Beneficial effects of tripterygium glycosides tablet on biomarkers in patients with ankylosing spondylitis

Ji,Wei; Chen,Yajun; Zhao,Xia; Guo,Yunke; Zhong,Lingyu; Li,Honggang; Wang,Dan; Song,Yanna

doi:10.3892/mmr.2015.3448

Beneficial effects of tripterygium glycosides tablet on biomarkers in patients with ankylosing spondylitis

Authors:
- Wei Ji
- Yajun Chen
- Xia Zhao
- Yunke Guo
- Lingyu Zhong
- Honggang Li
- Dan Wang
- Yanna Song
View Affiliations

Affiliations: Department of Rheumatology, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China, Department of Rheumatology and Immunology, Zhuzhou City Hospital, Zhuzhou, Hunan 412000, P.R. China, Department of Tuberculosis, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, P.R. China, Department of Immunity, Nanjing Jiangbei People's Hospital, Nanjing, Jiangsu 210048, P.R. China
Published online on: March 6, 2015 https://doi.org/10.3892/mmr.2015.3448
Pages: 684-690

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the current study was to explore the effects and possible mechanisms of tripterygium glycosides tablet (TGT) in the treatment of active ankylosing spondylitis (AS). Thirty‑six patients with active AS were given a 20 mg TGT treatment three times per day for 12 weeks, and 21 unrelated healthy controls were recruited as the control group. Efficacy measures included the Bath AS disease activity index (BASDAI), erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP) prior and subsequent to TGT treatment. Serum dickkopf homolog 1 (DKK1) and interleukin-17 (IL‑17) levels before and after TGT treatment were assessed using reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) and ELISA assay. The levels of several serum biomarkers were determined by ELISA, including receptor activator of nuclear factor κ‑B ligand (RANKL), osteoprotegerin (OPG), bone alkaline phosphatase (BAP), bone morphogenetic protein‑2 (BMP‑2), matrix metalloproteinase‑3 (MMP‑3), cross‑linked telopeptide of type II collagen (CTX‑II), vascular endothelial growth factor (VEGF), and prostaglandin E2 (PGE2). After 12 weeks of TGT treatment, the BASDAI score of the patients was significantly reduced (P<0.05), their levels of ESR and CRP were significantly reduced to a normal level (P<0.05, P<0.05), RT‑PCR and ELISA showed a significant increase in the level of DKK1 expression (P<0.05) and a significant decreased IL‑17 expression (P<0.05), there was a significant increase in the expression of OPG, BAP and BMP‑2 (P<0.01, P<0.01, P<0.01) and a significant reduction in the expression levels of RANKL, CTX‑II. MMP‑3, PGE2, and VEGF (P<0.01, P<0.01, P<0.01, P<0.05, P<0.01) compared with those of the controls. TGT is effective at improving the signs and symptoms of patients with AS through the regulation of serum biomarkers, and the mechanisms may be associated with the anti‑inflammatory effect, inhibition of new bone formation and potential bone‑protective effects.

View Figures

View References

1	Rolle AS, Zimmermann B and Poon SH: Etanercept-induced Henoch-Schönlein purpura in a patient with ankylosing spon-dylitis. J Clin Rheumatol. 19:90–93. 2013. View Article : Google Scholar : PubMed/NCBI
2	Braun J and Sieper J: Ankylosing spondylitis. Lancet. 369:1379–1390. 2007. View Article : Google Scholar : PubMed/NCBI
3	Calin A, Brophy S and Blake D: Impact of sex on inheritance of ankylosing spondylitis: a cohort study. Lancet. 354:1687–1690. 1999. View Article : Google Scholar : PubMed/NCBI
4	Ng SC, Liao Z, Yu DT, et al: Epidemiology of spondyloarthritis in the people’s republic of china: review of the literature and commentary. Semin Arthritis Rheum. 37:39–47. 2007. View Article : Google Scholar : PubMed/NCBI
5	Rubin LA, Amos CI, Wade JA, et al: Investigating the genetic basis for ankylosing spondylitis: linkage studies with the major histocompatibility complex region. Arthritis Rheum. 37:1212–1220. 1994. View Article : Google Scholar : PubMed/NCBI
6	Zeng QY, Chen R and Darmawan J: Rheumatic diseases In China. Arthritis Res Ther. 10:172008. View Article : Google Scholar
7	Zochling J and Smith EU: Sero negative spondyloarthritis. Best Pract Res Clin Rheumatol. 24:747–756. 2010. View Article : Google Scholar
8	Reveille JD: Epidemiology of spondyloarthritis in North America. Am J Med Sci. 341:284–286. 2011. View Article : Google Scholar : PubMed/NCBI
9	Wendling D, Cedoz JP, Racadot E, et al: Serum IL-17, BMP-7 and bone turnover markers in patients with ankylosing spondylitis. Joint Bone Spine. 74:304–305. 2007. View Article : Google Scholar : PubMed/NCBI
10	Mei Y, Pan F, Gao J, et al: Increased serum IL-17 and IL-23 in the patient with ankylosing spondylitis. Clin Rheumatol. 30:269–273. 2011. View Article : Google Scholar
11	Goldberger C, Dulak J, Duftner C, et al: Vascular endothelial growth factor (VEGF) in ankylosing spondylitis-a pilot study. Wien Med Wochenschr. 152:223–225. 2002. View Article : Google Scholar
12	Samoto H, Shimizu E, Matsuda-Honjyo Y, et al: Prostaglandin E2 stimulates bone sialoprotein (BSP) expression through cAMP and fibroblast growth factor 2 response elements in the proximal promoter of the rat BSP gene. J Biol Chem. 278:28659–28667. 2003. View Article : Google Scholar : PubMed/NCBI
13	Daoussis D, Liossis SN, Solomou EE, et al: Evidence that DKK-1 is dysfunctional in ankylosing spondylitis. Arthritis Rheum. 62:150–158. 2010. View Article : Google Scholar
14	Maksvmowych WP, Landewé R, Conner-Spady B, et al: Serum matrix metalloproteinase 3 is an independent predictor of structural damage progression in patients with ankylosing spon-dylitis. Arthritis Rheum. 56:1846–1853. 2007. View Article : Google Scholar
15	Christgau S, Garnero P, Fledelius C, et al: Collagen type II C-telopeptide fragments as an index of cartilage degradation. Bone. 29:209–215. 2001. View Article : Google Scholar : PubMed/NCBI
16	Maksvmowych WP: What do biomarkers tell us about the pathogenesis of ankylosing spondylitis? Arthritis Res Ther. 11:1012009. View Article : Google Scholar
17	van der Linden S, Valkenburg HA and Cats A: Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 27:361–368. 1984. View Article : Google Scholar : PubMed/NCBI
18	Garrett S, Jenkinson T, Whitelock HC, et al: A new approach to defining disease status in AS: the bath ankylosing spondylitis disease activity index. J Rheumatol. 21:2286–2291. 1994.PubMed/NCBI
19	Westergren A: Studies of the suspension stability of the blood in pulmonary tuberculosis. Acta Med Scand. 54:247–282. 1921. View Article : Google Scholar
20	Cansu DU, Calışır C, Savaş Yavaş U, et al: Predictors of radio-graphic severity and functional disability in Turkish patients with ankylosing spondylitis. Clin Rheumatol. 30:557–562. 2011. View Article : Google Scholar : PubMed/NCBI
21	Maksymowych WP, Morency N, Conner-Spady B, et al: Suppression of inflammation and effects on new bone formation in ankylosing spondylitis: evidence for a window of opportunity in disease modification. Ann Rheum Dis. 72:23–28. 2013. View Article : Google Scholar
22	Zhang X, Schwarz EM, Young DA, et al: Cyclooxygenase-2 regulates mesenchymal cell differentiation into the osteoblast lineage and is critically involved in bone repair. J Clin Invest. 109:1405–1415. 2002. View Article : Google Scholar : PubMed/NCBI
23	Minear S, Leucht P, Jiang J, et al: Wnt proteins promote bone regeneration. Sci Transl Med. 2:29–30. 2010. View Article : Google Scholar
24	Lories RJ, Daans M, Derese I, et al: Noggin haploinsufficiency differentially affects tissue responses in destructive and remodeling arthritis. Arthritis Rheum. 54:1736–1746. 2006. View Article : Google Scholar : PubMed/NCBI
25	O’Gradaigh D, Ireland D, Bord S, et al: Joint erosion in rheumatoid arthritis: interactions between tumour necrosis factor α, interleukin 1 and receptor activator of nuclear factor κb ligand (RANKl) regulate osteoclasts. Ann Rheum Dis. 63:354–359. 2004. View Article : Google Scholar
26	Chen CH, Chen HA, Liao HT, et al: Soluble receptor activator of nuclear factor-kappab ligand (RANKl) and osteoprotegerin in ankylosing spondylitis: OPG is associated with poor physical mobility and reflects systemic inflammation. Clin Rheumatol. 29:1155–1161. 2010. View Article : Google Scholar : PubMed/NCBI
27	Bao L, Zhu T, Zhao D, et al: Adeno-associated virus-mediated osteoprotegerin gene transfer protects against joint destruction in a collagen-induced arthritis rat model. Joint Bone Spine. 79:482–487. 2012. View Article : Google Scholar
28	Kress BC: Bone alkaline phosphatase: methods of quantitation and clinical utility. J Clin Ligand Assay. 21:139–148. 1998.
29	Park MC, Chung SJ, Park YB, et al: Bone and cartilage turnover markers, bone mineral density and radiographic damage in men with ankylosing spondylitis. Yonsei Med J. 49:288–294. 2008. View Article : Google Scholar : PubMed/NCBI
30	Poddubnyy D, Denis Congad, et al: Predictive and protective value of biomarkers in patients with ankylosing spondylitis who are at high risk of radiographic spinal progression. Arthritis Rheum. 63:13382011.