The purpose of this study is to evaluate whether EB is worthy of further investigation as a treatment for OA based on anti-inflammatory activity. This study aims to assess the potential of EB as a treatment for OA, focusing on its anti-inflammatory properties. Analgesic effects, functional improvements, and inhibition of cartilage destruction induced by EB were evaluated in acetic acid-induced peripheral pain mice and monosodium iodoacetate-induced OA rat models. Additionally, the anti-inflammatory effect of EB was assessed in serum and cartilage tissue in vivo, as well as in lipopolysaccharide-induced RAW 264.7 cells. EB demonstrated a significant alleviation of pain, functional impairment, and cartilage degradation in OA along with a notable inhibition of pro-inflammatory cytokines, including interleukin-1β, interleukin-6, matrix metalloproteinases 13, and nitric oxide synthase 2, both in vitro and in vivo, in a dose-dependent manner compared to the active control. Accordingly, EB merits further exploration as a potential disease-modifying drug for OA, capable of mitigating the multifaceted pathology of osteoarthritis through its anti-inflammatory properties. Nonetheless, additional validation through a broader experimental design is essential to substantiate the findings of this study.

Bibliometric Analysis of Research on Traditional Chinese Exercise and Osteoarthritis

Background

Osteoarthritis (OA) is a common disease in geriatric rehabilitation medicine caused by the progressive destruction of articular cartilage. Traditional Chinese exercise (TCE) is an important component of traditional sports in China and aims to stretch the musculoskeletal tract and relieve joint pain. Bibliometrics can help researchers find suitable partners and understand the research hotspots and trends in a certain field. However, there is still a lack of bibliometric analysis in the field of TCE and OA.

Methods

All the literature was obtained from the Web of Science Core Collection database. The last search was performed on July 28, 2023. The bibliometric indicators, such as publications, citations, and H-index, were recorded. Bibliometrix and CiteSpace were used for visualization analysis. In addition, randomized controlled trials were included to summarize the exercise prescription of TCE for OA.

Results

A total of 170 articles were included. The field of OA with TCE had great development potential and was in the rising period. The countries, institutions, and authors with the most publications were the United States, Tufts Medical Center, and Harvey WF, respectively. The most popular journal was Osteoarthritis and Cartilage. The recent burst keywords in this field were mainly "hip", "pilot", and "risk". Tai Chi was the most studied TCE with the most detailed content of exercise prescription, followed by Baduanjin and Wuqinxi.

Conclusion

Our study provides a basis for researchers in this field to choose appropriate partner and academic journals. Moreover, pain, muscle strength, and quality of life management of elderly OA patients are research hotspots in this field. The intervention of hip OA risk through TCE is expected to become a research direction for emerging teams. The TCE prescription we summarized can better provide researchers with more treatment details.

Network analysis, in vivo, and in vitro experiments identified the mechanisms by which Piper longum L. [Piperaceae] alleviates cartilage destruction, joint inflammation, and arthritic pain

Osteoarthritis (OA) is characterized by irreversible joint destruction, pain, and dysfunction. Piper longum L. [Piperaceae] (PL) is an East Asian herbal medicine with reported anti-inflammatory, analgesic, antioxidant, anti-stress, and anti-osteoporotic effects. This study aimed to evaluate the efficacy of PL in inhibiting pain and progressive joint destruction in OA based on its anti-inflammatory activity, and to explore its potential mechanisms using in vivo and in vitro models of OA. We predicted the potential hub targets and signaling pathways of PL through network analysis and molecular docking. Network analysis results showed that the possible hub targets of PL against OA were F2R, F3, MMP1, MMP2, MMP9, and PTGS2. The molecular docking results predicted strong binding affinities for the core compounds in PL: piperlongumine, piperlonguminine, and piperine. In vitro experiments showed that PL inhibited the expression of LPS-induced pro-inflammatory factors, such as F2R, F3, IL-1β, IL-6, IL-17A, MMP-1, MMP-2, MMP-3, MMP-9, MMP-13, NOS2, PTGS2, PGE2, and TNF-β. These mechanisms and effects were dose-dependent in vivo models. Furthermore, PL inhibited cartilage degradation in an OA-induced rat model. Thus, this study demonstrated that multiple components of PL may inhibit the multilayered pathology of OA by acting on multiple targets and pathways. These findings highlight the potential of PL as a disease-modifying OA drug candidate, which warrants further investigation.

Study of the curative effect of Zhang's Xibi formula and its underlying mechanism involving inhibition of inflammatory responses and delay of knee osteoarthritis

OBJECTIVE

To verify the clinical efficacy of Zhang's Xibi formula (ZSXBF) and explain the mechanism underlying its therapeutic effect.

METHODS

Preliminary elucidation of the clinical efficacy of ZSXBF in treating KOA in self-control studies, exploration of its mechanism of action with network pharmacology methods, and validation in animal experiments.

RESULTS

In clinical studies, ZSXBF administration effectively improved patient quality of life and reduce pain. Network pharmacology was used to explore the possible mechanisms underlying its treatment effect, and after verification in clinical experience and animal experiments, it was found that ZSXBF regulated the expression of immune-related proteins such as IL-17, ERK1, and TP53 in mouse knee joints.

CONCLUSION

ZSXBF, which is a traditional Chinese medicine compound that is used to clear heat and detoxify, can effectively improve the clinical symptoms of KOA patients, and its underlying mechanism includes the regulation of human immune-related proteins.

Molecular Mechanism of the Asarum-Angelica Drug Pair in the Treatment of Periodontitis Based on Network Pharmacology and Experimental Verification

(1) To examine the potential mechanism of the Asarum-Angelica drug pair against periodontitis and provide an experimental basis for the treatment of periodontitis with herbal medicine. (2) The core components and core targets of the Asarum-Angelica drug pair in the treatment of periodontitis were detected according to network pharmacology methods. Finally, the effect of the Asarum-Angelica drug pair on osteogenic differentiation was observed in mouse embryonic osteoblast precursor cells. (3) According to the results of network pharmacology, there are 10 potential active ingredients in the Asarum-Angelica drug pair, and 44 potential targets were obtained by mapping the targets with periodontitis treatment. Ten potential active ingredients, such as kaempferol and β-sitosterol, may play a role in treating periodontitis. Cell experiments showed that the Asarum-Angelica drug pair can effectively promote the expression of osteoblast markers alkaline phosphatase (ALP), Runt-related Transcription Factor 2 (RUNX2), and BCL2 mRNA and protein in an inflammatory environment (p < 0.05). (4) Network pharmacology effectively analyzed the molecular mechanism of Asarum-Angelica in the treatment of periodontitis, and the Asarum-Angelica drug pair can promote the differentiation of osteoblasts.

Stem of Sorbus commixta Hedl. Extract Inhibits Cartilage Degradation and Arthritic Pain in Experimental Model via Anti-Inflammatory Activity

Osteoarthritis (OA) is a widespread joint disease that affects millions of people worldwide. Conventional treatments for OA, including non-steroidal anti-inflammatory drugs (NSAIDs) and steroids, have a risk of various adverse events, including liver, gastrointestinal, cardiovascular, and kidney disease, which are unsatisfactory in their effectiveness. In this study, Sorbus commixta Hedl. Stem extracts (SCE) were evaluated in animal models as potential inhibitors for the progression of OA. Sorbus commixta Hedl., which was found to have substantial anti-inflammatory and antioxidant activities in earlier investigations, has shown potential as a candidate for OA treatment. To mimic human OA symptoms, male rats were injected using sodium iodoacetate (MIA) in their knee joints. SCE significantly reduced MIA-induced weight-bearing loss in rats after the MIA injection and alleviated cartilage degradation and subchondral bone injury caused by MIA. In addition, SCE administration reduced levels of TNF-α and IL-1β such as pro-inflammatory cytokines in serum, as well as the levels of matrix metalloproteinases (MMPs) such as MMP-1, -3, -8 and -13 in the joint cartilage. SCE significantly inhibited the writhing responses in acetic acid-administered mice and was used to quantify pain. In lipopolysaccharide (LPS)-activated RAW264.7, SCE suppressed NO production and reduced the expression of TNF-α, PGE2, IL-6, IL-1β, MMP1, MMP3, MMP8, and MMP-13. Our study showed that SCE alleviated inflammation and cartilage degradation in arthritis through its anti-inflammatory activities on multiple targets.