Peripheral blood cell factors of Graves ophthalmopathy and effect of intervention with tripterygium glycosides

Xu, Jianping; Xu, Chen; Jin, Zhihua; Zheng, Hong-fei; Zhu, Jun

doi:10.4268/cjcmm20140336

Cited by 4 publications

(1 citation statement)

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“…What’s more, thyroid function - with the exception of restored thyroid stimulating hormone (TSH) - was not significantly altered by TCM ( Zen et al, 2007 ). A systematic review included in 17 randomized controlled clinical trials with 1,536 participants showed that the serum glutamic pyruvate transaminase (SGPT) of participants slightly increased and menstrual quantity decreased during TCM treatment, but all of the aforementioned studies indicate that the occurrence rates of reported adverse effects in TCM intervention groups were fewer than controls ( Xu et al, 2014 ). Three studies reported drug-induced symptoms (such as nausea, vomiting, and gain weight), and the respondents had fewer adverse symptoms in the TCM intervention groups compared with the controls (RR: 0.32; 95% CI: 0.20–0.53; p < 0.00001; fixed model; I2 = 0%; three trials; n = 197) ( Liu et al, 2019 ).…”

Section: Prospects Of Traditional Chinese Medicine On Treating Gdmentioning

confidence: 99%

New Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine

Gong

Guo

et al. 2022

Front. Pharmacol.

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Graves’ disease is an autoimmune disease characterized by goiter and hyperthyroidism, and 25% patients develop GO. Traditional treatment options, such as antithyroid drugs, radioiodine or thyroidectomy, have remained largely unchanged over the past 70 years. For many patients, there is a high rate of recurrence after antithyroid drugs and lifelong hypothyroidism after ablation and thyroidectomy. The symptoms and quality of life of some patients have not been effectively improved. The clinical demand for new therapeutic regimens, coupled with a deeper understanding of the pathophysiology and immunobiology of Graves’ disease, has led to the emergence of several new therapeutic ideas, including biologics, small molecule peptides, immunomodulators and teprotumumab, a specific antibody targeting IGF-1R. Besides, the elements of TCM have attracted more and more interests in modern medicine, because some effective components have been successfully used in the treatment of autoimmune diseases. Based on the pathophysiology and efficacy of clinical management and treatment in Graves’ hyperthyroidism, here we review the new strategies under investigation and summarize the effective components of traditional Chinese medicine used for Graves’ hyperthyroidism, and explore their mechanisms. These therapies have opened a new window for the treatment of Graves’ disease, but the exact mechanism and the research direction still need to be further explored.

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Section: Prospects Of Traditional Chinese Medicine On Treating Gdmentioning

confidence: 99%

New Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine

Gong

Guo

et al. 2022

Front. Pharmacol.

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Immunoregulatory effects of Tripterygium wilfordii Hook F and its extracts in clinical practice

et al. 2019

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Efficacy and safety of tripterygium glycosides for Graves ophthalmopathy

et al. 2019

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Background: Graves ophthalmopathy (GO) is one of the remaining enigmas in thyroidology. Glucocorticoids (GCs) are strongly recommended but their effects are not completely satisfactory and adverse reactions can occur. Tripterygium glycosides (TG) is a promising component extracted from Tripterygium wilfordii Hook F (TwHF), and numerous patients with GO have benefited from it. However, its practical application value is still unclear. The aim of this systematic review and meta-analysis was to investigate the efficacy and safety of TG for patients with GO.Methods: By retrieving the PubMed, Embase, the Cochrane Library, CNKI, VIP, CBM, and WanFang Databases, the open published randomized controlled trials (RCTs) related to TG in the treatment of GO were collected. And inclusion and exclusion criteria were established. The Cochrane bias risk assessment tool conducts the evaluation of included studies, and meta-analysis was performed using Revman 5.3 software.Trial registration number: PROSPERO CRD42019131915.Results: A total of 19 trials (involving 1517 GO patients) were included in this review with generally acceptable validity of included RCTs. TG therapy brought about a significantly higher efficacy rate compared with non-TG treatments (RR: 1.40; 95% CI: 1.31-1.49). Subgroup meta-analysis showed that TG with or without immunosuppressive therapies were all better than controls: with GC (RR: 1.36; 95% CI: 1.27-1.46), with multiple intensification of immunosuppressive therapies (RR: 1.91; 95% CI: 1.37-2.67), with no immunosuppressive therapies (RR: 1.39; 95% CI:1.21-1.59); the dosage of TG for 15-60 mg/d (RR: 1.41; 95% CI: 1.30-1.53) were better compared with for ≥90 mg/d (RR: 1.47; 95% CI: 1.29-1.68); the course of treatment for 3 months (RR: 1.43; 95% CI: 1.33-1.52) was better than controls, but when >3 months (RR: 1.15; 95% CI: 0.94-1.41) there was no significant differences. After treatment, the degree of exophthalmus (SMD: À2.55; 95% CI: À2.93 to 2.17), the recurrence rate of 1 year (RR: 0.45; 95% CI: 0.27-0.74), and adverse reactions rate (RR: 0.32; 95% CI: 0.20-0.53) were all lower, while the CAS was no obvious gap in 2 groups (SMD: 0.08; 95% CI: À0.60 to 0.75).Conclusions: This review found that TG has some advantages in treating GO, especially in improving clinical efficacy and reducing adverse reactions. Nevertheless, large sample, multi-center, reasonable design, and high quality clinical studies are still needed for further verification.

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Peripheral blood cell factors of Graves ophthalmopathy and effect of intervention with tripterygium glycosides

Cited by 4 publications

References 0 publications

New Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine

New Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine

Immunoregulatory effects of Tripterygium wilfordii Hook F and its extracts in clinical practice

Efficacy and safety of tripterygium glycosides for Graves ophthalmopathy

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