Objective:

To summarize the efficacy, mechanisms, clinical evidence, and translational challenges of TWHf-derived monomers, Tripterygium Glycosides Tablets (TGT), and Xinfeng Capsule (XFC) in rheumatoid arthritis (RA).

Approach:

Key Findings:

• Preclinical evidence indicates that TWHf-derived compounds regulate multiple RA-related processes, including NF-κB and PI3K/AKT/mTOR signaling pathways, ROS-NLRP3 inflammasome activation, synovial hyperplasia, angiogenesis, and immune cell dysfunction.
• XFC exhibits broader multi-component and multi-target regulation compared to isolated monomers, involving epigenetic modulation, NETosis, cuproptosis, pyroptosis, oxidative stress, and coagulation homeostasis.
• Clinical studies suggest that TWHf-related preparations may improve disease activity, joint symptoms, and inflammatory markers, whether used alone or in combination with conventional DMARDs or biologics.

Interpretation:

While TWHf and XFC show promise in managing RA, challenges such as toxicity, insufficient high-quality multicenter RCTs, limited standardization, and a lack of personalized dosing remain.

Limitations:

• Toxicity concerns associated with TWHf.
• Insufficient high-quality multicenter randomized controlled trials (RCTs).
• Limited standardization of formulations.
• Lack of personalized dosing strategies.

Conclusion:

Future studies should focus on standardized formulations, rigorous clinical evaluation, safety monitoring, and toxicity-attenuating delivery systems, as well as biomarker-guided precision application of TWHf and XFC in RA.

Source

Based on findings from:

Tripterygium wilfordii Hook. f. and Xinfeng Capsule in Rheumatoid Arthritis: A Review of Clinical Evidence, Molecular Mechanisms, and Translational Perspectives

Wen, Jianting , Liu, Jian . Frontiers In Immunology, 2026.

https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1814416/full

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This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.