Phytochemical and In-Vivo Anti-Arthritic Significance of Aloe thraskii Baker in Combined Therapy with Methotrexate in Adjuvant-Induced Arthritis in Rats.

Rania M Kamal,Mohamed S Hifnawy,Zeinab Y Aly,Manal M Sabry

doi:10.3390/molecules26123660

Abstract

Unlike other widely known Aloe species used for treatment of rheumatoid arthritis, this species suffers from a lack of sufficient studies on its biological and chemical characters. This is what drove us to perform this work to evaluate the in vivo anti-arthritic potential of its leaf ethanolic extract. The in vivo anti-arthritic activity of the leaf ethanolic extract at 100 and 200 mg/kg/day b.wt. was evaluated alone and in combination with methotrexate (MTX) using complete Freund’s adjuvant. Serum levels of rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP), cytokines pro-inflammatory marker, inflammatory mediator serum levels, and oxidative stress mediators were analyzed, in addition to liver function. Orientin, isoorientin, β-sitosterol, its palmitate and its glucoside were isolated. The combined therapy of MTX and the leaf ethanolic extract (especially at 200 mg/kg b.wt.) group showed better activity compared to MTX alone. Moreover, the combined therapy provided additional benefits in lowering the liver toxicity by comparison to MTX alone. We concluded that a synergetic combination of the leaf ethanolic extract and MTX is beneficial in the management of rheumatoid arthritis with fewer side effects on liver function, as well as the possibility of the leaf extract to stand alone as an effective natural anti-arthritic agent.

Highlights

Accepted: 13 June 2021Rheumatoid arthritis (RA), a chronic joints inflammation, is described as an autoimmune ailment affecting 1–2% of human beings all over the world, especially females [1].The resulting joint damage, musculoskeletal deficits and pain provokes physical disabilities as well as physiological distress, leading to the subsequent social isolation of the patient [2].RA is accompanied by the development of different antigens which, in turn, activate certain inflammatory mediators (such as tumor necrosis factor-alpha (TNF-α) and interleukins (IL-1, IL-6, IL-10) [3,4])
The activation of the pro-inflammatory cytokine nuclear transcription factor kappa B (NF-kB) contributes to the development of chronic inflammation in RA [5], while IL-10 participates in inhibiting inflammatory and autoimmune processes [3]
The current phytochemical investigation resulted in the separation and the structure elucidation of five compounds from the leaf ethanolic extract of A. thraskii for the first time

Summary

Introduction

Rheumatoid arthritis (RA), a chronic joints inflammation, is described as an autoimmune ailment affecting 1–2% of human beings all over the world, especially females [1]. RA is accompanied by the development of different antigens which, in turn, activate certain inflammatory mediators (such as tumor necrosis factor-alpha (TNF-α) and interleukins (IL-1, IL-6, IL-10) [3,4]). The activation of the pro-inflammatory cytokine nuclear transcription factor kappa B (NF-kB) contributes to the development of chronic inflammation in RA [5], while IL-10 participates in inhibiting inflammatory and autoimmune processes [3]. Various medications are used in an attempt to keep the normal articulations functioning and retard or even stop the progressive inflammatory processes or reduce the pain. Methotrexate (MTX) is a known antirheumatic drug used for moderate to severe RA; hepatotoxicity is the main constraint to its use [7,8,9]

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Conclusion