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Acute Lymphoblastic Leukemia Presenting as Systemic Juvenile Idiopathic arthritis: Experience from Bangladesh

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第1期14卷 1-12页

作者： Manik Kumar Talukder Kamrul Laila Md. Arif Hossain Md. Shafiqul Islam Md. Zahidul Islam Kalyan Benjamin Gomes Mujammel Haque Md. Mahbubul Islam Md. Imnul Islam Department of Paediatrics Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Health Services Dhaka Bangladesh NICVD Dhaka Bangladesh

Background: Acute lymphoblastic leukemia (ALL), the most common paediatric malignancy, is a heterogeneous hematologic disease. ALL patients may present with isolated and persistent osteo-articular complaints, lower incidence of hepatomegaly, splenomegaly or lymphadenopathy without clear laboratory features, and misdiagnosed as systemic juvenile idiopathic arthritis (sJIA). Methods: This was a single center cross sectional study over a period of 4 years. Clinic laboratory profiles of 39 ALL children were compared with 39 age and sex-matched sJIA cases. Result: Among 39 ALL patients 89.7% were initially misdiagnosed as sJIA upon clinical presentation. Majority (66.7%) of ALL patients had oligo-articular joint involvement. In sJIA, small joints of the hands were most commonly involved. The total WBC count was significantly higher in ALL patients (p-value 0.0065). CRP and LDH values between the two groups showed significant differences (p-value 0.00006 and 0.00001 respectively). Conclusion: The presentation of leukemia with arthralgia or arthritis makes the diagnosis difficult for the physicians. The diagnosis of sJIA must be made with caution keeping the possibility of haematological malignancy in mind.

关键词： ALL sJIA arthritis Arthralgia Musculoskeletal

Iron metabolism and arthritis: Exploring connections and therapeutic avenues

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中华医学杂志(英文版) 2024年第14期137卷 2024 Jun 12页

作者： Zhuo Dachun Xiao Wenze Tang Yulong Jiang Shuai Geng Chengchun Xie Jiangnan Ma Xiaobei Zhang Qing Tang Kunhai Yu Yuexin Bai Lu Zou Hejian Liu Jing Wang Jiucun Department of Rheumatology Shanghai Pudong Hospital Human Phenome Institute Zhangjiang Fudan International Innovation Center Fudan University Shanghai China State Key Laboratory of Genetic Engineering School of Life Science Fudan University Shanghai China Department of Vascular Surgery Shanghai Pudong Hospital Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling Fudan University Pudong Medical Center Shanghai China Department of Anthropology and Human Genetics School of Life Sciences Ministry of Education Key Laboratory of Contemporary Anthropology Fudan University Shanghai China Division of Rheumatology Huashan Hospital State Key Laboratory of Genetic Engineering School of Life Science Fudan University Shanghai China Institute of Rheumatology Immunology and Allergy Allergy and Disease Research Center Fudan University Shanghai China Research Unit of Dissecting the Population Genetics and Developing New Technologies for Treatment and Prevention of Skin Phenotypes and Dermatological Diseases (2019RU058) Chinese Academy of Medical Sciences Beijing China

Iron is indispensable for the viablility of nearly all living organisms, and it is imperative for cells, tissues, and organisms to acquire this essential metal sufficiently and maintain its metabolic stability for survival. Disruption of iron homeostasis can lead to the development of various diseases. There is a robust connection between iron metabolism and infection, immunity, inflammation, and aging, suggesting that disorders in iron metabolism may contribute to the pathogenesis of arthritis. Numerous studies have focused on the significant role of iron metabolism in the development of arthritis and its potential for targeted drug therapy. Targeting iron metabolism offers a promising approach for individualized treatment of arthritis. Therefore, this review aimed to investigate the mechanisms by which the body maintains iron metabolism and the impacts of iron and iron metabolism disorders on arthritis. Furthermore, this review aimed to identify potential therapeutic targets and active substances related to iron metabolism, which could provide promising research directions in this field.

关键词： Iron metabolism arthritis Inflammation Immunity Rheumatoid arthritis Psoriatic arthritis Gouty arthritis

Anti-inflammatory Effect of Polysaccharide from Embelia parviflora *** Rheumatoid arthritis in Rats

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Medicinal Plant 2024年第3期15卷 41-44页

作者： Jiangcun WEI Yong CHEN Xiumei MA Meiyan QIU Bing QING Leimin JIANG Wen ZHONG Zujie QIN Guangxi International Zhuang Medicine Hospital Nanning 530201China Guangxi University of Chinese Medicine Nanning 530200China

[Objectives]To investigate the anti-inflammatory effect of Embelia parviflora *** on rheumatoid arthritis(RA)in rats.[Methods]RA rat model was induced by type II *** successful modeling,the rats were divided into model group,positive group,low,medium and high dose of *** *** groups,and normal control *** mass,toe volume and arthritis index were measured,and thymus index and spleen index were *** levels of interleukin-1β,interleukin-6 and tumor necrosis factor-αin serum and synovial tissue of ankle joint were detected by ELISA.[Results]Compared with the normal control group,the pathological changes such as synovial hyperplasia and unclear layer were observed in the model group,the body mass was decreased(Parthritis index,thymus and spleen index were increased(Parthritis index,thymus index and spleen index were decreased(P0.05).[Conclusions]*** *** can reduce the body's inflammatory response and improve RA,which may be related to the inhibition of the activation of inflammatory cytokines IL-1β,IL-6 and TNF-α.

关键词： Polysaccharide from Embelia parviflora Wall. Rheumatoid arthritis (RA) Anti-inflammatory effect

Electroacupuncture stimulating Zusanli(ST36),Sanyinjiao(SP6)in mice with collagen-induced arthritis leads to adenosine A2A receptor-mediated alteration of p38αmitogen-activated protein kinase signaling and inhibition of osteoclastogenesis

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Journal of Traditional Chinese Medicine 2023年第6期43卷 1103-1109页

作者： DU Zhongheng CONG Wenjie TANG Kejing ZHENG Qiqi SONG Zhiwei CHEN Yong YANG Su ZHANG Chunwu YE Tianshen Department of Acupuncture the First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000China Department of Traditional Chinese Orthopedics&Traumatology the First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000China Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research the First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000China

OBJECTIVE:To observe the effect of electroacupuncture(EA)stimulating Zusanli(ST36),Sanyinjiao(SP6)on inhibition of osteoclastogenesis and the role of the adenosine A2A receptor(A2AR)and the p38αMitogen-Activated Protein Kinase(MAPK)signaling pathway in mediating this ***:Mice with collagen induced arthritis(CIA)received different *** and western blotting were used to determine the levels of multiple signaling molecules in these joints[receptor activator of nuclear transcription factor-κB(NF-κB)ligand(RANKL),receptor activator of NF-κB(RANK),tumor necrosis factor receptor associated factor 6(TRAF6),p38α,NF-κB,and nuclear factor of activated T cells C1(NFATc1)].Osteoclasts were identified using tartrate-resistant acid phosphatase(TRAP)***:The immunohistochemistry results indicated upregulation of p38α,NF-κB,and NFATc1 in the CIA-control and CIA-EA-SCH58261 groups,but reduced levels in the CIA-EA *** blotting indicated upregulation of RANKL,RANK,TRAF6,p38α,NF-κB,and NFATc1 in the CIA-control and CIA-EA-SCH58261 groups,but reduced expression in the CIA-EA *** were more abundant in the CIA-control and CIA-EA-SCH58261 groups than in the CIA-EA ***:EA treatment enhanced the A2AR activity and inhibited osteoclast formation by inhibition of RANKL,RANK,TRAF6,p38α,NF-κB,and ***58261 reversed the effect of *** results suggest that EA regulated p38α-MAPK signaling by increasing A2AR activity,which inhibited osteoclastogenesis.

关键词： electroacupuncture arthritis experimental receptor adenosine A2A mitogen-activated protein kinases signal transduction osteoclasts

Effect of moxibustion on autophagy and the inflammatory response of synovial cells in rheumatoid arthritis model rats

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Journal of Traditional Chinese Medicine 2022年第1期42卷 73-82页

作者： HAO Feng WANG Qiang LIU Lei WU Libin CAI Ronglin SANG Jiajia HU Jun WANG Jie YU Qing HE Lu SHEN Yingchao MIAO Yiming HU Ling WU Zijian College of Acupuncture-moxibustion and Tuina Nanjing University of Chinese MedicineNanjing 210023China Translational Medicine Research Center of Nanjing University of Chinese Medicine Nanjing 210023China Changshu Hospital Affiliated to Nanjing University of Chinese Medicine Changshu 215500China College of Acupuncture-moxibustion and Tuina Anhui University of Chinese MedicineHefei 230012China Institute of Acupuncture and Meridian Anhui Academy of Chinese MedicineHefei 230038China Affiliate Hospital of Nanjing University of Chinese Medicine/Jiangsu Province of Chinese Medicine Nanjing 210029China the first clinical medical college of Nanjing University of Chinese Medicine Nanjing 210029China

OBJECTIVE:To investigate the effect of moxibustion on synovitis and the autophagy of synoviocytes in rheumatoid arthritis(RA).METHODS:Forty Sprague-Dawley rats were randomly divided into a normal group,model group,moxibustion group,cigarette moxibustion group,and medicine group,with eight rats included in each *** RA model was established by subcutaneous injection of complete Freund's adjuvant into the left posterior *** in the model group were not interfered *** the moxibustion group,rats were treated by moxibustion,where a 1-cm diameter moxa stick was applied at the left Zusanli(ST 36)*** distance of the moxa stick to the skin was 2 cm and moxibustion was completed for 20 min daily for 15 d *** the cigarette moxibustion group,the moxa stick was replaced by a common *** the medicine group,rats were treated with a tripterygium glycoside suspension(8 mg/kg)once a day for 15 d *** each group,the left hind limb toe volume was measured with a toe volume meter;the synovial cells were observed by hematoxylin and eosin staining;the interleukin(IL)-4,IL-6,IL-10,IL-1β,IL-23,IL-17,and tumor necrosis factor(TNF)-αlevels in serum were measured by enzyme-linked immunosorbent assay;the erythrocyte sedimentation rate(ESR)were detected by Westergren sedimentation rate testing;the C-reactive protein(CRP)and rheumatoid factor(RF)levels in serum were detected by rate nephelometry;the expression levels of ULK1,autophagy-associated protein(Atg)3,Atg5,and Atg12 messenger RNA(m RNA)in synovium were detected by real time-quantitative polymerase chain reaction(RT-q PCR);and the protein expression levels of phosphatidylinositol-3-kinase(PI3K),protein kinase B(Akt),mammalian target of rapamycin(mTOR),LC3-Ⅱ,beclin-1,phosphorylated-PI3K(p-PI3K),p-Akt,p-mTOR in synovium were detected by Western ***:Among the RA model rats,joint swelling,an inflammatory reaction,and the proliferation of synovial tissue were obvious and the signal of the PI3K/Ak

关键词： moxibustion arthritis rheumatoid synovitis autophagy

Efficacy of electroacupuncture stimulating Zusanli(ST36)and Xuanzhong(GB39)on synovial angiogenesis in rats with adjuvant arthritis

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中医杂志:英文版 2023年第5期43卷 955-962页

作者： JIANG Jianzhen ZHANG Xin LUO Zhenguo SU Chengguo ZHOU Haiyan JIANG Yuqing XIAO Xianjun CHEN Yunfei ZHU Jun School of Acupuncture-Moxibustion and Tuina Chengdu University of Traditional Chinese MedicineChengdu 610075China Vocational Training Department Acupuncture and Moxibustion School Affiliated to Chengdu University of Traditional Chinese MedicineChengdu 610075China Department of Acupuncture Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China

OBJECTIVE:To investigate the efficacy of electroacupuncture(EA)stimulating Zusanli(ST36)and Xuanzhong(GB39)on synovial angiogenesis in rats with adjuvant arthritis(AA).METHODS:AA models were established by bilateral injection of Freund's complete adjuvant(FCA)in male Sprague-Dawley *** days after injection,rats were given EA at Zusanli(ST36)and Xuanzhong(GB39)acupoints,once every other day,for 16 *** arthritis index score,paw volume,and hematoxylin-eosin(HE)staining was performed for each *** marker cluster of differentiation 34(CD34)expression and synovial cell apoptosis in synovial tissue were *** levels of Notch1,hairy and enhancer of split homolog-1(Hes1),transforming growth factor-beta(TGF-β)and basic fibroblast growth factor(bFGF)were subsequently ***:We found that EA significantly decreased arthritis index scores,paw volume,and HE staining *** could significantly inhibit the expression of CD34,promoting apoptosis of synovial cells in the joint synovial tissue of AA *** expression of Notch1 signaling pathway proteins and mR NAs(Notch1,Hes1,TGF-β,and bFGF)were markedly downregulated by EA ***:These results prove that EA attenuates synovial angiogenesis by inhibiting the Notch1 signaling pathway in AA rat *** on our findings,we propose that EA is a promising complementary and alternative therapy in rheumatoid arthritis.

关键词： electroacupuncture arthritis experimental synovial angiogenesis receptor Notch1 signal transduction

Moxibustion enables protective effects on rheumatoid arthritis-induced myocardial injury via transforming growth factor beta1 signaling and metabolic reprogramming

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Journal of Traditional Chinese Medicine 2023年第6期43卷 1190-1199页

作者： WANG Miao ZHU Yan ZHAO Hui ZHAO Hongfang the Geriatrics Anhui University of Traditional Chinese MedicineHefei 230031China the Geriatrics the Second Hospital Affiliated of Anhui University of Traditional Chinese MedicineHefei 230061China

OBJECTIVE:To examine the effects of moxibustion on myocardial injury and myocardial metabolomics in rats with rheumatoid arthritis(RA)based on the transforming growth factor beta1(TGF-β1)/Smads signaling ***:One hundred rats were treated with saline[normal control(NC)group]or complete Freund’s adjuvant(CFA)by right plantar injection for the RA model group,and the latter were randomly divided into 4 *** wilfordii polyglycoside tablets(雷公藤多苷片,TPT)have anti-inflammatory and are widely used in the clinical treatment of RA,therefore serving as a positive control *** days post injection rats were given TPT tablet(TPT group),acupuncture therapy(APT group),and moxibustion treatment(MOX group)for 15 consecutive days,while NC group and model group were equally grasped and fixed and received normal *** joint swelling scores and arthritis index(AI)were evaluated in each group before the CFA challenge,therapy and after receiving *** ultrastructure was observed by electron ***-linked immunosorbent assay was used to detect cardiac troponin I(cTnI)levels in rat myocardial *** reverse transcription polymerase chain reaction and Western blotting analysis were used to measure the mRNA and protein levels of TGF-βsignaling molecules including TGF-β1,Smad2,Smad3,Smad4,and *** metabolomics was analyzed using gas chromatography-mass ***:Compared with model group,RA model rats receiving TPT,acupuncture,or moxibustion therapy all showed reduced joint swelling scores and AI(all P<0.01)and improved myocardial damage,whereas rats treated with moxibustion were found to be more ***,the expressions of cTnI,TGF-β1,Smad2,Smad3,and Smad4 were found to be elevated in model rat group in contrast to NC rats and were significantly downregulated in TPT,APT and MOX group when compared with model group,while the levels of Smad7 showed the opposite result(all P<0.01).Moreover,

关键词： moxibustion arthritis rheumatoid transforming growth factor beta1 smad proteins signal transduction myocardial injury metabolomics

Shikonin alleviates collagen-induced arthritis mice by inhibiting M1 macrophage polarization

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Journal of Traditional Chinese Medicine 2022年第6期42卷 932-939页

作者： HE Lianhua LUAN Huijie QIN Qingxia HE Juan CHEN Jian HU Yiping CAI Yueming SUN Desheng SHI Yu WANG Qingwen Department of Rheumatism and Immunology Peking University Shenzhen HospitalShenzhen 518036China Shenzhen China Resources Sanjiu Pharmaceutical Trading Co. Ltd.Shenzhen 518029China The Key Laboratory of Inflammatory and Immunology Diseases Shenzhen 518036China Department of ultrasound Peking University Shenzhen HospitalShenzhen 518036China

OBJECTIVE: To investigate the effects of shikonin(SKN) on M1 and M2 polarization of macrophages both in vitro and in vivo. METHODS: Collagen-induced arthritis(CIA) in male DBA/1 mice were treated with a dose of 4 mg/kg/day of SKN for 23 d(n = 6/group). The histopathology of inflamed joints in CIA mice was evaluated to test the antiarthritic effect of SKN. M1/M2 polarization of macrophages induced by lipopolysaccharide(LPS) and interferon(IFN)-γ or interleukin(IL)-4 and IL-13, were used to assess the effect of SKN(0.05, 0.1, and 0.2 μM). The effect of SKN on the protein expression of nitric oxide synthase, arginase, CD68, and CD206 was evaluated using western blot analysis. RESULTS: The results of this study revealed that SKN delayed the arthritis feet symptom score, reduced the incidence rate of arthritis, and relieved the inflammation of joints in CIA mice. SKN inhibited M1 macrophage polarization but did not affect M2 macrophage polarization in the joints of CIA mice. Moreover, SKN inhibited M1 polarization induced by LPS and IFN-γ, but did not affect M2 polarization induced by IL-4 and IL-13. CONCLUSION: These findings suggest that SKN alleviated CIA through inhibiting M1 macrophage polarization and has great potential as a new drug for RA treatment.

关键词： Shikonin arthritis rheumatoid macrophages M1 polarization

Tripterygium hypoglaucum extract ameliorates adjuvant-induced arthritis in mice through the gut microbiota

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Chinese Journal of Natural Medicines 2023年第10期21卷 730-744页

作者： HU Jianghui NI Jimin ZHENG Junping GUO Yanlei YANG Yong YE Cheng SUN Xiongjie XIA Hui LIU Yanju LIU Hongtao College of Basic Medical Sciences Hubei University of Chinese MedicineWuhan 430065China Chongqing Academy of Chinese Materia Medica Chongqing 400065China Wuhan Customs Technology Center Wuhan 430050China

Traditionally,Tripterygium hypoglaucum(Levl.)Hutch(THH)are widely used in Chinese folk to treat rheumatoid arthritis(RA).This study aimed to investigate whether the anti-RA effect of THH is related with the gut *** main components of prepared THH extract were identified by HPLC-MS.C57BL/6 mice with adjuvant-induced arthritis(AIA)were treated with THH extract by gavage for one *** extract significantly alleviated swollen ankle,joint cavity exudation,and articular cartilage destruction in AIA *** mRNA and protein levels of inflammatory mediators in muscles and plasma indicated that THH extract attenuated inflammatory responses in the joint by blocking TLR4/MyD88/MAPK signaling *** extract remarkably restored the dysbiosis of the gut microbiota in AIA mice,featuring the increases of Bifidobacterium,Akkermansia,and Lactobacillus and the decreases of Butyricimonas,Parabacteroides,and ***,the altered bacteria were closely correlated with physiological indices and drove metabolic changes of the intestinal *** addition,antibiotic-induced pseudo germ-free mice were employed to verify the role of the intestinal ***,THH treatment failed to ameliorate the arthritis symptoms and signaling pathways in pseudo germ-free mice,which validates the indispensable role of the intestinal *** the first time,we demonstrated that THH extract protects joint inflammation by manipulating the intestinal flora and regulating the TLR4/MyD88/MAPK signaling ***,THH extract may serve as a microbial modulator to recover RA in clincial *** practice.

关键词： arthritis Gut microbiota Immunity Inflammation Tripterygium hypoglaucum