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