The study was aimed to conduct an evidence-based evaluation on the safety of Tripterygium wilfordii(TW) preparations through a method combined bibliometrics research with evidence-based evaluation research， to provide evidence-based safety information of the TW preparations(nephrotoxicity) for the government decision-making and clinical application， and to provides methods and suggestions for evaluating nephrotoxicity of Chinese herbal medicine(CHM) in the future. We searched relevant databases at home and abroad systematically， and six Chinese and English databases including CNKI， SinoMed， VIP， WanFang， PubMed， and Cochrane library were comprehensively searched. All types of research documents about the safety of TW preparations. Literature were screened and extracted based on inclusion and exclusion criteria. The methodology quality of all included studies were assessed by internationally recognized evaluation tools or standards. The incidence rate was analyzed by using R software. Subgroup analysis were conducted according to the type of disease treated， drug delivery way， medication time， and study types.
Bibliometrics ; Drugs, Chinese Herbal ; standards ; Tripterygium

On the basis of the previous work of the research group, the orthogonal design method was further used to optimize the processing technology for reducing toxicity of fried Tripterygium wilfordii in Lysimachia christinae Decoction. A total of 9 processed products of T.wilfordii in L.christinae decoction were prepared by four factors and three levels orthogonal design table. The contents of triptolide in T.wilfordii were determined by high performance liquid chromatography(HPLC) before and after processing: 4.27, 3.92, 3.57, 2.75, 2.42, 2.66, 3.51, 1.87, 1.75, 2.03 μg·g~(-1). On this basis, the above processed products were orally given to mice for 28 days. 12 hours after the last administration, food fasting except water was provided, and 24 hours later, the eyeballs were taken for blood and liver tissue. Serum biochemical indexes, liver lipid peroxidation and antioxidant related indexes were detected by kit method. Twenty-eight days after oral administration of raw T.wilfordii, the levels of serum alanine aminotransferase(AST), alanine aminotransferase(ALT), alkaline phosphatase(ALP) and liver malondialdehyde(MDA) in mice increased by 91%(P<0.01), 46%(P<0.05), 73%(P<0.01) and 99%(P<0.01), while the liver antioxidant indexes such as superoxide dismutase(SOD), glutathione(GSH), glutathione peroxidase(GPX) and glutathione-S transferase(GST) significantly decreased(P<0.01). After administration of the processed products, the above indexes were significantly reversed(P<0.01 or P<0.05). Especially, the processing conditions of A_3B_2C_1D_3 had the best detoxification effect on T.wilfordii, which decreased the high levels of AST, ALT, ALP and MDA by 49%(P<0.01), 32%(P<0.01), 42%(P<0.01), and 17%(P<0.05). Therefore, the best processing conditions for T.wilfordii in L.christinae decoction were A_3B_2C_1D_3, namely "15% mass fraction of L.christinae, 1 h moistening time, 160 ℃ frying temperature, and 9 min frying time".
Animals ; Antioxidants ; Liver ; Mice ; Primulaceae ; Technology ; Tripterygium

A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.
Blood Cells ; drug effects ; Hemoglobins ; analysis ; Humans ; Tripterygium ; adverse effects

OBJECTIVETo investigate the extraction method of polyglycosides from Tripterygium wilfordii.

METHODThe extraction method of pressurized liquid extraction was employed and chromogenic colorimetric technique were used for quantitative analysis. Based on the single-factor experiment, according to the center combination design this paper used three factors and three levels of response surface methodology for process optimization.

RESULTThe optimized conditions were as follows: ratio of solid to liquid was 1:9.5, at the temperature of 115 degrees C for 80 minutes, the actual extract ratio and purity of polyglycosides obtained were 0.21% and 0.52%, respectively.

CONCLUSIONThe method of pressurized liquid extraction has obvious advantages over conventional reflux extracting.

Glycosides ; isolation & purification ; Plant Extracts ; chemistry ; Pressure ; Tripterygium ; chemistry

Tripterygium wilfordii preparations,with various biological activities such as immunosuppressive,anti-inflammatory and anti-cancer effects,are widely used in the treatment of autoimmune diseases such as rheumatoid arthritis,lupus erythematosus,and nephrotic syndrome. They have definite therapeutic effect,but often cause serious adverse reactions and result in damages to liver,kidney,blood,reproduction,and other systems due to their complex compositions,great toxicity,and narrow margin between the toxic and therapeutic dosages. At present,T. wilfordii preparations produced by different manufacturers exhibit large variations in clinical efficacy and side effects in account of their different chemical compositions and quality fluctuation due to differences in raw materials and production process. However,the existing quality standards are controversial in terms of index components and content limit,which cannot be effectively used for the overall quality control of the preparations. In this paper,the research progress on chemical constituents,quality standard and quality control methods of four T. wilfordii preparations including Tripterygium Tablets,Tripterygium Zongtie Tablets,Tripterygium Shuangceng Tablets and Tripterygium Glycosides Tablets was reviewed,in order to provide ideas and reference for the quality improvement of this type of preparations.
Drugs, Chinese Herbal ; standards ; Quality Control ; Tablets ; Tripterygium ; chemistry

As entering a new era,our country has introduced a series of favorable policies,which may provide the powerful and new momentum for the development of traditional Chinese medicine( TCM). However,more and more attentions have been paid to the safety and effectiveness of TCM. Tripterygium wilfordii Hook.f. is one of Chinese herbs with clinical efficacy and safety risk. In recent years,accumulating groups have carried out a series of exploratory studies on the clinical rational use of T. wilfordii-related preparations. Considering this situation,the goal of this special issue is to bring together a collection of original research and review articles addressing the expanding field of T. wilfordii. The special issue covers the clinical application,pharmacodynamics,toxicology,pharmacodynamics,resource identification and molecular pharmacognosy of T. wilfordii-related preparations. It focuses on the multi-disciplinary collaborative innovation,and may provide a stimulating resource for the fascinating subject of the safe and rational use of TCM,as well as have important practical significance and promotion value for the healthy development of TCM industry.
Drugs, Chinese Herbal ; standards ; Medicine, Chinese Traditional ; Tripterygium

This study systematically searched CNKI and Web of Science(WoS) for the research papers on the toxicity of Tripterygium wilfordii included from database inception to August 31, 2021, and visually displayed the authors, research institutions, keywords, and other contents using bibliometrics and CiteSpace 5.8.3. Furthermore, the current situation and research progress on T. wilfordii safety were also analyzed based on information extraction to find the research hotspot, evolution path, and development trend, and to provide references for future research. A total of 1 876 Chinese papers and 243 English papers were included in the study. The analysis of authors showed that WANG Qi and ZHANG Luyong had the most publications in Chinese and English papers, respectively. According to the analysis of research institutions, National Institutes for Food and Drug Control and China Pharmaceutical University possessed the largest number of Chinese and English papers, respectively, but there was less cooperation between them. The analysis of keywords in Chinese and English papers showed that the research contents of the safety of T. wilfordii mainly focused on clinical monitoring, mechanism, dosage form improvement, quality standard, component analysis, monomer research, efficiency and toxicity reduction, etc. Metabonomics, tripterine, and the underlying mechanism of toxicity were the research hotspots in the future. At present, the research on the toxicity of T. wilfordii is still under development. It is necessary to highlight the in-depth research and strengthen the inter-group and inter-region cooperation of authors or institutions to provide references for the research on the toxicity of T. wilfordii.
Bibliometrics ; China ; Drugs, Chinese Herbal/toxicity* ; Humans ; Tripterygium

Aged ; Drugs, Chinese Herbal ; Humans ; Male ; Pemphigoid, Bullous ; drug therapy ; Psoriasis ; drug therapy ; Tripterygium ; chemistry

OBJECTIVETo investigate the total alkaloids content profile and diversity of medicinal materials of Tripterygium.

METHODThe total alkaloids were extracted by organic solvent and purified by column chromatography (aluminium oxide), and determined by UV spectrometry.

RESULT AND CONCLUSIONThe total alkaloids content in phloem was 2 to 5 times richer than that in xylem, and their changes had shown concordance. For the different species/types, the content from high to low in order was T. hypoglaucum, Tripterygium F, T. wilfordii and T. regellii, but in each type, the disparity among different populations content was very small. The populations with higher content were in Suichuan, Jiangxi Province, Huangshan, Anhui Province, Jingning, Zhejiang Province and Kunming, Yuannan Province; which came from T. hypoglaucum and Tripterygium F. The degree of difference of total alkaloids content among individuals in each population was different. The populations, which had a rich content diversity, were in Jingning, Zhejiang Province, Taining, Fujian Province and Kunming, Yunnan Province. They will be used for good germplasm selecting. The thickness of medicinal materials did not affect the total alkaloids content in the same plant. The total alkaloids content in xylem changed with seasons: the highest in March, then declining from June to December, the lowest in December, While this did not happen in phloem.

Alkaloids ; analysis ; chemistry ; China ; Drugs, Chinese Herbal ; chemistry ; Seasons ; Tripterygium ; chemistry

OBJECTIVETo explore the effects of high dose glycosides of Tripterygium wilfordii Hook. f (GTW) on the fertility of young rats.

METHODSFifty female SD young rats and 50 male SD young rats were randomly divided into the blank group and the GTW group, 25 in each. GTW was given at the daily dose of 9 mg/kg. After 12 weeks of medication, the male rats were caged together with healthy adult female rats in the ratio of 1:1. The female rats were caged together with healthy adult male rats in the ratio of 2:1. The cage process lasted for two weeks, totally for three times. The pregnant rate of female rats and the survival rate of baby rats were then observed.

RESULTSThere was no significant difference in the pregnant rate or the survival rate of baby rats in the GTW group.

CONCLUSIONHigh dose GTW showed no obvious effects on the fertility of adult rats or the growth and development of new born rats.

Animals ; Female ; Fertility ; drug effects ; Glycosides ; administration & dosage ; pharmacology ; Male ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Tripterygium