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OBJECTIVE: To investigate the clinical application of Tripterygii Radix,evaluate the safety of clinical medication,so as to provide references for the rational application of Tripterygii Radix. METHODS: A total of 510 prescriptions containing Tripterygii Radix for internal application were collected from the outpatient department of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from Jan. 2020 to Jun. 2021. The clinical application of Tripterygii Radix was statistically analyzed from the basic information of patients,clinical diagnosis,departments,decocting methods,dosage and compatibility of medicinal materials. RESULTS: Totally 510 prescriptions containing Tripterygii Radix were used for 510 patients,of which 334 cases were female patients,about1. 90 times as many as male patients（ 176 cases）; most patients were > 40 to 60 years,totally 219 cases（ 42. 94%）.The largest number of prescriptions containing Tripterygii Radix were issued by Mingyitang,with 314 prescriptions（ 61. 57%）. The clinical diagnosis of prescriptions containing Tripterygii Radix was mainly arthralgia syndrome（ 152 prescriptions,29. 80%）. In terms of dosage and decoction,90. 98% of prescriptions（ 464 prescriptions） had a dosage of Tripterygii Radix ≤ 15 g,while the proportion of decocting firstly was only 1. 76%（ 9 prescriptions）.CONCLUSIONS: Tripterygii Radix is highly toxic. Therefore,traditional Chinese medicine pharmacists should strictly formulate the review and approval system for off-label application of Tripterygii Radix,and monitor the medication of patients to ensure the safety of clinical medication. [ABSTRACT FROM AUTHOR]

Tripterygii Radix exhibits good clinical efficacy and safety in rheumatoid arthritis (RA) patients, but its effective components and mechanism of action are still unclear. The purpose of this study was to explore and verify the major ingredients and molecular targets of Tripterygii Radix in RA using drug-compounds-biotargets-diseases network and protein-protein interaction (PPI) network analyses. The processes and pathways were derived from Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. The most important compounds and biotargets were determined based on the degree values. RA fibroblast-like synoviocytes (RA-FLS) were separated from RA patients and identified by hematoxylin and eosin (HE) staining and immunohistochemistry. The purity of RA-FLS was acquired by flow cytometry marked with CD90 or VCAM-1. RA-FLS were subjected to control, dimethyl sulfoxide (control), kaempferol, or lenalidomide treatment. Cell migration was evaluated by the transwell assay. The relative expression of biotarget proteins and cytokines was analyzed by western blotting and flow cytometry. In total, 144 chemical components were identified from Tripterygii Radix; kaempferol was the most active ingredient among 33 other components. Fourteen proteins were found to be affected in RA from 285 common biotargets. The tumor necrosis factor (TNF) signaling pathway was predicted to be one of the most latent treatment pathways. Migration of RA-FLS was inhibited and the expression of protein kinase B (AKT1), JUN, caspase 3 (CASP3), TNF receptor 1 and 2 (TNFR1 and TNFR2), interleukin-6 (IL-6), and TNF-α was significantly affected by kaempferol. Thus, this study confirmed kaempferol as the effective component of Tripterygii Radix against RA-FLS and TNF signaling pathway and its involvement in the regulation of AKT1, JUN, CASP3, TNFR1, TNFR2, IL-6, and TNF-α expression.

Tripterygii Radix exhibits good clinical efficacy and safety in rheumatoid arthritis (RA) patients, but its effective components and mechanism of action are still unclear. The purpose of this study was to explore and verify the major ingredients and molecular targets of Tripterygii Radix in RA using drug-compounds-biotargets-diseases network and protein-protein interaction (PPI) network analyses. The processes and pathways were derived from Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. The most important compounds and biotargets were determined based on the degree values. RA fibroblast-like synoviocytes (RA-FLS) were separated from RA patients and identified by hematoxylin and eosin (HE) staining and immunohistochemistry. The purity of RA-FLS was acquired by flow cytometry marked with CD90 or VCAM-1. RA-FLS were subjected to control, dimethyl sulfoxide (control), kaempferol, or lenalidomide treatment. Cell migration was evaluated by the transwell assay. The relative expression of biotarget proteins and cytokines was analyzed by western blotting and flow cytometry. In total, 144 chemical components were identified from Tripterygii Radix ; kaempferol was the most active ingredient among 33 other components. Fourteen proteins were found to be affected in RA from 285 common biotargets. The tumor necrosis factor (TNF) signaling pathway was predicted to be one of the most latent treatment pathways. Migration of RA-FLS was inhibited and the expression of protein kinase B (AKT1), JUN, caspase 3 (CASP3), TNF receptor 1 and 2 (TNFR1 and TNFR2), interleukin-6 (IL-6), and TNF-α was significantly affected by kaempferol. Thus, this study confirmed kaempferol as the effective component of Tripterygii Radix against RA-FLS and TNF signaling pathway and its involvement in the regulation of AKT1, JUN, CASP3, TNFR1, TNFR2, IL-6, and TNF-α expression. [ABSTRACT FROM AUTHOR]