背景:类风湿性关节炎(RA)是一种自身免疫性疾病,其特征是受影响关节的慢性滑膜炎。白芍总苷(TGP)胶囊已广泛应用于临床治疗RA,具有良好的疗效和安全性。然而,其对炎性细胞因子的影响尚不清楚.目的:本研究旨在总结TGP对RA动物模型血清炎症因子表达水平的影响及其可能的机制。方法:截至2023年8月14日,检索了6个数据库,筛选了相关的动物实验研究,数据被提取,采用SYRCLE动物实验偏倚风险评估工具进行风险评估。结果:共纳入24项研究,包括581只动物。结果表明,与模型对照组相比,TGP降低了TNF-α的水平,IL-1β,IL-6、PGE2和TGF-β1水平在干预1-2周后升高,降低TNF-α水平,IL-1β,IL-6、IL-2、IL-17、IL-17α、IL-21,VEGF,IFN-γ和PGE2,并在干预3-4周后增加IL-10和IL-4的水平,降低TNF-α水平,干预8周后IL-6、IL-17α和IL-10水平升高。TGP对干预1~2周后IL-10、IL-17、IFN-γ水平及干预3~4周后IL-1、TGF-β1水平的影响无显著性差异。结论:总之,基于现有的研究,本研究发现,与对照组的RA动物模型相比,TGP可以降低血清促炎细胞因子如TNF-α,IL-1β,和IL-6,增加血清抗炎细胞因子如IL-10的水平,通过调节和提高炎症细胞因子的水平发挥抗炎作用,从而缓解疾病。鉴于纳入研究的质量低,缺乏足够的证据,仍需要更多高质量的研究来验证本研究的结果.
Background: Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic synovitis of the affected joints. Total glucosides of paeony (TGP) capsules have been widely used clinically for the treatment of RA with good efficacy and safety. However, its effect on inflammatory cytokines remains unclear. Objectives: This study aimed to summarize the effect of TGP on the expression level of serum inflammatory cytokines in RA animal models and its potential mechanisms. Methods: Six databases were searched up to 14 August 2023, relevant animal experiment studies were screened, data were extracted, and the SYRCLE animal experiment bias risk assessment tool was used for risk assessment. Results: A total of 24 studies were included, including 581 animals. Results showed that compared with the model control group, TGP decreased the levels of TNF-α, IL-1β, IL-6, and PGE2 and increased the levels of TGF-β1 after 1-2 weeks of intervention, decreased the levels of TNF-α, IL-1β, IL-6, IL-2, IL-17, IL-17α, IL-21, VEGF, IFN-γ and PGE2 and increased the levels of IL-10 and IL-4 after 3-4 weeks of intervention, decreased the levels of TNF-α, IL-6, IL-17α and increased the level of IL-10 after 8 weeks of intervention. There was no significant difference in the effects of TGP on the levels of IL-10, IL-17, and IFN-γ after 1-2 weeks of intervention and IL-1 and TGF-β1 after 3-4 weeks of intervention. Conclusion: In summary, based on the existing studies, this study found that compared with the control group of the RA animal model, TGP can reduce the levels of serum pro-inflammatory cytokines such as TNF-α, IL-1β, and IL-6 and increase the levels of serum anti-inflammatory cytokines such as IL-10, exerting an anti-inflammatory effect by regulating and improving the levels of inflammatory cytokines, and thus alleviating the disease. Given the low quality of the included studies and the lack of sufficient evidence, more high-quality studies are still needed to validate the results of this study.