Rheumatoid arthritis (RA) is a chronic inflammatory disease that leads to a significant social burden. East Asian herbal medicine (EAHM) has long been used to treat RA. Therefore, a systematic study of how EAHM treatments can be developed into new drugs using specific materials is needed.Eleven databases containing literature in English, Korean, Chinese, and Japanese were searched for randomized controlled trials comparing EAHM with conventional medicine (CM). A meta-analysis was performed on the variable data to assess their effects on inflammatory pain. Subsequently, we searched for core materials and combinations of core material-based data mining methods.A total of 186 trials involving 19,716 patients with RA met the inclusion criteria. According to the meta-analysis, EAHM had a significantly superior effect on continuous pain intensity, tender joint count, and response rate. Patients treated with EAHM had a significantly reduced incidence of adverse events compared with those treated with CM. Based on additional analysis of the EAHM formula data included in this meta-analysis, 21 core materials and five core herbal combinations were identified.EAHM remedies for RA have the adequate potential for use as candidate materials for treating inflammatory pain in RA. The candidate core herbs evaluated in this study act on multiple pathways and are expected to provide pain relief, sustained inflammation suppression, immune regulation, and prevention of joint destruction. It seems worthwhile to conduct follow-up research on drug development using the core materials derived from this review. 

Clinical evidence construction of East Asian herbal medicine for inflammatory pain in rheumatoid arthritis based on integrative data mining approach

Rheumatoid arthritis (RA) is characterized by processive synovial hyperplasia and abnormal proliferation of fibroblast-like synoviocytes (FLSs), and can eventually lead to progressive joint destruction. Increasing evidence has demonstrated that cytokines play pivotal roles in the pathogenesis of RA. In particular, the production of interleukin (IL)-17 by T helper 17 (Th17) cells is closely associated with the development of RA, and inhibition of IL-17/IL-17R could regulate the production of inflammatory factors by FLSs, which may be a feasible way to reduce inflammation and bone destruction in RA. Currently, accumulating evidence suggests that the utilization of natural herbal medicines is advantageous in the management of RA. In our present paper, a comprehensive reference search was conducted of the classic Materia Medica books, literature, online databases, academic search engines, and MS. or Ph. D theses. In conclusion, natural herbal medicines with antirheumatic activities that modulate FLSs by targeting IL-17/IL-17R were summarized. Furthermore, we also discuss the limitations and potential research directions for the future development of natural herbal medicines as candidate drugs for RA management in the clinic.

Targeting IL-17 and its receptors: A feasible way for natural herbal medicines to modulate fibroblast-like synoviocytes in rheumatoid arthritis

Two novel GCK mutations in Chinese patients with maturity-onset diabetes of the young.

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Unveiling the Potential of Buds of Lonicera Japonica Thunb. VAR. Chinensis (Wats.) Bak (Red Honeysuckle) Based on Comparative Metabolomics

A Comparison of Daily Glucose Fluctuation Between GCK-MODY and Type 2 Diabetes Using Continuous Glucose Monitoring Technology. Diabetes 2023;72:812-818.

Type 2 innate lymphocytes (ILC2s), promoting inflammation resolution, was a potential target for rheumatoid arthritis (RA) treatment. Our previous studies confirmed that R. astragali and R. angelicae sinensis could intervene in immunologic balance of T lymphocytes. C. lonicerae also have anti-inflammatory therapeutic effects. In this study, the possible molecular mechanisms of the combination of these three herbs for the functions of ILC2s and macrophages contributing to the resolution of collagen-induced arthritis (CIA) were studied. Therefore, we used R. astragali, R. angelicae sinensis, and C. lonicerae as treatment. The synovial inflammation and articular cartilage destruction were alleviated after herbal treatment. The percentages of ILC2s and Tregs increased significantly. The differentiation of Th17 cells and the secretion of IL-17 and IFN-γ significantly decreased. In addition, treatment by the combination of these three herbs could increase the level of anti-inflammatory cytokine IL-4 secreted, active the STAT6 signaling pathway, and then contribute to the transformation of M1 macrophages to M2 phenotype. The combination of the three herbs could promote inflammation resolution of synovial tissue by regulating ILC2s immune response network. The synergistic effects of three drugs were superior to the combination of R. astragali and R. angelicae sinensis or C. lonicerae alone.

/pdf/the-herbal-combination-of-radix-astragali-radix-angelicae-psmk54xr.pdf

The Herbal Combination of Radix astragali, Radix angelicae sinensis, and Caulis lonicerae Regulates the Functions of Type 2 Innate Lymphocytes and Macrophages Contributing to the Resolution of Collagen-Induced Arthritis

Is Oxalic Acid Secretion A Detoxification Strategy for Rice Exposed to Tl(I) or Tl(III)?

Chinese herbal formula, modified Xianfang Huoming Yin, alleviates the inflammatory proliferation of rat synoviocytes induced by IL-1β through regulating the migration and differentiation of T lymphocytes.

Glucokinase variant-induced maturity-onset diabetes of the young (GCK-MODY) exhibits the unique clinical features of mild fasting hyperglycaemia. However, formal studies of its glucose excursion pattern in daily life in comparison with those with or without other types of diabetes are lacking. We conducted a case-control study including 25 patients with GCK-MODY, 25 A1c-matched, drug naive patients with type 2 diabetes (T2DM) and 25 age-, BMI- and sex-matched subjects with normal glucose tolerance (NGT). All the subjects wore flash glucose monitoring (FGM) sensors for 2 weeks, and glucose readings were masked. Glucose excursion was significantly lower in the GCK-MODY than that in A1c-matched T2DM during the daytime, but was similar during the nighttime. The daytime coefficient of variation [CV] driven by postprandial glucose could separate GCK-MODY from well-controlled T2DM, but the nighttime CV could not. In discriminating between GCK-MODY and T2DM, the area under the curve (AUC) of the CV was 0.875. However, in GCK-MODY and NGT subjects, the CVs were similar at 24h, whereas the other four excursion parameters were significantly higher in GCK-MODY than those in NGT subjects. FGM confirmed the stability and mildness of hyperglycemia in GCK-MODY patients. Postprandial regulation is a key driver of the difference in excursion between GCK-MODY and T2DM.

A comparison of daily glucose fluctuation among GCK-MODY and type 2 diabetes using continuous glucose monitoring technology.

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The Herbal Combination of Radix astragali, Radix angelicae sinensis, and Caulis lonicerae Regulates the Functions of Type 2 Innate Lymphocytes and Macrophages Contributing to the Resolution of Collagen-Induced Arthritis

Is Oxalic Acid Secretion A Detoxification Strategy for Rice Exposed to Tl(I) or Tl(III)?

Chinese herbal formula, modified Xianfang Huoming Yin, alleviates the inflammatory proliferation of rat synoviocytes induced by IL-1β through regulating the migration and differentiation of T lymphocytes.

A comparison of daily glucose fluctuation among GCK-MODY and type 2 diabetes using continuous glucose monitoring technology.