Therapeutic Function Of TGP In Rheumatoid Arthritis

Objective Rheumatoid arthritis(RA)is a systemic autoimmune disease characterized by persistent synovitis.Although the current drug therapy can effectively control the progression of RA,the treatments are limited and there are many adverse reactions.Total glucosides of paeony(TGP)are active ingredients extracted from the dried root of Paeonia.Pharmacological studies have shown that it has the functions of regulating immune response,anti-inflammatory and analgesia,and its clinical application is broadly wide.However,the mechanism of TGP in the RA treatment is not yet clear.Excessive activation and proliferation of fibroblast-like synoviocytes(FLS)in RA is one of the important mechanisms leading to the pathogenesis of RA,thus FLS is also the target for RA treatment.Under activation,FLS secretes inflammatory cytokines,chemokines and degradative enzymes,which promote the occurrence and progression of RA.In this study,the therapeutic effect of TGP on RA patients were assessed,and TGP treatment in FLS was detected via regulating proliferation,cell apoptosis and the expression of inflammatory factors.The results provide evidence of TGP treatment in clinical application.Methods 1.Forty severe rheumatoid arthritis patients admitted to the Rheumatology Department of Gaomi Municipal people’s Hospital from January 2020 to December 2020 were selected for study.They were divided into experimental groups and control groups according to the different treatment methods,each group of 20 cases.Patients were treated with methotrexate(MTX)and leflunomide(LEF)in control groups,while treated with MTX + LEF + TGP in experimental groups.Blood samples were collected on 0 d,12 d and 24 d after drug treatment,the levels in serum amyloid(SAA),erythrocyte sedimentation level(ESR),C reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin 6(IL-6),alanine amino transferase(ALT),creatinine(Cr),white blood cells(WBC)were compared before and after treatment and between the two groups.The improvement of clinical symptoms was also assessed.2.MH7 A cells were incubated with TGP(15.625,62.5,250,1000 μg/m L)in the presence or absence of TNF-α,the effects of different concentrations of TGP on cell viability were detected by CCK8.The effect of TGP on the apoptosis of MH7 A cells was detected by Annexin V-FITC/PI.The m RNA of IL-6 and IL-1β was detected by RT-q PCR.Results 1.Compared with untreated group,the clinical symptoms and signs of experimental and control groups were significantly improved in drug treated groups.After treatment,the clinical symptoms and signs of experimental group were better than control group,and the difference was statistically significant(P< 0.05).2.Compared with untreated group,the level of SAA,CRP,ESR,IL-6 and TNF-α of experimental and control group were lower in drug treated groups.After treatment,the level of SAA,CRP,ESR,IL-6 and TNF-α of experimental group were lower than control group,and the difference was statistically significant(P< 0.05).3.Compared with untreated group,the clinical side effects factors of experimental and control groups were significantly improved in drug treated groups.After treatment,the clinical side effects factors of experimental group were better than control group,and the difference was statistically significant(P< 0.05).4.Compared with the control group,TGP inhibited the proliferation of FLS in a concentration dependent manner.TGP promoted FLS apoptosis,and down-regulated IL-6 and IL-1 β levels,and the difference was statistically significant(P<0.05).Conclusion 1.TGP complimentary treatment improved the clinical symptoms and signs,down-regulated the expression of inflammatory factors,and played an important role in RA therapy.2.TGP regulated the proliferation,apoptosis and the expression of inflammatory factors of FLS,which maybe one of the mechanisms of TGP in RA therapy.