This study performed to observe the effect of Yiqi Jianpi Shengjin recipe on Tfr/Tfh cell balance and autophagy expression in primary Sj?gren's syndrome(pSS)patients,and to explore the intervention mechanism of Yiqi Jianpi Shengjin recipe in treating pSS.We collected 60 cases of pSS with deficiency of both qi and yin from the Department of Rheumatology and Immunology of Anhui Provincial Hospital of TCM and randomly grouped them into experimental group and control group,with each group consisting of 30 cases.The control group was given a dose of hydroxychloroquine sulphate 0.2 g bid,the experimental group received an additional oral dose of Yiqi Jianpi Shengjin formula on top of the control group's treatment,and both continued to take it for 12 weeks.IL-10,IL-21 and IL-6 levels were measured by enzyme-linked immunosorbent assay,Tfh and Tfr cells ratios were measured by Flow cytometry,Western blot was used to detect the protein expression of Atg5,Beclin1 and LC3-Ⅱ/Ⅰ,and qPCR was used to detect the RNA expression of Atg5,Beclin1 and LC3.The indexes of inflammation,dryness,ESSPRI,ESSDAI and TCM syndrome integral before and after treatment were statistically analyzed.Data showed that the scores of corneal fluorescence stainin g in the experimental group were significantly lower and the static saliva flow rate was significantly higher compared with the control group.The experimental group showed a marked reduction in TCM,ESSPRI and ESSDAI score after treatment compared to control group.The expression of IL-21,IL-10 and IgG in the experimental group was markedly lower compa red with the control group.Tfr cells were significantly lower in the experimental group as compared to the control group.T he expression and ratio of autophagy protein and mRNA in the experimental group were significantly lower compared with t he control group.In conclusion,Yiqi Jianpi Shengjin recipe can effectively reestablish the balance of Tfr/Tfh cells,regulate cytokines,inhibit autophagy and activity,relieve clinical symptoms,delay disease activity,and improve the secretion of lacrimal gland and salivary gland.

The aim of this study is to investigate the mechanism by which triptolide(TP)ameliorates inflammation in adjuvant arthritis(AA)rats by inhibiting pyroptosis through the lncRNA GAS5/miR-21/TLR4 signaling axis.Rats were divided into 4 groups:normal control group(NC),model control group(MC),triptolide group(TP)and methotrexate group(MTX),with 6 rats in each group.The AA rat model was established,and the general state,right foot-plantar swelling and arthritis index were observed;HE staining was used to detect the histopathological morphology of synovial joints of rats in each group;ELISA was used to detect the levels of inflammatory factors IL-1β,IL-6,IL-18 and TNF-α;fluorescence quantitative PCR was used to detect the mRNA expression levels of Caspase-1,IL-1β,NLRP3,GSDMD,GAS5,TLR4,NF-κB and miR-21;and Western blot was used to detect the expression levels of Caspase-1,NLRP3,GSDMD,NF-κB,Caspase-4 and TLR4 proteins.Compared with the NC group,rats in the MC group showed significantly higher levels of swelling,arthritis index(P<0.05)and inflammatory cell infiltration;compared with the MC group,the levels of IL-1β,IL-6,IL-18 and TNF-α were decreased in the TP and MTX groups(P<0.05),and the levels of Caspase-1,IL-1β,NLRP3,GSDMD,TLR4,NF-κB,miR-21 mRNA expression decreased,GAS5 mRNA expression increased(P<0.05),and the protein levels of Caspase-1,NLRP3,GSDMD,NF-κB,Caspase-4 and TLR4 decreased(P<0.05);compared with the MTX group,the TP group showed lower levels of IL-1β,IL-6,IL-18,TNF-α(P<0.05),and lower expression levels of Caspase-1,IL-1β,NLRP3,GSDMD,TLR4,NF-κB and miR-21 mRNA(P<0.05).In conclusion,triptolide may inhibit the production of pro-inflammatory factors and inhibit pyroptosis through the lncRNA GAS5/miR-21/TLR4 signaling axis,thus ameliorate inflammation in AA rats.