Background : Specific treatment for rheumatoid arthritis (RA) is still an unmet need. Yu-Xue-Bi (YXB) capsule effectively treats RA with blood stasis syndrome (BS). However, its mechanism remains unclear. Purpose : Exploring and elucidating the therapeutic effect and pharmacological mechanism of YXB capsule in treating RA. Methods : This study identified differentially expressed genes (DEGs) in patients with RA and BS compared to healthy controls using clinical transcriptomics data. Clinical symptoms of RA and BS, and the related genes were collected from the SoFDA and HPO databases. Candidate bioactive constituents in YXB were identified via UPLC-QTOF/MS and evaluated using ADMET rules. Putative targets were predicted, and a network linking disease-related DEGs and drug targets was constructed. Key targets were screened utilizing random walk-with-restart (RWR) algorithms and verified through experiments using rat models of collagen-induced arthritis with BS (CIA-BS model) in vivo . Results : We found 1220 DEGs along with 976 clinical symptom-related genes, as RA with BS-related genes. Chemical profiling identified 193 YXB constituents, with 98 meeting optimal ADMET criteria. We predicted 459 putative targets for these constituents. Network calculations screened 209 key targets, 129 RA with BS-related genes and 92 YXB targets involved in immune inflammation, blood stagnation, and hyperalgesia imbalance. Notably, the SUCNR1/HIF-1α/TRPV1 axis was enriched by YXB targets against RA with BS. Experimentally, YXB inhibited inflamed joint deterioration, including synovial inflammation, cartilage damage and bone erosion, relieving mechanical and cold allodynia hyperglasia. It reversed hemorrheology and vascular function in CIA-BS rats, restoring SDHB and eNOS expression, preventing SDHA, SUCNR1 and HIF-1α activation, reducing SUCN, TNF-1α and IL-1β production, and TRPV1 and TRPA1 expression. Conclusion : Our data support YXB's therapeutic effects on aggressive RA-BS by modulating the SUCNR1/HIF-1α/TRPV1 axis.
Jun Li,Xiaomin Wang,Min Tan,Jianxiong Zheng,Jing Mao,Jiayao Hao,Haili Shen
Synovial hyperplasia and inflammation are the main pathological features of rheumatoid arthritis (RA). Fibroblast‑like synoviocytes (FLSs) are the major effector cells contributing to chronic inflation and joint injury in the synovial microenvironment. Neutrophil extracellular traps (NETs) play an important role in the pathogenesis of RA, but their downstream regulatory mechanisms remain unclear. In order to improve the therapeutic prospects for RA, it is crucial to identify the targets of NETs and the molecular mechanisms of synovial dysfunction. ATP-citrate lyase (ACLY) directs glucose metabolism to de novo lipogenesis (DNL) by generating acetyl-CoA, which is also an acetyl donator to protein acetylation. ACLY has gained attention in studies on tumors, fatty liver, inflammation, and metabolic diseases. However, its involvement in RA progression is still uncertain. The present study revealed increased expression of NETs in the RA synovial microenvironment, including synovial fluid and synovial tissue, and a positive correlation to disease activity. In vitro experiments demonstrated that NETs activate ACLY, which not only triggers DNL, and enhances procreation, migration and invasiveness of RA-FLSs, but also stimulates the nuclear factor kappa-B (NF-κB) signaling pathway. This enhances the expression and nuclear translocation of acetyl-NF-kappaB p65 (Ac-p65), intensifying the transcription of inflammatory mediators and exacerbating synovial inflammation. Additionally, a high level of NETs expression in synovial tissues of arthritis animal models and the therapeutic effect of inhibiting ACLY on joint inflammation, bone erosion and bone destruction were also confirmed in vivo. In conclusion, our results elucidate the molecular mechanisms involved in the activation of RA-FLSs by NETs, and ACLY may be a candidate target for regulating metabolic reprogramming and inflammation to mitigate RA joint injuries.
危险品化学品经营许可证（带存储）