Abstract

BackgroundAs a degenerative joint disease with severe cartilage destruction and pain, osteoarthritis (OA) has no satisfactory therapy to date. In traditional Chinese medicine (TCM), Aconitum carmichaeli Debeaux derived Hei-shun-pian (Hsp) has been developed for joint pain treatment. However, it causes adverse events in OA patients. Long-time decoction has been traditionally applied to reduce the aconite toxicity of Hsp and other aconite herbs, but its detoxifying effect is uncertain.Methods Hsp was extracted with dilute decoction times (30, 60, and 120 min) and evaluated by toxicological, chemical, pharmacological assays. Acute toxicity assay and chemical analysis were employed to determine the toxicity and chemoprofile of Hsp extracts, respectively. Since the detoxified Hsp (dHsp) was defined, its therapeutic effect was evaluated by using an OA rat model induced by monosodium iodoacetate. dHsp at 14 g/kg was orally administered for 28 days, and the pain assessments (mechanical withdrawal threshold and thermal withdrawal latency) and histopathological analyses (HE and safranin-O staining) were performed. Real-time PCR (qPCR) was applied to determine the molecular actions of dHsp on cartilage tissue and on chondrocytes. MTT assay was conducted to evaluate the effect of dHsp on the cell viability of chondrocytes. The cellular and molecular assays were also conducted to analyze the functions of chemical components in dHsp.ResultsThe chemoprofile result showed that the contents of toxic alkaloids (aconitine, mesaconitine, and hypaconitine) were decreased but that of non-toxic alkaloids (benzoylaconitine, benzoylmesaconitine, and benzoylhypaconitine) were increased with increasing decoction time. Acute toxicity assay showed that only Hsp extract with 120 min decoction was non-toxic within the therapeutic dose range. Thus, it was defined as dHsp for further experiment. In OA experiment, dHsp significantly attenuated joint pain and prevented articular degeneration from MIA attack. qPCR data showed that dHsp restored the abnormal expressions of Col10, Mmp2, Sox5, Adamts4/5/9, and up-regulated Col2 expression in rat cartilage. In vitro, dHsp-containing serum significantly proliferated rat chondrocytes and regulated the gene expressions of Col2, Mmp1, Adamts9, and Aggrecan in a similar way as the in vivo data. Moreover, aconitine, mesaconitine, and hypaconitine exerted cytotoxic effects on chondrocytes, while benzoylaconitine and benzoylhypaconitine except benzoylmesaconitine exhibited similar molecular actions to dHsp, indicating contributions of benzoylaconitine and benzoylhypaconitine to dHsp.ConclusionsThis study defined dHsp and demonstrated dHsp as a potential analgesic and disease modifying agent against OA with molecular actions on the suppression of chondrocyte hypertrophy and extracellular matrix degradation, providing a promising TCM candidate for OA therapy.

Highlights

  • Osteoarthritis (OA) is a progressive joint disease characterized by cartilage degradation, sclerosis of subchondral bone and osteophyte formation, resulting in chronic joint pain, joint stiffness, and disability

  • We found that the molecular actions of detoxicated Hsp (dHsp) were mediated by the regulation of gene expressions of Col2, Aggrecan, Col10, Mmp1, Mmp2, Adamts4/5/9, and Sox5 in cartilage tissue and chondrocytes, suggesting a mechanism of dHsp in association with the inhibition of extracellular matrix (ECM) degradation and chondrocyte hypertrophy

  • This is the first study reported that dHsp has anti-OA effect independent of its toxicity, which provides a safe candidate for traditional Chinese medicine (TCM) formulation in OA therapy

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Summary

Introduction

Osteoarthritis (OA) is a progressive joint disease characterized by cartilage degradation, sclerosis of subchondral bone and osteophyte formation, resulting in chronic joint pain, joint stiffness, and disability. The incidence and severity of OA in women are higher than that in men. It is estimated that the lifetime risk of knee OA is about 40% in men and 47% in women (Johnson and Hunter, 2014). Due to the aging of the global population and the aggravation of obesity, the incidence of OA is getting higher and is expected to double by the year 2020 (Johnson and Hunter, 2014; Mandl, 2019). As a degenerative joint disease with severe cartilage destruction and pain, osteoarthritis (OA) has no satisfactory therapy to date. In traditional Chinese medicine (TCM), Aconitum carmichaeli Debeaux derived Hei-shun-pian (Hsp) has been developed for joint pain treatment. It causes adverse events in OA patients. Long-time decoction has been traditionally applied to reduce the aconite toxicity of Hsp and other aconite herbs, but its detoxifying effect is uncertain

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