Chinese Medicine Huzhen Tongfeng Formula Effectively Attenuates Gouty Arthritis by Inhibiting Arachidonic Acid Metabolism and Inflammatory Mediators

The Chinese herbal medicine, Huzhen Tongfeng Formula (HZTF), derived from traditional Chinese medicine (TCM) practice, has recognized therapeutic benefits for gouty arthritis (GA). HZTF is currently in the late stage of approval process as a new anti-GA drug application. However, the underlying mechanism of HZTF as an antigout medication is unclear. In this study, we combined network pharmacology and experimental validation approaches to elucidate the mechanism of action of HZTF. First, the relative drug-disease target networks were constructed and analyzed for pathway enrichment. Potential pathways were then validated by in vitro and in vivo experiments. We found that 34 compounds from HZTF matched 181 potential drug targets. Topology analysis revealed 77 core targets of HZTF, which were highly related to gout, following screening of KEGG pathway enrichment. Further analysis demonstrated that the arachidonic acid metabolic pathway was the most relevant pathway involved in the mechanism of HZTF. Validation experiments showed that HZTF significantly inhibited the inflammatory cell infiltration into gouty joints, improved the swelling of affected joints, and increased the pain threshold. HZTF significantly reduced the transcription and production of various cytokines and inflammatory mediators in vitro. In particular, cyclooxygenase (COX)-1, COX-2, and 5-lipoxygenase were simultaneously downregulated. In conclusion, our study suggests that the antigout mechanism of HZTF is associated with the inhibition of the arachidonic acid pathway, resulting in the suppression of inflammatory cytokines and mediators. These findings extend our understanding of the pharmacological action of HZTF, rationalizing the application HZTF as an effective herbal therapy for GA.

[1]  Xue Xiao,et al.  Network Pharmacology in Research of Chinese Medicine Formula: Methodology, Application and Prospective , 2020, Chinese journal of integrative medicine.

[2]  Xiaoxia Lu,et al.  Coptisine from Coptis chinensis blocks NLRP3 inflammasome activation by inhibiting caspase-1. , 2019, Pharmacological research.

[3]  Tianlong Liu,et al.  Study on the multi-targets mechanism of triphala on cardio-cerebral vascular diseases based on network pharmacology. , 2019, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie.

[4]  Chong-Zhi Wang,et al.  Genkwanin ameliorates adjuvant-induced arthritis in rats through inhibiting JAK/STAT and NF-κB signaling pathways. , 2019, Phytomedicine : international journal of phytotherapy and phytopharmacology.

[5]  K. Reddi,et al.  Dry leaf extracts of Tinospora cordifolia (Willd.) Miers attenuate oxidative stress and inflammatory condition in human monocytic (THP-1) cells. , 2019, Phytomedicine : international journal of phytotherapy and phytopharmacology.

[6]  T. Kang,et al.  Chrysanthemum indicum extract inhibits NLRP3 and AIM2 inflammasome activation via regulating ASC phosphorylation. , 2019, Journal of ethnopharmacology.

[7]  F. Moccia,et al.  Arachidonic Acid Evokes an Increase in Intracellular Ca2+ Concentration and Nitric Oxide Production in Endothelial Cells from Human Brain Microcirculation , 2019, Cells.

[8]  Dexin Kong,et al.  Inhibitory effect of taxifolin on mast cell activation and mast cell-mediated allergic inflammatory response. , 2019, International immunopharmacology.

[9]  Yong Jiang,et al.  Systematic Identification and Analysis of Expression Profiles of mRNAs and Incrnas in Macrophage Inflammatory Response , 2019, Shock.

[10]  Xiaoxiong Zeng,et al.  Anti-inflammatory effects of dicaffeoylquinic acids from Ilex kudingcha on lipopolysaccharide-treated RAW264.7 macrophages and potential mechanisms. , 2019, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[11]  D. Steinhilber,et al.  Two‐pronged approach to anti‐inflammatory therapy through the modulation of the arachidonic acid cascade , 2018, Biochemical pharmacology.

[12]  Yuxue Yang,et al.  Anti-Inflammatory Effect of a TCM Formula Li-Ru-Kang in Rats With Hyperplasia of Mammary Gland and the Underlying Biological Mechanisms , 2018, Front. Pharmacol..

[13]  Jing Chen,et al.  Evaluating the Efficacy and Adverse Effects of Clearing Heat and Removing Dampness Method of Traditional Chinese Medicine by Comparison with Western Medicine in Patients with Gout , 2018, Evidence-based complementary and alternative medicine : eCAM.

[14]  S. Mandal,et al.  Ichnocarpus frutescens (L.) R. Br. root derived phyto-steroids defends inflammation and algesia by pulling down the pro-inflammatory and nociceptive pain mediators: An in-vitro and in-vivo appraisal , 2018, Steroids.

[15]  O. Werz,et al.  Lipophilic extracts of Leucas zeylanica, a multi-purpose medicinal plant in the tropics, inhibit key enzymes involved in inflammation and gout. , 2018, Journal of ethnopharmacology.

[16]  Cong Li,et al.  Anti-endometriosis Mechanism of Jiawei Foshou San Based on Network Pharmacology , 2018, Front. Pharmacol..

[17]  Drug and Therapeutics Bulletin Latest guidance on the management of gout , 2018, British Medical Journal.

[18]  A. Vysakh,et al.  Terminalia bellirica (Gaertn.) Roxb fruit exerts anti-inflammatory effect via regulating arachidonic acid pathway and pro-inflammatory cytokines in lipopolysaccharide-induced RAW 264.7 macrophages , 2018, Inflammopharmacology.

[19]  Qingsong Liu,et al.  Oridonin is a covalent NLRP3 inhibitor with strong anti-inflammasome activity , 2018, Nature Communications.

[20]  Yiming Li,et al.  Antinociceptive and anti-inflammatory activities of a standardizedextract of bis-iridoids from Pterocephalus hookeri. , 2018, Journal of ethnopharmacology.

[21]  L. M. de Carvalho,et al.  Arctium minus crude extract presents antinociceptive effect in a mice acute gout attack model , 2018, Inflammopharmacology.

[22]  Yi Zhang,et al.  Effect and mechanism of dioscin from Dioscorea spongiosa on uric acid excretion in animal model of hyperuricemia. , 2018, Journal of ethnopharmacology.

[23]  E. Park,et al.  Luteolin activates ERK1/2- and Ca2+-dependent HO-1 induction that reduces LPS-induced HMGB1, iNOS/NO, and COX-2 expression in RAW264.7 cells and mitigates acute lung injury of endotoxin mice , 2018, Inflammation Research.

[24]  C. Michet,et al.  My Treatment Approach to Gout , 2017, Mayo Clinic proceedings.

[25]  P. Morin,et al.  Substituted Caffeic and Ferulic Acid Phenethyl Esters: Synthesis, Leukotrienes Biosynthesis Inhibition, and Cytotoxic Activity , 2017, Molecules.

[26]  Xiaofeng Li,et al.  The Immunological Basis in the Pathogenesis of Gout. , 2017, Iranian journal of immunology : IJI.

[27]  Manmei Li,et al.  Anhuienoside C Ameliorates Collagen-Induced Arthritis through Inhibition of MAPK and NF-κB Signaling Pathways , 2017, Front. Pharmacol..

[28]  Xiaojuan He,et al.  Wu-Tou Decoction in Rheumatoid Arthritis: Integrating Network Pharmacology and In Vivo Pharmacological Evaluation , 2017, Front. Pharmacol..

[29]  Nam Soo Kim,et al.  Anti-inflammatory activity of rhein isolated from the flowers of Cassia fistula L. and possible underlying mechanisms , 2017, Saudi journal of biological sciences.

[30]  G. Xing,et al.  The Effects of Modified Simiao Decoction in the Treatment of Gouty Arthritis: A Systematic Review and Meta-Analysis , 2017, Evidence-based complementary and alternative medicine : eCAM.

[31]  Hyon K. Choi,et al.  The rising prevalence and incidence of gout in British Columbia, Canada: Population-based trends from 2000 to 2012. , 2017, Seminars in arthritis and rheumatism.

[32]  A. Qaseem,et al.  Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians. , 2017, Annals of internal medicine.

[33]  Damian Szklarczyk,et al.  The STRING database in 2017: quality-controlled protein–protein association networks, made broadly accessible , 2016, Nucleic Acids Res..

[34]  M. Doherty,et al.  Global epidemiology of gout: prevalence, incidence and risk factors , 2015, Nature Reviews Rheumatology.

[35]  Le Shi,et al.  A network pharmacology approach to determine active ingredients and rationality of herb combinations of Modified-Simiaowan for treatment of gout. , 2015, Journal of ethnopharmacology.

[36]  C. van Durme,et al.  Nonsteroidal anti-inflammatory drugs for treatment of acute gout. , 2015, JAMA.

[37]  Young-Jin Kim,et al.  Anti-Inflammatory Effect of Quercetin on RAW 264.7 Mouse Macrophages Induced with Polyinosinic-Polycytidylic Acid , 2015, Molecules.

[38]  J. Y. Lee,et al.  Anti-Inflammatory Effect of Wogonin on RAW 264.7 Mouse Macrophages Induced with Polyinosinic-Polycytidylic Acid , 2015, Molecules.

[39]  F. Cunha,et al.  The quassinoid isobrucein B reduces inflammatory hyperalgesia and cytokine production by post-transcriptional modulation. , 2015, Journal of natural products.

[40]  Wing Lam,et al.  Safety Surveillance of Traditional Chinese Medicine: Current and Future , 2015, Drug Safety.

[41]  Youxin Wang,et al.  Chuanhu Anti-Gout Mixture versus Colchicine for Acute Gouty Arthritis: A Randomized, Double-Blind, Double-Dummy, Non-Inferiority Trial , 2014, International journal of medical sciences.

[42]  P. Chan,et al.  Contemporary epidemiology of gout and hyperuricemia in community elderly in Beijing , 2014, International journal of rheumatic diseases.

[43]  Ling Meng,et al.  Analysis of patents on anti-gout therapies issued in China , 2014, Expert opinion on therapeutic patents.

[44]  Min Zhou,et al.  [Treatment of gouty arthritis in different phases by a series of tongfeng granule: an efficacy observation]. , 2013, Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine.

[45]  R. Day,et al.  The modern pharmacology of paracetamol: therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings , 2013, Inflammopharmacology.

[46]  P. Brown,et al.  Effect of Zileuton and Celecoxib on Urinary LTE4 and PGE-M Levels in Smokers , 2013, Cancer Prevention Research.

[47]  Jinan Wang,et al.  Systems approaches and polypharmacology for drug discovery from herbal medicines: an example using licorice. , 2013, Journal of ethnopharmacology.

[48]  L. Punzi,et al.  Gout as autoinflammatory disease: new mechanisms for more appropriated treatment targets. , 2012, Autoimmunity reviews.

[49]  Weidong Zhang,et al.  The inhibitory activities of the components of Huang-Lian-Jie-Du-Tang (HLJDT) on eicosanoid generation via lipoxygenase pathway. , 2011, Journal of ethnopharmacology.

[50]  M. Egger,et al.  Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis , 2011, BMJ : British Medical Journal.

[51]  Hong Zhang,et al.  Clinical effect and action mechanism of Weicao Capsule (威草胶囊) in treating gout , 2008, Chinese journal of integrative medicine.

[52]  C. Weel,et al.  Use of oral prednisolone or naproxen for the treatment of gout arthritis: a double-blind, randomised equivalence trial , 2008, The Lancet.

[53]  T. Nabeshima,et al.  Tumor Necrosis Factor-α and Its Inducer Inhibit Morphine-Induced Rewarding Effects and Sensitization , 2007, Biological Psychiatry.

[54]  T. Miura,et al.  [Metabolism of non-steroidal anti-inflammatory drugs by peroxidase: implication for gastrointestinal mucosal lesions]. , 2007, Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan.

[55]  王一飞,et al.  Medicine for treating gouty arthritis and its prepn process and application , 2006 .

[56]  Tan Wen-feng,et al.  Effects of Rebixiao granules on blood uric acid in patients with repeatedly attacking acute gouty arthritis , 2005 .

[57]  K. Naidu,et al.  Spice phenolics inhibit human PMNL 5-lipoxygenase. , 2004, Prostaglandins, leukotrienes, and essential fatty acids.

[58]  M. Brownstein,et al.  A role for ASIC3 in the modulation of high-intensity pain stimuli , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[59]  C. Funk,et al.  Prostaglandins and leukotrienes: advances in eicosanoid biology. , 2001, Science.

[60]  C. Leslie,et al.  Intracellular Calcium Signals Regulating Cytosolic Phospholipase A2 Translocation to Internal Membranes* 210 , 2001, The Journal of Biological Chemistry.

[61]  P. Isakson,et al.  Altered Arachidonic Acid Metabolism in Urate Crystal Induced Inflammation , 1997, Inflammation.

[62]  P. Wall,et al.  Ankle joint urate arthritis (AJUA) in rats: an alternative animal model of arthritis to that produced by Freund's adjuvant , 1987, Pain.

[63]  T. Mosmann Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays. , 1983, Journal of immunological methods.

[64]  B. Samuelsson Leukotrienes: mediators of immediate hypersensitivity reactions and inflammation. , 1983, Science.

[65]  R. Carroll,et al.  Quercetin Suppresses Early Colon Carcinogenesis Partly through Inhibition of Inflammatory Mediators. , 2009, Acta horticulturae.

[66]  Brad T. Sherman,et al.  Nucleic Acids Research Advance Access published June 18, 2007 , 2007 .

[67]  R. Garavito,et al.  Cyclooxygenases: structural, cellular, and molecular biology. , 2000, Annual review of biochemistry.