The Effect On Rheumatoid Arthritis Treated With Abrotani Herba

Objective:To observe the curative effect and explore mechanism of action by abrotani herba in rheumatoid arthritis.Methods:1.The Clinical Observation of Rheumatoid Arthritis treated with Abrotani herba:50 patients were randomly averagely divided into 2 groups, the controlled and the treated group.All patients were treated with Diclofenac enteric coated tablet and MTX for 12 weeks.At the same time, the patients in treated group were given abrotani herba.The clinical symptoms,objective signs and laboratory's datas after and before treatment were evaluated between the two groups.Levels of IL-6,TNF-a and IL-10 between the two groups were detected by sandwich Enzyme-linked immunosorbent assay(ELISA).2.Artesunate(ART) make a difference to Fibroblast-like synoviocytes(FLS) in vitro culture.FLS was disassociated and cultivated.(1) FLS were incubated with 12.5μg /ml ART,20μg /mlMTX,mixture of ART and MTX for 48h.ELISA was applied to detect the levels of CCL5,TNF-α,IL-6 in the cell culturation clear supematant.(2) FLS were incubated with 3.125,6.25,12.5,25,50μg/ml ART for 48h.MTT was applied to detect the inhibition ratio of ART on the growth of FLS.(3) FLS were incubated with 3.125,6.25,12.5,25,50μg /ml ART for 24h,and were incubated with 12.5μg /ml ART for 8,24,48h,Flow cytometry was applied to detect the apoptosis of FLS. Results:1.The Clinical Observation of Rheumatoid Arthritis treated with Abrotani herba:(1) After the clinical treatment 12 weeks,the effective rate of the treated group was 96%,otherwise the controlled group was 72%,the effective rate was significant different between the two groups(P＜0.05). The treated and the controlled group can improve clinical symptoms and objective signs,decrease laboratory's datas,the effective rate was significant different between the two groups(P＜0.05).Levels of ESR,CRP,RF in the blood serum of RA patients of the treated group were markedly decreased compared with the controlled group(P＜0.05).(2) Levels of TNF-a,IL-6 in the blood serumof RA patients of the treated group were decreased,level of IL-10 was increased,the effective rate was significant different after and before treatment.Leves of IL-6 and IL-10 of the controlled were significant different after and before treatment(P＜0.05),while the level of TNF-a was not remarkable different(P＞0.05);otherwise no significant difference was found between the three cell factors of the two groups(P＞0.05).2 ART make a differenceon to FLS in vitro culture:(1)To make a difference to the level of cell factor:Different medicine were found to markedly decrease the levels of CCL5,TNF-α,IL-6 in RA synoviocytes,the effective rate was significant different compare with the controlled(P＜0.05);mixture of ART and MTX was found to markedly decrease the levels of the three cell factors,the effective rate was significant different compare with MTXand ART(P＜0.05).(2) To make a difference on FLS proliferation:Different concentration ART presented remarkerable inhibitory action on FLS proliferation,Moreover,the inhibition ratio of ART appeared to be in a dosage dependent manner at the concentration ranging from 3.125-50μg /ml.(3)To make a difference on FLS apoptosis:Different concentration ART were found to promot apoptosis on FLS.The apoptosis ratio of FLS was markedly increased compared with the controlled group(P＜0.05). Moreover,Art appeared to be in a dosage dependent manner at the concentration ranging from 3.125-50μg /ml;the apoptosis effect of Art appeared to be in a time dependent manner at the time ranging from 8h～48h.Conclusion:The curative effect of Abrotani herba combined with Methotrexate was remarkable on patients with rheumatoid arthritis.The mechanism of action may be realized through these links as follows decrease the levels of pro-inflammation cytokine,inhibite FLS proliferation and advance FLS apoptosis.