BackgroundThe root of Angelica sinensis (AS), also known as “Dang-gui,” was a popular herbal medicine widely used in the treatment of gynecological diseases in China, Korea, and Japan for a long time. This study aimed to determine the effects of ethyl acetate fraction from Angelica sinensis (EAAS) on the interleukin-1β (IL-1β)-induced proliferation of rheumatoid arthritis synovial fibroblasts (RASFs), and production of matrix metalloproteinases (MMPs), cyclooxygenase (COX) 2, and prostaglandin E2 (PGE2), involved in articular bone and cartilage destruction, by RASFs.ResultsRASF proliferation was evaluated with cholecystokinin octapeptide (CCK-8) reagent in the presence of IL-1β with/without EAAS. Expression of MMPs, tissue inhibitor of metalloproteinases-1 (TIMP-1), COXs, PGE2, and intracellular mitogen-activated protein kinase (MAPK) signaling molecules, including p-ERK, p-p38, p-JNK, and NF-κB, were examined using immunoblotting or semi-quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay. EAAS inhibited IL-1β-induced RASF proliferation; MMP-1, MMP-3, and COX-2 mRNA and protein expressions; and PGE2 production. EAAS also inhibits the phosphorylation of ERK-1/2, p38, and JNK, and activation of NF-κB by IL-1β.ConclusionEAAS might be a new therapeutic modality for rheumatoid arthritis management.

A 21-year-old woman who had a 2-year history of mixed connective tissue disease (MCTD) developed rapidly evolving ulcers consistent with livedoid vasculitis (LV) in all distal extremities. She presented clinically with Raynaud's phenomenon, polyarthritis and swollen hands; serologically with high titres of ANA and anti-nRNP; and immunogenetically with HLA-DR4 and HLA-DR53. Although there was initial success in treatment except for the skin defects over the ankles, the patient died from disseminated intravascular coagulation. We suggest that LV may be a poor prognostic manifestation in MCTD.

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Sjögren syndrome (SS) is a chronic inflammatory autoimmune disorder involving the exocrine glands, which often presents with salivary and tear gland dysfunction leading to dry mouth and eyes (sicca symptoms). This disease occurs alone as primary SS, or in the background of connective tissue diseases as secondary SS. Neurological involvement is seen in 20-25% of SS cases. Cerebral involvement is generally heterogeneous both in terms of localization (focal or diffuse) and progression (acute, progressive or reversible) and may resemble the clinical and radiological findings of multiple sclerosis (MS). Here we present the case of a patient with primary SS who experienced acute progressive diffuse MS.

Churg-Strauss syndrome (CSS), known as eosinophilic granulomatosis with polyangiitis, is a rare type of systemic vasculitis characterized by the presence of asthma, peripheral eosinophilia, and necrotizing vasculitis with eosinophilic infiltration of multiple organs. Approximately 3-4% of all CSS cases are associated with alveolar hemorrhage. Untreated CSS may lead to a poor prognosis, but glucocorticoid and cytotoxic agent treatments may result in clinical remission. The careful diagnosis and understanding of CSS is important for making treatment decisions and providing effective care. Here, we report a case of CSS with diffuse alveolar hemorrhage.