Abstract
The etiology and pathogenesis of rheumatoid arthritis (RA) have not yet been fully elucidated, with greater adverse drug effects in traditional treatment of RA. It is particularly necessary to develop and study Chinese herbal formula as a supplement and alternative drug for the treatment of RA. The traditional Chinese medicine compound Longteng Decoction (LTD), as an empirical prescription in the treatment of RA in Dongzhimen Hospital of Beijing University of Chinese Medicine, has been widely used in clinic. Type 2 innate lymphocytes (ILC2s) have specific transcription factors and signature cytokines that are very similar to Th cells, which have been proved to be necessary in addressing RA inflammation, and are potential targets for RA prevention and treatment. Our previous studies have confirmed that LTD can intervene in the differentiation of peripheral blood Th17 and Treg cells, reduce joint pain index and swelling degree, shorten the time of morning stiffness, reduce ESR, and inhibit joint inflammation. However, it is unclear whether LTD can promote the regression of RA synovial inflammation by regulating the immune response mechanism of ILC2s.Therefore, our team established a collagen-induced arthritis mouse model and conducted an experimental study with LTD as the intervention object. The results showed that joint swelling, synovial inflammatory infiltration, and articular cartilage destruction were alleviated in CIA mice after intervention with LTD. The proliferation and differentiation of Th17 inflammatory cells and the secretion of proinflammatory cytokines (IL-17 and IFN-γ) were inhibited. In addition, LTD can also activate ILC2s to secrete the anti-inflammatory cytokine IL-4, activate the STAT6 signaling pathway, and act synergistic with Treg cells to inhibit the infiltration of type M1 macrophages in synovial tissue and promote its transformation to M2 phenotype. Taken together, these results confirm that LTD can be used as an adjunct or alternative to RA therapy by modulating the ILC2s immune response network and slowing down the inflammatory process of synovial tissue.
Highlights
Rheumatoid arthritis (RA) is a general chronic autoimmune disease with an incidence rate of 0.4–1.3% (Lin et al, 2020)
The results showed that the swelling thickness of the bilateral plantar joint of mice decreased gradually with the intervention period, and there were significant differences on both sides from the 42nd day
The results suggest that Longteng Decoction (LTD) can promote the proliferation of ILC2s and Treg cells
Summary
Rheumatoid arthritis (RA) is a general chronic autoimmune disease with an incidence rate of 0.4–1.3% (Lin et al, 2020). The disease mainly invades synovial and joints, and its pathological manifestations include synovial hyperplasia with extensive inflammatory cells infiltration, the generation of pannus and the damage of articular cartilage, with a high disability rate (Daniel and Josef, 2018; Stefan et al, 2015). The detailed pathogenesis of RA are still unclear, synovial inflammation remains a major target of the disease in its mature clinical stage (Bugatti et al, 2019). The constant immune cell activation leads to chronic inflammatory of the joints and synovial swelling, which in turn leads to synovial expansion and invasion of the periarticular bone at the cartilage-bone junction, leading to cartilage degeneration and bone invasion (Daniel and Josef, 2018)
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