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Chin Med J (Taipei) 1996;57:S35.
Department of Rheumatology, Peking Union Medical College Hospital
Chinese Academy of Medical Sciences
Tripterygium wilfordii Hook f. is a plant of the genus Tripterygium of the family celastraceae. Many preparations, mainly from its root, have been used in the clinic, among which the polyglycoside (TP) has shown better effects with relatively mild side effects.
Its pharmacological effect is mainly inhibitory on all stages of cell cycle. Using a flow cytometer, we analyzed the behavior of T cells stimulated with PHA, and found that TP exerted marked inhibition on the transition of T cells from G0 to G1. Similar inhibitory effect was also observed on the transition of colchicine-related T cells from G1 to S and from S to G2/M. Besides, TP acts much like cytotoxic drugs.
The effective rate of TP in the treatment of rheumatoid arthritis is 90%; it led to marked resolution of the symptoms in 8% of the cases. Ankylosing spondylitis responded to TP, sulfasalazine and methotrexate with effective rates of 85%, 60% and 60% respectively after half a year of treatment. In most cases treated with TP, alleviation was noted in symptoms of the spine and joints 2 weeks after starting the drug, and improvement in pain and swelling of joints and backache was observed 4 weeks after. In patients with lupus nephritis unresponsive to prednisone and other immunosuppressive drugs, combined administration of prednisone and TP resulted in reduction or even complete disappearance of protien in urine in 40% to 50% of cases.
Many side effects, however, have been reported. About 45% of patients who received TP complained of such adverse effects as skin rashes, skin pigmentation, stomatis and softening of finger nails. In female patients treated with TP, reduction of menses was noted 4 weeks after initiation of therapy, and amenorrhea was observed in 30% and 90% of the cases respectively 3 months after and 6 months after. In male patients, the number and motility of sperms were reduced and the sperms disappeared completely after a month. In general, the longer the duration of administration and the older the patients, the smaller the probability of their menses or sperms returning to normal. Besides, frequent upper abdominal pain, nausea, reduced appetite were also reported and impairment of hepatic and renal functions appeared in a few cases.
[Chin Med J (Taipei) 1996; 57: S35.]
Copyright: 1996, Chinese Medical Association (Taipei)