Research progress of Sinomenium in the treatment of rheumatoid arthritis and suggestions for future research
Main Article Content
Keywords
Sinomenium, rheumatoid arthritis, immune, inflammation, orthopedic disorders.
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune joint disease. Its main pathological manifestations are joint cartilage, bone tissue injury, synovial hyperplasia, and chronic inflammation. At present, the pathogenesis of the disease has not been fully defined, and delaying the disease to improve joint function is the existing treatment. Sinomenium (SIN) is an effec-tive ingredient in Sinomenium acutum (Thunb.) Rehd. et Wils., with anti-inflammatory, analgesic, immunosuppressive, anti-tumor, and other pharmacological activities, which is quite effective in the treatment of RA. There are many SIN compound preparations in the market, such as Zhengqing Fengtongning capsule, Zhubi Huoluo prescription, and Qinxitong tablet. They all exhibit good anti-RA effect with less adverse reactions. This study summarized the mechanism of action of SIN in the treatment of RA and further explored the possibility of SIN in the treatment of RA combined with other diseases for future research.
References
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9. Luo J, Wang Y, Qi Q, et al. Sinomenium improves embryo survival by regulating Th1/Th2 balance in a mouse model of recurrent spontaneous abortion. Med Sci Monit. 2021;27:e927709. https://doi.org/10.12659/MSM.927709
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12. Huang H, Hu MY, Xu L, et al. Research progress on immunosuppressive mechanism of Sinomenium. Chinese Trad Herbal Drugs. 2022;53(01):261–9.
13. Xie YM. Effect of Sinomenium on DC2.4 maturation and mechanism of inducing apoptosis in DC2.4. China: Chengdu University of Traditional Chinese Medicine; 2016.
14. Zhang XY. Effect of Sinomenium on CD80/CD86 on BMDC surface of mice model of rheumatoid arthritis. China: Chengdu University of Traditional Chinese Medicine; 2016.
15. Mei X. Effect of Sinomenium on mannose receptor expression and related antibody in rheumatoid arthritis model rats. China: Chengdu University of Traditional Chinese Medicine; 2014.
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17. Li XJ, Wang PX, Liu L, Chen GX, Zhao JX. Effects of Sinomenium on activation of T lymphocytes and expression of TH1 intracellular cytokines. Chinese J Immunol. 2004;2004(04):249–52.
18. Wang GF. Effect of Qingfengteng decoction on Tfh, IL-21 and anti-CCP antibody in patients with rheumatoid arthritis. Modern Pract Med. 2019;31(08):1005–7.
19. Ma LW, Yu D, Wu JK, et al. Mechanism of action of Chinese medicine and active ingredients in treatment of rheumatoid arthritis. Hebei Med J. 2019;42(18):2832–6.
20. Li N, Deng J, Zhou JR, et al. Effect of Sinomenium on the ratio of auxiliary T lymphocytes 17/ regulatory T lymphocytes in peripheral blood of patients with rheumatoid arthritis. Shanghai Med J. 2013;36(03):254–8.
21. Mateen S, Zafar A, Moin S, et al. Understanding the role of cytokines in the pathogenesis of rheumatoid arthritis. Clin Chim Acta. 2016;455:161–71. https://doi.org/10.1016/j.cca.2016.02.010
22. Qin YX, Guo MZ. Effects of Sinomenium on proliferation and inflammatory factors of rat synovial cell line RSC-364 induced by IL-1β. Acta Chinese Med Pharmacol. 2019;50(05):34–9.
23. He L, Ge ZZ, Wu YQ, et al. Effect of Sinomenium on ankle arthritis in rats through PI3K/Akt signaling pathway. Northwest Pharm J. 2019;37(03):71–6.
24. Fu MY, Yang JY, Wen X, et al. Sinomenium inhibits IL-1β-induced inflammation and degeneration of intervertebral disc endplate chondrocytes by blocking the activation of NF-κB pathway. Chinese J Gerontol. 2019;42(16):4045–9.
25. Kim T W, Han J M, Han Y K, et al. Anti-inflammatory effects of Sinomenium acutum extract on endotoxin-induced uveitis in Lewis rats. Int J Med Sci. 2018;8:758–64. https://doi.org/10.7150/ijms.24834
26. Cheng H, Xia B, Guo Q, et al. Sinomenium attenuates 2, 4, 6-trinitrobenzene sulfonic acid-induced colitis in mice. Int Immunopharmacol. 2007;7(5):604–11. https://doi.org/10.1016/j.intimp.2007.01.003
27. Tao CS. Preliminary study on the role of Sinomenium in melanin synthesis and skin inflammation and its external preparation. China: Naval Medical University; 2017.
28. Jiang Y, Gao M, Wang W, et al. Sinomenium hydrochloride protects against polymicrobial sepsis via autophagy. Int J Mol Sci. 2015;2015(2):2559–73. https://doi.org/10.3390/ijms16022559
29. Wu M Y, Li C J, Yiang G T, et al. Molecular regulation of bone metastasis pathogenesis. Cell Physiol Biochem. 2018;46(4):1423–38. https://doi.org/10.1159/000489184
30. Coury F, Peyruchaud O, Machuca-Gayet I. Osteoimmunology of bone loss in inflammatory rheumatic diseases. Front Immunol. 2019 ;10:679. https://doi.org/10.3389/fimmu.2019.00679
31. Wang K, Zeng XZ, Tao L, et al. Effects of Sinomenium combined with aconitine on RANKL expression and osteoclast formation in CD4~+ T cells. Pharmacol Clin Chinese Mater Med. 2016;32(03):61–5.
32. Zou Y, Li H, Shangjiang YZ, et al. Effects of Sinomenium hydrochlorideaspirin on proliferation, differentiation, mineralization of MC3T3E1 cells and its possible mechanism. Jiangxi Med J. 2018;53(02):119–21.
33. Ding CZ, Yao Y, Fang Y, et al. Effects of Sinomenium on serum OPG/RANKL and IL-17 levels in collagen-induced arthritis rats [J]. Journal of Nanjing University of Traditional Chinese Medicine,2012,28(04):330-333.
34. Zhang HR, Ji JY, Hou XQ, et al. Effect of Sinomenium on CaN/NFAT pathway on CIA bone destruction. Chinese J Immunol. 2019;36(12):1447–52.
35. Ji JY, Guo Z, Huang YG, et al. Research progress of Sinomenium in inhibiting bone destruction in rheumatoid arthritis. J Pract Med. 2019;35(14):2338–41.
36. Ji JY. Study on the mechanism of Sinomenium regulating NF-κB signaling pathway to inhibit the differentiation of MDSC into OC in CIA mice. China: China Three Gorges University; 2021.
37. Wang ZL. Effect of Zhengqing Fengtongning injection on expression of β-CATENIN, MMP-13 and TGF-β in rabbit KOA model. China: Heilongjiang Academy of Chinese Medicine; 2021.
38. Shen RM, Li GQ, Li L, et al. lncRNA RGMB-AS1 regulates proliferation, migration and invasion of synovial fibroblasts in rheumatoid arthritis by targeting miR-129-5p. Curr Immunol. 2002;42(05):387–94.
39. Cai H, Zhang BB. Research progress of fibroblast-like synovial cells in rheumatoid arthritis. Modern Med J. 2017;45(09):1362–6.
40. Sheng XH, Xie XF. Effect of Zhengqing Fengtongning sustained-release tablet on apoptosis of synovial fibroblast-like cells in human rheumatoid arthritis by regulating HOTAIRM1/miR-137 axis. Chinese J Immunol. 2019;37(20):2475–81.
41. Cai ST, Sun JT, Wei X. The mechanism of miR-23b-3p targeting XIAP to regulate the proliferation and apoptosis of synovial fibroblasts in rheumatoid arthritis. Chinese J Pathophysiol. 2019;35(07):1310–5.
42. Li J, Fu TT, Zhang GF, et al. Sinomenium induces apoptosis of human rheumatoid arthritis fibroblast-like synovial cells by miR-23b-3p/FGF9. Chinese J Pathophysiol. 2019;36(09):1653–60.
43. Xu J. Study on the therapeutic effect and mechanism of ethanol extract of Sinomenium in the treatment of rheumatoid arthritis. China: Nanjing University of Chinese Medicine; 2015.
44. Han J. Experimental study of Sinomenium against synovial-related cytokines in rheumatoid arthritis. China: Chengdu University of Traditional Chinese Medicine; 2013.
45. Yi L, Lyn Y J, Peng C, et al. Sinomenium inhibits fibroblast-like synoviocyte proliferation by regulating alpha7nAChR expression via ERK/Egr-1 pathway. Int Immunopharmacol. 2018;56:65–70. https://doi.org/10.1016/j.intimp.2018.01.015
46. Ouyang L. Study on efficacy of Qingfengteng combined with Heishun tablet in treatment of rheumatoid arthritis. China: Hunan University of Chinese Medicine; 2019.
47. Yang J. Clinical effect of Zhengqing Fengtongning on degenerative knee arthritis. Inner Mongolia J Trad Chinese Med. 2001;40(7):32–3 [in Chinese].
48. Guo JQ. Effect of Zhengqing Fengtongning Tablet combined with Febuxostat Tablets on gouty arthritis. Clin Res. 2019;27(3):118–9.
49. Liu JF, You ZX, Yang CG. Effect of minimally invasive technique of traditional Chinese medicine combined with Zhengqing Fengtongning intraarticular injection on knee osteoarthritis. Inner Mongolia J Trad Chinese Med. 2019;42(7):91–3.
50. Rong QJ, Yang S, Han JC, et al. Mechanism of action of Sinomenium acutum in intervention against knee osteoarthritis: A study based on network pharmacology and molecular docking. Hunan J Trad Chinese Med. 2019;39(10):170–6.
51. Zheng J, Wang RH, Kou JS, et al. Effects of Sinomenium on the expression of endothelial growth factor and nerve growth factor in cartilage and synovial blood vessels of rabbit model of knee osteoarthritis. Chinese J Inform Trad Chinese Med. 2016;23(03):38–41.
52. Liu Z, Sun J, Liang T, et al. Increased expression of cyclooxygenase‑2 in synovium tissues and synovial fluid from patients with knee osteoarthritis is associated with downregulated microRNA‑758‑3p expression. Exp Ther Med. 2021;22(3):1001. https://doi.org/10.3892/etm.2021.10433
53. Ma AX, Kou JS, Lu XH. Study on the mechanism of Sinomenium intervention in knee osteoarthritis rats based on RNA-Seq technique. Chinese J Integr Trad Western Med. 2018;44(1):77–83.
54. Wu ZY, Chen ZQ, Song WG, et al. Study on the mechanism of the treatment of diabetic nephropathy based on network pharmacology. Hunan J Trad Chinese Med. 2022;38(4):156–61.
55. Sharmila R, Sindhu G, Arockianathan P M. Nephroprotective effect of beta-sitosterol on N-diethylnitrosamine initiated and ferric nitrilotriacetate promoted acute nephrotoxicity in Wistar rats. J Basic Clin Physiol Pharmacol. 2016;27(5):473–82. https://doi.org/10.1515/jbcpp-2015-0085
56. Teng J, Zhao LJ, Zhou SH, et al. Research progress of Sinomenium hydrochloride in the treatment of nephropathy. Guiding J Trad Chinese Med Pharm. 2019;25(16):120–4.
57. Yang CM, Yang ZX, Ma XL. Research progress of AGE-RAGE signaling pathway in diabetic nephropathy. Acta Chinese Med. 2019;34(09):1864–8.
58. Ni HM. Protective effect of Sinomenium hydrochloride on mesangial proliferative glomerulonephritis in rats. China: Guangdong Pharmaceutical University; 2021.
59. Liu Y, Li PY, Zhang QH, et al. Effect of Sinomenium on PI3K/mTOR signaling pathway and mesangial hyperplasia in adriamycin nephropathy rats. J Clin Nephrol. 2001;21(04):314–9.
60. Bi GY, Liu CH, Xu J, et al. Clinical observation of 24 cases of IgA nephropathy with moderate albuminuria treated by glucocorticoid combined with Zhengqing Fengtongning. J Trad Chinese Med. 2013;19(05):52–4.
61. Duan XY, Huo ZP, Feng XC, et al. Progress of pharmacological research on Sinomenium in the treatment of gouty arthritis. Tianjin Pharm. 2019;36(1):73–8.
62. Chen X, Mao B, Che DY, et al. Clinical observation of electro-porous transdermal administration of Zhengqing Fengtongning Injection in the treatment of gouty arthritis. J Emerg Trad Chinese Med. 2014;23(04):706–8.
63. Zhang LY, He CH, Zhao ZZ, et al. Neuroprotective effect of Sinomenium regulating GSK3β/Nrf2/HO-1 and NF-κB signaling pathway in mice with Parkinson’s disease. Trad Chinese Drug Res Clin Pharmacol. 2019;35(05):607–14.
64. Langston J W. The MPTP story. J Parkinsons Dis. 2017;7(s1):S11–S19. https://doi.org/10.3233/JPD-179006
65. Nagatsu T, Nakashima A, Watanabe H, et al. Neuromelanin in Parkinson’s disease: Tyrosine hydroxylase and tyrosinase. Int J Mol Sci. 2022;23(8):4176. https://doi.org/10.3390/ijms23084176
66. Huo YH, Wang J, Yin LX. Sinomenium alleviates MPP+ induced SK-N-SH cell damage by ANRIL/miR-626 axis. Chinese J Pathophysiol. 2019;36(08):1404–12.
67. Zhang YH, Wen WL, Zhang WY, et al. Treatment of rheumatoid arthritis by injection of Sinomenium solid lipid nanoparticles under fluorescence confocal microscope. China J Chinese Mater Med. 2019;48(14):3786–92.
68. Dong HY, Cong Y, Wu CS, et al. Clinical effect of acupuncture and moxibustion combined with Zhengqing Fengtongning injection on knee joint swelling pain of rheumatoid arthritis. Inner Mongolia J Trad Chinese Med. 2023;42(7):117–8.
2. Xu HY, Kuang NZ, Zhang YJ, et al. Research progress in the treatment of rheumatoid arthritis. J Nanchang University. 2019;60(05):97–102.
3. Hu C, Tu RD, Leng WF, et al. Research progress of Zhengqing Fengtongning in treatment of rheumatoid arthritis. J Pract Trad Chinese Med. 2023;39(5):1048–50.
4. Wan YY, Liu CX, Zhang JH, et al. Analysis on the efficacy and safety of Zhengqing Fengtongning injection in the treatment of osteoarthritis. Guiding J Trad Chinese Med Pharm. 2019;25(14):105–9.
5. Wang XC, Yi TX, Leng WF, et al. Effect of Zhengqing Fengtongning combined with triamcinolone acetonide injection on knee joint osteoarthritis. J Pract Trad Chinese Med. 2019;35(09):1111–2.
6. Wang Y, Wang LW. Research progress on pathogenesis of immune cells and cytokines in rheumatoid arthritis. Chinese J Rehab Med. 2007;2007(04):370–373.
7. Jian L, Equilibria Z, Cao YH. Xinfeng capsule promotes apoptosis of CD4~+T cells in peripheral blood of patients with rheumatoid arthritis by regulating apoptosis-related proteins. Rheumatism Arthritis. 2019;8(01):15–20.
8. Zhou YY, Liu YL, Lin LF, et al. Research progress of Sinomenium and its new dosage forms in the treatment of rheumatoid arthritis. Chinese Trad Herbal Drugs. 2001;52(24):7709–17.
9. Luo J, Wang Y, Qi Q, et al. Sinomenium improves embryo survival by regulating Th1/Th2 balance in a mouse model of recurrent spontaneous abortion. Med Sci Monit. 2021;27:e927709. https://doi.org/10.12659/MSM.927709
10. He HP, Xu GH, Lin J, et al. The role of macrophages in rheumatoid arthritis. J Med Res. 2019;51(02):8–11.
11. Wei ZQ, Bao CH, Chen YX, et al. Sinomenium increases expression of paired immunoglobulin receptor B and inhibits classical activation of macrophages. Acta Pharm Sinica. 2018;56(06):1644–52.
12. Huang H, Hu MY, Xu L, et al. Research progress on immunosuppressive mechanism of Sinomenium. Chinese Trad Herbal Drugs. 2022;53(01):261–9.
13. Xie YM. Effect of Sinomenium on DC2.4 maturation and mechanism of inducing apoptosis in DC2.4. China: Chengdu University of Traditional Chinese Medicine; 2016.
14. Zhang XY. Effect of Sinomenium on CD80/CD86 on BMDC surface of mice model of rheumatoid arthritis. China: Chengdu University of Traditional Chinese Medicine; 2016.
15. Mei X. Effect of Sinomenium on mannose receptor expression and related antibody in rheumatoid arthritis model rats. China: Chengdu University of Traditional Chinese Medicine; 2014.
16. Hu JW, Ding C, Wu Y, et al. Research progress of Sinomenium and its preparations in the treatment of rheumatoid arthritis. J Shaanxi Univ Chinese Med. 2019;47(3):1–7.
17. Li XJ, Wang PX, Liu L, Chen GX, Zhao JX. Effects of Sinomenium on activation of T lymphocytes and expression of TH1 intracellular cytokines. Chinese J Immunol. 2004;2004(04):249–52.
18. Wang GF. Effect of Qingfengteng decoction on Tfh, IL-21 and anti-CCP antibody in patients with rheumatoid arthritis. Modern Pract Med. 2019;31(08):1005–7.
19. Ma LW, Yu D, Wu JK, et al. Mechanism of action of Chinese medicine and active ingredients in treatment of rheumatoid arthritis. Hebei Med J. 2019;42(18):2832–6.
20. Li N, Deng J, Zhou JR, et al. Effect of Sinomenium on the ratio of auxiliary T lymphocytes 17/ regulatory T lymphocytes in peripheral blood of patients with rheumatoid arthritis. Shanghai Med J. 2013;36(03):254–8.
21. Mateen S, Zafar A, Moin S, et al. Understanding the role of cytokines in the pathogenesis of rheumatoid arthritis. Clin Chim Acta. 2016;455:161–71. https://doi.org/10.1016/j.cca.2016.02.010
22. Qin YX, Guo MZ. Effects of Sinomenium on proliferation and inflammatory factors of rat synovial cell line RSC-364 induced by IL-1β. Acta Chinese Med Pharmacol. 2019;50(05):34–9.
23. He L, Ge ZZ, Wu YQ, et al. Effect of Sinomenium on ankle arthritis in rats through PI3K/Akt signaling pathway. Northwest Pharm J. 2019;37(03):71–6.
24. Fu MY, Yang JY, Wen X, et al. Sinomenium inhibits IL-1β-induced inflammation and degeneration of intervertebral disc endplate chondrocytes by blocking the activation of NF-κB pathway. Chinese J Gerontol. 2019;42(16):4045–9.
25. Kim T W, Han J M, Han Y K, et al. Anti-inflammatory effects of Sinomenium acutum extract on endotoxin-induced uveitis in Lewis rats. Int J Med Sci. 2018;8:758–64. https://doi.org/10.7150/ijms.24834
26. Cheng H, Xia B, Guo Q, et al. Sinomenium attenuates 2, 4, 6-trinitrobenzene sulfonic acid-induced colitis in mice. Int Immunopharmacol. 2007;7(5):604–11. https://doi.org/10.1016/j.intimp.2007.01.003
27. Tao CS. Preliminary study on the role of Sinomenium in melanin synthesis and skin inflammation and its external preparation. China: Naval Medical University; 2017.
28. Jiang Y, Gao M, Wang W, et al. Sinomenium hydrochloride protects against polymicrobial sepsis via autophagy. Int J Mol Sci. 2015;2015(2):2559–73. https://doi.org/10.3390/ijms16022559
29. Wu M Y, Li C J, Yiang G T, et al. Molecular regulation of bone metastasis pathogenesis. Cell Physiol Biochem. 2018;46(4):1423–38. https://doi.org/10.1159/000489184
30. Coury F, Peyruchaud O, Machuca-Gayet I. Osteoimmunology of bone loss in inflammatory rheumatic diseases. Front Immunol. 2019 ;10:679. https://doi.org/10.3389/fimmu.2019.00679
31. Wang K, Zeng XZ, Tao L, et al. Effects of Sinomenium combined with aconitine on RANKL expression and osteoclast formation in CD4~+ T cells. Pharmacol Clin Chinese Mater Med. 2016;32(03):61–5.
32. Zou Y, Li H, Shangjiang YZ, et al. Effects of Sinomenium hydrochlorideaspirin on proliferation, differentiation, mineralization of MC3T3E1 cells and its possible mechanism. Jiangxi Med J. 2018;53(02):119–21.
33. Ding CZ, Yao Y, Fang Y, et al. Effects of Sinomenium on serum OPG/RANKL and IL-17 levels in collagen-induced arthritis rats [J]. Journal of Nanjing University of Traditional Chinese Medicine,2012,28(04):330-333.
34. Zhang HR, Ji JY, Hou XQ, et al. Effect of Sinomenium on CaN/NFAT pathway on CIA bone destruction. Chinese J Immunol. 2019;36(12):1447–52.
35. Ji JY, Guo Z, Huang YG, et al. Research progress of Sinomenium in inhibiting bone destruction in rheumatoid arthritis. J Pract Med. 2019;35(14):2338–41.
36. Ji JY. Study on the mechanism of Sinomenium regulating NF-κB signaling pathway to inhibit the differentiation of MDSC into OC in CIA mice. China: China Three Gorges University; 2021.
37. Wang ZL. Effect of Zhengqing Fengtongning injection on expression of β-CATENIN, MMP-13 and TGF-β in rabbit KOA model. China: Heilongjiang Academy of Chinese Medicine; 2021.
38. Shen RM, Li GQ, Li L, et al. lncRNA RGMB-AS1 regulates proliferation, migration and invasion of synovial fibroblasts in rheumatoid arthritis by targeting miR-129-5p. Curr Immunol. 2002;42(05):387–94.
39. Cai H, Zhang BB. Research progress of fibroblast-like synovial cells in rheumatoid arthritis. Modern Med J. 2017;45(09):1362–6.
40. Sheng XH, Xie XF. Effect of Zhengqing Fengtongning sustained-release tablet on apoptosis of synovial fibroblast-like cells in human rheumatoid arthritis by regulating HOTAIRM1/miR-137 axis. Chinese J Immunol. 2019;37(20):2475–81.
41. Cai ST, Sun JT, Wei X. The mechanism of miR-23b-3p targeting XIAP to regulate the proliferation and apoptosis of synovial fibroblasts in rheumatoid arthritis. Chinese J Pathophysiol. 2019;35(07):1310–5.
42. Li J, Fu TT, Zhang GF, et al. Sinomenium induces apoptosis of human rheumatoid arthritis fibroblast-like synovial cells by miR-23b-3p/FGF9. Chinese J Pathophysiol. 2019;36(09):1653–60.
43. Xu J. Study on the therapeutic effect and mechanism of ethanol extract of Sinomenium in the treatment of rheumatoid arthritis. China: Nanjing University of Chinese Medicine; 2015.
44. Han J. Experimental study of Sinomenium against synovial-related cytokines in rheumatoid arthritis. China: Chengdu University of Traditional Chinese Medicine; 2013.
45. Yi L, Lyn Y J, Peng C, et al. Sinomenium inhibits fibroblast-like synoviocyte proliferation by regulating alpha7nAChR expression via ERK/Egr-1 pathway. Int Immunopharmacol. 2018;56:65–70. https://doi.org/10.1016/j.intimp.2018.01.015
46. Ouyang L. Study on efficacy of Qingfengteng combined with Heishun tablet in treatment of rheumatoid arthritis. China: Hunan University of Chinese Medicine; 2019.
47. Yang J. Clinical effect of Zhengqing Fengtongning on degenerative knee arthritis. Inner Mongolia J Trad Chinese Med. 2001;40(7):32–3 [in Chinese].
48. Guo JQ. Effect of Zhengqing Fengtongning Tablet combined with Febuxostat Tablets on gouty arthritis. Clin Res. 2019;27(3):118–9.
49. Liu JF, You ZX, Yang CG. Effect of minimally invasive technique of traditional Chinese medicine combined with Zhengqing Fengtongning intraarticular injection on knee osteoarthritis. Inner Mongolia J Trad Chinese Med. 2019;42(7):91–3.
50. Rong QJ, Yang S, Han JC, et al. Mechanism of action of Sinomenium acutum in intervention against knee osteoarthritis: A study based on network pharmacology and molecular docking. Hunan J Trad Chinese Med. 2019;39(10):170–6.
51. Zheng J, Wang RH, Kou JS, et al. Effects of Sinomenium on the expression of endothelial growth factor and nerve growth factor in cartilage and synovial blood vessels of rabbit model of knee osteoarthritis. Chinese J Inform Trad Chinese Med. 2016;23(03):38–41.
52. Liu Z, Sun J, Liang T, et al. Increased expression of cyclooxygenase‑2 in synovium tissues and synovial fluid from patients with knee osteoarthritis is associated with downregulated microRNA‑758‑3p expression. Exp Ther Med. 2021;22(3):1001. https://doi.org/10.3892/etm.2021.10433
53. Ma AX, Kou JS, Lu XH. Study on the mechanism of Sinomenium intervention in knee osteoarthritis rats based on RNA-Seq technique. Chinese J Integr Trad Western Med. 2018;44(1):77–83.
54. Wu ZY, Chen ZQ, Song WG, et al. Study on the mechanism of the treatment of diabetic nephropathy based on network pharmacology. Hunan J Trad Chinese Med. 2022;38(4):156–61.
55. Sharmila R, Sindhu G, Arockianathan P M. Nephroprotective effect of beta-sitosterol on N-diethylnitrosamine initiated and ferric nitrilotriacetate promoted acute nephrotoxicity in Wistar rats. J Basic Clin Physiol Pharmacol. 2016;27(5):473–82. https://doi.org/10.1515/jbcpp-2015-0085
56. Teng J, Zhao LJ, Zhou SH, et al. Research progress of Sinomenium hydrochloride in the treatment of nephropathy. Guiding J Trad Chinese Med Pharm. 2019;25(16):120–4.
57. Yang CM, Yang ZX, Ma XL. Research progress of AGE-RAGE signaling pathway in diabetic nephropathy. Acta Chinese Med. 2019;34(09):1864–8.
58. Ni HM. Protective effect of Sinomenium hydrochloride on mesangial proliferative glomerulonephritis in rats. China: Guangdong Pharmaceutical University; 2021.
59. Liu Y, Li PY, Zhang QH, et al. Effect of Sinomenium on PI3K/mTOR signaling pathway and mesangial hyperplasia in adriamycin nephropathy rats. J Clin Nephrol. 2001;21(04):314–9.
60. Bi GY, Liu CH, Xu J, et al. Clinical observation of 24 cases of IgA nephropathy with moderate albuminuria treated by glucocorticoid combined with Zhengqing Fengtongning. J Trad Chinese Med. 2013;19(05):52–4.
61. Duan XY, Huo ZP, Feng XC, et al. Progress of pharmacological research on Sinomenium in the treatment of gouty arthritis. Tianjin Pharm. 2019;36(1):73–8.
62. Chen X, Mao B, Che DY, et al. Clinical observation of electro-porous transdermal administration of Zhengqing Fengtongning Injection in the treatment of gouty arthritis. J Emerg Trad Chinese Med. 2014;23(04):706–8.
63. Zhang LY, He CH, Zhao ZZ, et al. Neuroprotective effect of Sinomenium regulating GSK3β/Nrf2/HO-1 and NF-κB signaling pathway in mice with Parkinson’s disease. Trad Chinese Drug Res Clin Pharmacol. 2019;35(05):607–14.
64. Langston J W. The MPTP story. J Parkinsons Dis. 2017;7(s1):S11–S19. https://doi.org/10.3233/JPD-179006
65. Nagatsu T, Nakashima A, Watanabe H, et al. Neuromelanin in Parkinson’s disease: Tyrosine hydroxylase and tyrosinase. Int J Mol Sci. 2022;23(8):4176. https://doi.org/10.3390/ijms23084176
66. Huo YH, Wang J, Yin LX. Sinomenium alleviates MPP+ induced SK-N-SH cell damage by ANRIL/miR-626 axis. Chinese J Pathophysiol. 2019;36(08):1404–12.
67. Zhang YH, Wen WL, Zhang WY, et al. Treatment of rheumatoid arthritis by injection of Sinomenium solid lipid nanoparticles under fluorescence confocal microscope. China J Chinese Mater Med. 2019;48(14):3786–92.
68. Dong HY, Cong Y, Wu CS, et al. Clinical effect of acupuncture and moxibustion combined with Zhengqing Fengtongning injection on knee joint swelling pain of rheumatoid arthritis. Inner Mongolia J Trad Chinese Med. 2023;42(7):117–8.