1.Cardiovascular disease and risk factors among patients with rheumatoid arthritis in a tertiary government hospital in the Philippines.
Mark Andrian O. Yano ; Evelyn O. Salido
Acta Medica Philippina 2026;60(1):38-44
BACKGROUND
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement. Comorbidities are highly prevalent in patients with RA, in particular cardiovascular disease (CVD), which is responsible for over 50% of premature deaths. This study aimed to describe cardiovascular diseases and their risk factors among patients with rheumatoid arthritis in the Philippine General Hospital (PGH).
OBJECTIVETo describe cardiovascular (CV) diseases and their risk factors among patients with rheumatoid arthritis.
METHODSA retrospective descriptive cross-sectional study was done in the University of the Philippines – Philippine General Hospital (UP-PGH) inpatient and outpatient services. The study included patients 18 years old and above diagnosed with RA and fulfills the 1987 American College of Rheumatology or 2010 American College of Rheumatology-European League Against Rheumatism (ACR/EULAR) classification criteria with no overlap features with other autoimmune connective tissue diseases and with complete records of the information required for the study from January 2019-December 2022. The primary outcomes of interest were the prevalence of CV diseases and CV risk factors. Descriptive statistics were used to summarize the data.
RESULTSThere were 123 patients in the study, 93.4% outpatients, and 95.1% females, with a mean age and disease duration of 51.3 and 9.8 years, respectively. Disease activity was moderate in 35% and high in 9.7%, based on disease activity score (DAS 28) or clinical disease activity index (CDAI) scores. Methotrexate (54%) was the most commonly used conventional synthetic disease-modifying antirheumatic drug (csDMARD). Glucocorticoid use was observed in 51.2%. None of the patients were receiving a biologic DMARD. There were 24 (19.5%) patients with CV diseases, namely myocardial infarction, heart failure, and stroke. There were 87 (70%) patients with at least one CV risk factor and 62 (50.4%) with multiple risk factors. The risk factors identified were: dyslipidemia (43.1%), hypertension (40.7%), elevated body mass index (35.7%), and diabetes mellitus (15.4%). There were f ive deaths in the hospitalized patients (4%), one due to a myocardial infarction.
CONCLUSIONThe majority (70%) in our cohort had at least one CV risk factor, 19.5% had an identified CV disease, and one died from a myocardial infarction. Dyslipidemia was the most common CV risk factor. The high proportion of patients with CV disease and CV risk factors highlights the need to add the screening and management of CV diseases and risk factors as a priority among patients with rheumatoid arthritis.
Human ; Female ; Cardiovascular Diseases ; Arthritis, Rheumatoid ; Asian
2.Effect of Programmed Exercise through Telerehabilitation at Home on Visual Analogue Scale, Body Mass Index, and WOMAC among Patients with Obesity and Knee Osteoarthritis: A Quasi-Experimental Study
Binar Sasono ; Tirza Z Tamin ; Melinda Harini ; Maria Regina Rachmawati
Acta Medica Indonesiana 2026;58(1):44-51
Abstract
Background: This study aims to determine the effectiveness of programmed exercise with telerehabilitation at home in patients with obesity and knee osteoarthritis on visual analogue scale scores, body mass index, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Methods: This research is a pre–post study in patients with obesity and knee osteoarthritis. Research subjects performed a series of exercise programs at home for 28 days. Before the program, there was an initial assessment from a psychologist and a nutritionist. During the program, there was tele-education, telemonitoring, and teleconsultation from doctors. Twenty-six female subjects participated. Results: Visual analogue scale scores decreased statistically significantly every week, until the end of the fourth week, compared with before the intervention (p<0.001). Body mass index and WOMAC scores decreased statistically significantly at the end of the fourth week compared with before the intervention (both p<0.001). Further analysis of all WOMAC components in the intervention group, including pain, stiffness, and physical function, also showed a statistically significant decrease (p<0.001). Conclusion: Programmed exercise as part of telerehabilitation at home has been statistically proven to reduce visual analogue scale scores, body mass index, and WOMAC in patients with obesity and knee osteoarthritis.
Telerehabilitation
;
Knee Osteoarthritis
;
Obesity
;
Body Mass Index
;
Visual Analogue Scale
;
WOMAC
3.Exploration of pharmacodynamic substances and potential mechanisms of Huazhuo Sanjie Chubi Decoction in treatment of gouty arthritis based on UPLC-Q-Exactive Orbitrap-MS technology and network pharmacology.
Yan XIAO ; Ting ZHANG ; Ying-Jie ZHANG ; Bin HUANG ; Peng CHEN ; Xiao-Hua CHEN ; Ming-Qing HUANG ; Xue-Ting CHEN ; You-Xin SU ; Jie-Mei GUO
China Journal of Chinese Materia Medica 2025;50(2):444-488
Based on ultra-high performance liquid chromatography-quadrupole-Exactive Orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap-MS) technology and network pharmacology, this study explored the pharmacodynamic substances and potential mechanisms of Huazhuo Sanjie Chubi Decoction in the treatment of gouty arthritis(GA). UPLC-Q-Exactive Orbitrap-MS technology was used to identify the components in Huazhuo Sanjie Chubi Decoction, and the qualitative analysis of its active ingredients was carried out, with a total of 184 active ingredients identified. A total of 897 active ingredient targets were screened through the PharmMapper database, and 491 GA-related disease targets were obtained from the OMIM, GeneCards, CTD databases. After Venn analysis, 60 intersecting targets were obtained. The component target-GA target network was constructed through the Cytoscape platform, and the STRING database was used to construct a protein-protein interaction network, with 16 core targets screened. The core targets were subjected to Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses, and the component-target-pathway network was constructed. It was found that the main active ingredients of the formula for the treatment of GA were phenols, flavonoids, alkaloids, and terpenoids, and the key targets were SRC, MMP3, MMP9, REN, ALB, IGF1R, PPARG, MAPK1, HPRT1, and CASP1. Through GO analysis, it was found that the treatment of GA mainly involved biological processes such as lipid response, bacterial response, and biostimulus response. KEGG analysis showed that the pathways related to the treatment of GA included lipids and atherosclerosis, neutrophil extracellular traps(NETs), IL-17, and so on. In summary, phenols, flavonoids, alkaloids, and terpenoids may be the core pharmacodynamic substances of Huazhuo Sanjie Chubi Decoction in the treatment of GA, and the pharmacodynamic mechanism may be related to SRC, MMP3, MMP9, and other targets, as well as lipids and atherosclerosis, NETs, IL-17, and other pathways.
Drugs, Chinese Herbal/therapeutic use*
;
Network Pharmacology
;
Arthritis, Gouty/metabolism*
;
Chromatography, High Pressure Liquid/methods*
;
Humans
;
Mass Spectrometry/methods*
;
Protein Interaction Maps/drug effects*
4.Effect of Duhuo Jisheng Decoction on knee osteoarthritis model rabbits through regulation of cell pyroptosis mediated by PI3K/Akt/mTOR signaling pathway.
Lin-Qin HE ; Peng-Fei LI ; Xiao-Dong LI ; Qi-Peng CHEN ; Zong-Han TANG ; Yu-Xin SONG ; Han-Bing SONG
China Journal of Chinese Materia Medica 2025;50(1):187-197
This study aimed to investigate the underlying mechanisms of Duhuo Jisheng Decoction(DJD) in the prevention and treatment of knee osteoarthritis(KOA). Forty SPF New Zealand rabbits were randomly divided using SPSS 26.0 software into five groups: blank group, model group, low-dose DJD group, high-dose DJD group, and high-dose DJD+phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR) signaling pathway activator group(high-dose DJD+740Y-P group), with eight rabbits in each group. Except for the blank group, the KOA model was established in the other groups using papain injection into the knee joint cavity combined with forced flexion of the knee joint. The day after modeling, the blank group and model group were given normal saline at 10 mL·kg~(-1) by gavage, the low-dose DJD group received DJD at 8.8 g·kg~(-1) by gavage, the high-dose DJD group received DJD at 35.2 g·kg~(-1) by gavage, and the high-dose DJD+740Y-P group received DJD at 35.2 g·kg~(-1) by gavage along with 740Y-P at 0.15 μmoL·kg~(-1) injected via the auricular vein. All groups received treatment continuously for four weeks. After modeling and intervention, behavioral observations were performed for all groups, and after the intervention, imaging assessments of the knee joints were conducted. Cartilage from the knee joints was collected, and gross morphological changes were observed. Pathological changes in cartilage tissue were examined using hematoxylin-eosin(HE) staining. The results of these observations were quantitatively evaluated using the Lequesne MG score, Kellgren-Lawrence(K-L) grading, Pelletier score, and Mankin score. ELISA was used to measure the levels of interleukin-1β(IL-1β), interleukin-18(IL-18), and matrix metalloproteinase 13(MMP13) in cartilage tissue. Real-time RT-PCR was used to detect the mRNA expression levels of PI3K, Akt, mTOR, Nod-like receptor protein 3(NLRP3), cysteine protease 1(caspase-1), and gasdermin D(GSDMD) in cartilage tissue. Western blot was employed to measure the protein expression levels of PI3K, Akt, mTOR, NLRP3, caspase-1, and GSDMD. The results showed that compared with the blank group, the model group exhibited significant knee joint degeneration, increased Lequesne MG score, K-L grading, Pelletier score, and Mankin score, elevated levels of IL-1β, IL-18, and MMP13 in cartilage tissue, activation of PI3K, Akt, and mTOR phosphorylation along with increased mRNA expression levels, and elevated protein and mRNA expression levels of NLRP3, caspase-1, and GSDMD. Compared with the model group, these indicators were reversed in both the low-dose and high-dose DJD groups, with the high-dose group showing greater decline degree than the low-dose DJD group. However, compared with the high-dose DJD group, the improvements in knee joint degeneration were less pronounced in the high-dose DJD+740Y-P group, with increased Lequesne MG score, K-L grading, Pelletier score, Mankin score, elevated levels of IL-1β, IL-18, and MMP13, activation of PI3K, Akt, and mTOR phosphorylation along with increased mRNA expression, and increased protein and mRNA expression levels of NLRP3, caspase-1, and GSDMD. In conclusion, DJD is effective and safe in the treatment of KOA, and its mechanism may be related to the inhibition of PI3K/Akt/mTOR signaling pathway-mediated pyroptosis in cartilage tissue, thereby improving knee joint bone structure, reducing the inflammatory response, and preventing cartilage matrix degradation.
Animals
;
Drugs, Chinese Herbal/administration & dosage*
;
Rabbits
;
TOR Serine-Threonine Kinases/genetics*
;
Osteoarthritis, Knee/genetics*
;
Proto-Oncogene Proteins c-akt/genetics*
;
Signal Transduction/drug effects*
;
Male
;
Disease Models, Animal
;
Pyroptosis/drug effects*
;
Phosphatidylinositol 3-Kinases/genetics*
;
Humans
;
Female
5.Characterization of protective effects of Jianpi Tongluo Formula on cartilage in knee osteoarthritis from a single cell-spatial heterogeneity perspective.
Yu-Dong LIU ; Teng-Teng XU ; Zhao-Chen MA ; Chun-Fang LIU ; Wei-Heng CHEN ; Na LIN ; Yan-Qiong ZHANG
China Journal of Chinese Materia Medica 2025;50(3):741-749
This study aims to integrate data mining techniques of single cell transcriptomics and spatial transcriptomics, along with animal experiment validation, so as to systematically characterize the protective effects of Jianpi Tongluo Formula(JTF) on the cartilage in knee osteoarthritis(KOA) and elucidate the underlying molecular mechanisms. Single cell transcriptomics and spatial transcriptomics datasets(GSE254844 and GSE255460) of the cartilage tissue obtained from KOA patients were analyzed to map the single cell-spatial heterogeneity and identify key pathogenic factors. After that, a KOA rat model was established via knee joint injection of papain. The intervention effects of JTF on the expression features of these key factors were assessed through real-time quantitative polymerase chain reaction(PCR), Western blot, and immunohistochemical staining. As a result, the integrated single cell and spatial transcriptomics data identified distinct cell subsets with different pathological changes in different regions of the inflamed cartilage tissue in KOA, and their differentiation trajectories were closely related to the inflammatory fibrosis-like pathological changes of chondrocytes. Accordingly, the expression levels of the two key effect targets, namely nuclear receptor coactivator 4(NCOA4) and high mobility group box 1(HMGB1) were significantly reduced in the articular surface and superficial zone of the inflamed joints when JTF effectively alleviated various pathological changes in KOA rats, thus reversing the abnormal chondrocyte autophagy level, relieving the inflammatory responses and fibrosis-like pathological changes, and promoting the repair of chondrocyte function. Collectively, this study revealed the heterogeneous characteristics and dynamic changes of inflamed cartilage tissue in different regions and different cell subsets in KOA patients. It is worth noting that NCOA4 and HMGB1 were crucial in regulating chondrocyte autophagy and inflammatory reaction, while JTF could reverse the regulation of NCOA4 and HMGB1 and correct the abnormal molecular signal axis in the target cells of the inflamed joints. The research can provide a new research idea and scientific basis for developing a personalized therapeutic schedule targeting the spatiotemporal heterogeneity characteristics of KOA.
Animals
;
Drugs, Chinese Herbal/administration & dosage*
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Rats
;
Osteoarthritis, Knee/pathology*
;
Humans
;
Male
;
Cartilage, Articular/metabolism*
;
Chondrocytes/metabolism*
;
Rats, Sprague-Dawley
;
Female
;
Protective Agents/administration & dosage*
;
Single-Cell Analysis
;
Middle Aged
;
HMGB1 Protein/metabolism*
6.Characterization and features of dampness-heat obstruction syndrome in rats with knee osteoarthritis based on "disease-syndrome-symptom" combination research strategy.
Li-Li WANG ; Teng-Teng XU ; Xiao-Xiao WANG ; Qun LI ; Li-Ting XU ; Wei-Heng CHEN ; Chun-Fang LIU ; Na LIN
China Journal of Chinese Materia Medica 2025;50(7):1861-1871
A combination of the "disease-syndrome-symptom" approach was used to study the syndrome characterization and features of dampness-heat obstruction syndrome in papain-induced knee osteoarthritis(KOA) model rats during the disease process. Forty-eight male SD rats were randomly divided into sham and model groups. The KOA model was established by injecting a mixture of papain and L-cysteine into the joint cavity on days 1, 3, and 5. During the 8 weeks following model establishment, the rats were assessed weekly for the plantar mechanical pain threshold, knee joint diameter, local skin temperature of the knee joint, weight-bearing difference between the two hind feet, and the modified Lequesne MG score of the knee joint. Samples were collected at 1, 2, 4, 6, and 8 weeks after model establishment to observe the gross lesions in cartilage and synovium. Histopathological changes in joint tissues were examined using hematoxylin-eosin, Masson's trichrome, and Senna red O-solid green staining. ELISA and immunohistochemical analysis were performed to detect the levels of interleukin(IL)-1β, IL-6, tumor necrosis factor(TNF)-α, prostaglandin E2(PGE2), and the expression of aquaporins(AQP) 1 and 3 in serum and synovium. The results showed that the ink score of articular cartilage in the model group significantly increased from 4 to 8 weeks, the cartilage Mankin's score and the percentage of Masson-positive area in cartilage increased significantly from 1 to 8 weeks. The percentage of red-stained area for cartilage proteoglycans decreased significantly from 1 to 8 weeks. The synovitis score from 1 to 6 weeks and the percentage of blue-stained collagen fibers in the synovium from 1 to 8 weeks increased significantly, with statistically significant differences compared to the sham group. The mechanical pain threshold in the model group significantly decreased from 1 to 8 weeks, the knee joint diameter significantly increased from 1 to 6 weeks, and the local skin temperature of the knee joint, the weight-bearing difference between the two hind feet, and the modified Lequesne MG score from 1 to 5 weeks significantly increased, all with statistically significant differences compared to the sham group. The levels of IL-1β, IL-6, TNF-α, and PGE2 in serum and synovium of the model group significantly increased from 1 to 6 weeks. Serum TNF-α and PGE2, and synovial IL-1β, also significantly increased at 8 weeks. The levels of cartilage AQP1 and AQP3 significantly increased from 1 to 4 weeks, while synovial AQP1 and AQP3 increased significantly from 1 to 6 weeks, with all differences statistically significant compared to the sham group. In conclusion, papain-induced KOA rats exhibited pathological changes, including articular cartilage degeneration and synovial inflammation, within 1 week of induction. The KOA rats showed characteristics of dampness-heat obstruction syndrome, such as joint pain, swelling, elevated skin temperature, and decreased function, as well as increased inflammatory factors and AQP1、AQP3 in serum and joint tissues within 5 to 6 weeks of disease onset. These results provide an experimental model for studying the syndromes of KOA with dampness-heat obstruction syndrome.
Animals
;
Male
;
Rats, Sprague-Dawley
;
Rats
;
Osteoarthritis, Knee/physiopathology*
;
Disease Models, Animal
;
Humans
;
Interleukin-1beta/metabolism*
;
Interleukin-6/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
Knee Joint/pathology*
7.Mechanism of Syngnathus extract in treating knee osteoarthritis of rats via regulating PI3K/Akt/mTOR signaling pathway.
Quan-Wei ZHENG ; Guo-Wei WANG ; Si-Xian WU ; Tao ZHUO ; Yi HE ; Jian-Hang LIU
China Journal of Chinese Materia Medica 2025;50(9):2442-2449
To investigate the mechanism of action of Syngnathus extract in treating knee osteoarthritis of rats, forty-eight male SD rats were randomly divided into the blank group, model group, positive drug group, as well as low-dose, medium-dose, and high-dose groups of Syngnathus extract. The rat model of knee osteoarthritis was constructed by intra-articular injection of sodium iodoacetate. After successful modeling, celecoxib(18 mg·kg~(-1)·d~(-1)) and Syngnathus extract(0.4, 0.8, and 1.6 g·kg~(-1)·d~(-1)) were given in different groups by gavage intervention for two weeks. Hematoxylin-eosin(HE) staining was used to observe the histopathological changes of cartilage in knee joints, and enzyme-linked immunosorbent assay(ELISA) was used to detect the expression level of inflammatory factors in serum. Real-time fluorescence quantitative PCR, Western blot, and immunohistochemistry were used to detect the levels of phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target protein of rapamycin(mTOR) pathway-related mRNA and protein expression. The results showed that, comparied with the blank group, the cartilage surface of the knee joints of rats in the model group was uneven, with disorganized levels and defective cartilage tissue. The serum levels of interleukin-1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) and the mRNA levels of PI3K, Akt, and mTOR in cartilage tissue, as well as the protein expression levels of phosphorylated PI3K(p-PI3K)/PI3K, phosphorylated Akt(p-Akt)/Akt, phosphorylated mTOR(p-mTOR)/mTOR, and P62 were significantly increased. Beclin1 protein expression was decreased. Comparied with the model group, the number of chondrocytes in the knee joint of rats in each group of Syngnathus extract increased, and the arrangement of chondrocytes was relatively neat. The cartilage layer was restored, and the serum levels of IL-1β, IL-6, and TNF-α, as well as the mRNA expression levels of PI3K, Akt, and mTOR in cartilage tissue were significantly reduced. The protein expression levels of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, and P62 were significantly reduced in the rats in the middle-dose and high-dose groups of Syngnathus extract, and the Beclin1 protein expression was significantly increased. The protein expression levels of p-PI3K/PI3K, p-Akt/Akt, and P62 in rats in the low-dose group of Syngnathus extract were significantly reduced. In summary, Syngnathus extract may be used to treat knee osteoarthritis by inhibiting the expression of PI3K/Akt/mTOR signaling pathway, so as to alleviate the inflammatory response in the organism, enhance the autophagy activity of chondrocytes, and reduce the apoptosis of chondrocytes.
Animals
;
TOR Serine-Threonine Kinases/genetics*
;
Male
;
Rats, Sprague-Dawley
;
Signal Transduction/drug effects*
;
Proto-Oncogene Proteins c-akt/genetics*
;
Rats
;
Osteoarthritis, Knee/metabolism*
;
Drugs, Chinese Herbal/administration & dosage*
;
Phosphatidylinositol 3-Kinases/genetics*
;
Humans
8.Mechanism of Quanduzhong Capsules in treating knee osteoarthritis from perspective of spatial heterogeneity.
Zhao-Chen MA ; Zi-Qing XIAO ; Chu ZHANG ; Yu-Dong LIU ; Ming-Zhu XU ; Xiao-Feng LI ; Zhi-Ping WU ; Wei-Jie LI ; Yi-Xin YANG ; Na LIN ; Yan-Qiong ZHANG
China Journal of Chinese Materia Medica 2025;50(8):2209-2216
This study aims to systematically characterize the targeted effects of Quanduzhong Capsules on cartilage lesions in knee osteoarthritis by integrating spatial transcriptomics data mining and animal experiments validation, thereby elucidating the related molecular mechanisms. A knee osteoarthritis model was established using Sprague-Dawley(SD) rats, via a modified Hulth method. Hematoxylin and eosin(HE) staining was employed to detect knee osteoarthritis-associated pathological changes in knee cartilage. Candidate targets of Quanduzhong Capsules were collected from the HIT 2.0 database, followed by bioinformatics analysis of spatial transcriptomics datasets(GSE254844) from cartilage tissues in clinical knee osteoarthritis patients to identify spatially specific disease genes. Furthermore, a "formula candidate targets-spatially specific genes in cartilage lesions" interaction network was constructed to explore the effects and major mechanisms of Quanduzhong Capsules in distinct cartilage regions. Experimental validation was conducted through immunohistochemistry using animal-derived biospecimens. The results indicated that Quanduzhong Capsules effectively inhibited the degenerative changes in the cartilage of affected joints in rats, which was associated with the regulation of Quanduzhong Capsules on the thioredoxin-interacting protein(TXNIP)-NOD-like receptor family pyrin domain containing 3(NLRP3)-bone morphogenetic protein receptor type 2(BMPR2)-fibronectin 1(FN1)-matrix metallopeptidase 2(MMP2) signal axis in the articular cartilage surface and superficial zones, subsequently inhibiting cartilage matrix degradation leading to oxidative stress and inflammatory diffusion. In summary, this study clarifies the spatially specific targeted effects and protective mechanisms of Quanduzhong Capsules within pathological cartilage regions in knee osteoarthritis, providing theoretical and experimental support for the clinical application of this drug in the targeted therapy on the inflamed cartilage.
Animals
;
Osteoarthritis, Knee/metabolism*
;
Drugs, Chinese Herbal/administration & dosage*
;
Rats, Sprague-Dawley
;
Rats
;
Male
;
Humans
;
Capsules
;
Female
;
Disease Models, Animal
9.Mechanism of regulating PI3K-Akt signaling pathway and inhibiting chondrocyte apoptosis to improve inflammation levels in rats with knee osteoarthritis by Shenzhuo Decoction.
Ye-Hang WANG ; Hong SONG ; Wang-Qin YU
China Journal of Chinese Materia Medica 2025;50(12):3389-3398
This study aims to investigate the action mechanism of Shenzhuo Decoction(SZT, i.e., Ganjiang Lingzhu Decoction) in treating knee osteoarthritis(KOA). Network pharmacology was used to analyze the key targets of SZT in the treatment of KOA. At the cellular experimental level, primary chondrocytes extracted from rats were used for in vitro validation. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) staining was employed to detect chondrocyte apoptosis in the knee joint. Western blot was performed to analyze the expression of the anti-apoptotic factor(Bcl2), the apoptosis marker gene Bax, and key proteins in the phosphoinositide 3-kinase(PI3K)-protein kinase B(Akt) signaling pathway. In animal experiments, 60 7-week-old male SD rats were used to establish a KOA model and randomly divided into a control group, a KOA model group, high-, medium-, and low-dose SZT groups, and a celecoxib group, with 10 rats in each group. Micro-CT was used to observe changes in bone mineral density and osteophytes at the articular cartilage surface. Hematoxylin-eosin(HE) staining and safranin O-fast green(SFO) staining were used to observe pathological changes in cartilage tissue. Immunohistochemistry was used to detect the expression of inflammatory factor matrix metalloproteinase 13(MMP13) and cartilage marker collagen Ⅱ. Quantitative reverse transcription-polymerase chain reaction(qRT-PCR) was used to detect the expression of chondrocyte marker SRY-box transcription factor 9(SOX9) and inflammatory markers matrix metalloproteinase 9(MMP9), interleukin-6(IL-6), interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α). Cell experiments revealed that SZT effectively improved KOA, and the results of micro-CT and HE and SFO staining showed that compared with the control group, the model group had obvious formation of osteophytes on the joint surface, which became rough, with significant decreases in the trabecular bone volume fraction(BV/TV), trabecular number(Tb.N), and trabecular thickness(Tb.Th) and a significant increase in trabecular spacing(Tb.Sp). The SZT groups had few osteophytes and a smoother joint surface than the model group. Additionally, BV/TV, Tb.N, and Tb.Th were significantly increased, while Tb.Sp was gradually decreased. A SZT-component-KOA target network was constructed to locate the core targets in KOA treatment, which was further validated through in vivo and in vitro animal experiments. The immunohistochemistry results of the pathological section of rat joint tissue showed that compared with the control group, the model group had a significant increase in MMP13 and a decrease in collagen Ⅱ, while SZT could inhibit inflammation and strengthen the protection of collagen Ⅱ in articular cartilage. The qRT-PCR results showed that SZT could significantly inhibit the mRNA expression of IL-6, IL-1β, TNF-α, and MMP9 and upregulate the mRNA level of SOX9. The TUNEL detection results showed that in the lipopolysaccharide(LPS)-induced KOA model group, chondrocyte apoptosis was significantly increased, and the fluorescence intensity was significantly enhanced. SZT, however, significantly reduced the trend of chondrocyte apoptosis and decreased the fluorescence intensity. The Western blot results showed that SZT could effectively inhibit the phosphorylation level of proteins in the PI3K-Akt pathway, reduce the expression of Bax, increase the expression of Bcl2, and inhibit the degradation of SOX9. In conclusion, SZT may alleviate the degenerative damage of KOA by inhibiting the phosphorylated expression of key proteins in the PI3K-Akt signaling pathway, reducing the release of inflammatory factors, and inhibiting chondrocyte apoptosis.
Animals
;
Chondrocytes/metabolism*
;
Drugs, Chinese Herbal/administration & dosage*
;
Male
;
Osteoarthritis, Knee/physiopathology*
;
Rats, Sprague-Dawley
;
Rats
;
Apoptosis/drug effects*
;
Signal Transduction/drug effects*
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Proto-Oncogene Proteins c-akt/immunology*
;
Humans
10.Mechanism of Hippocampus in treatment of knee osteoarthritis based on network pharmacology, molecular docking, and experimental verification.
Tao ZHUO ; Guo-Wei WANG ; Si-Xian WU ; Quan-Wei ZHENG ; Yi HE ; Jian-Hang LIU
China Journal of Chinese Materia Medica 2025;50(14):4026-4036
This study predicts the potential mechanism of Hippocampus in the treatment of knee osteoarthritis(KOA) through network pharmacology, with preliminary verification using molecular docking and animal experiments. The database was used to screen the active chemical components of Hippocampus and the targets of KOA, and Gene Ontology(GO) functional analysis, Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis, and molecular docking were performed on the relevant core targets to preliminarily explore the potential targets and mechanisms of Hippocampus in the treatment of KOA. A rat KOA model was constructed by intra-articular injection of sodium iodoacetate, and the rats were intervened with different doses of Hippocampus decoction and celecoxib. The expression of relevant targets was detected through hematoxylin-eosin(HE) staining, enzyme-linked immunosorbent assay(ELISA), RT-qPCR, and Western blot to further validate the network pharmacology results. A total of 23 drug-like components of the Hippocampus were screened, and 128 common targets with KOA were identified, involving interleukin-17(IL-17) signaling pathway, transcription factor(FoxO) signaling pathway, tumor necrosis factor(TNF) signaling pathway. Molecular docking results showed that the screened core chemical components exhibited good affinity with key targets. HE staining demonstrated that Hippocampus improved the morphology of the cartilage layer. ELISA confirmed that Hippocampus significantly reduced the levels of IL-6 and TNF-α in the serum of KOA rats. Western blot and RT-qPCR analysis showed that Hippocampus significantly reduced the expression of IL-6, TNF-α, matrix metalloproteinase(MMP) 13, IL-17A, nuclear factor κB activator 1(ACT1), tumor necrosis factor receptor-associated factor 6(TRAF6) and nuclear factor κB(NF-κB) in cartilage tissue. The results suggest that Hippocampus can alleviate the degree of joint damage in the KOA rat model induced by sodium iodoacetate. The mechanism of action is related to the inhibition of the IL-17 signaling pathway, reduction of inflammation, and inhibition of extracellular matrix(ECM) degradation.
Animals
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Molecular Docking Simulation
;
Rats
;
Drugs, Chinese Herbal/administration & dosage*
;
Network Pharmacology
;
Male
;
Osteoarthritis, Knee/metabolism*
;
Rats, Sprague-Dawley
;
Signal Transduction/drug effects*
;
Humans
;
Interleukin-17/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
Disease Models, Animal
;
Hippocampus/chemistry*


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