Work

Potential efficacy and preliminary mechanistic insights of the Jianpi Yishen Zhuanggu Tongluo formula for rheumatoid arthritis with sarcopenia-osteopenia: an integrated pilot study

Year: 2026

Type: article

Abstract: Objectives To explore the potential efficacy and identify preliminary metabolic biomarkers of the Jianpi Yishen Zhuanggu Tongluo formula (JPYSZGT) in rheumatoid arthritis (RA) complicated with sarcopenia-osteopenia (SO) using 1H-NMR-based metabolomics and in vitro experiments. Methods In this pilot study, forty RA-SO patients were randomly allocated into a treatment group (Group C, n = 20) receiving JPYSZGT plus conventional therapy and a control group (Group D, n = 20) receiving conventional therapy alone for 12 months. Clinical outcomes, including inflammatory markers (CRP, ESR), bone metabolism markers (CTX, PINP), insulin-like growth factor (IGF), cytokines (IL-6, TNF-α), bone mineral density (BMD), and appendicular skeletal muscle mass index (ASMI), were analyzed. Results Compared to Group D, Group C showed greater improvements in DAS28-ESR, ASMI, and BMD, and greater reductions in ESR, CRP, TNF-α, CTX, and PINP, along with a significant increase in IGF levels. Metabolomics analysis identified preliminary alterations in 14 pathways involving glucose, lipid, and amino acid metabolisms. In vitro experiments suggested that JPYSZGT may suppress macrophage activation, potentially upregulate PINK1/PARKIN, downregulate OPG/RANK pathways, and reduce TNF-α and IL-6 secretion. Conclusion This exploratory study suggests that JPYSZGT may improve bone-muscle metrics in RA-SO and that its potential mechanisms could involve the modulation of the PINK1/PARKIN, OPG/RANK, and PI3K/Akt pathways. It also appears to inhibit macrophage-driven inflammation. These findings warrant further investigation in larger-scale studies. Clinical Trial Registration identifier ChiCTR2500106729.

Source: Frontiers in Pharmacology

DOI: 10.3389/fphar.2026.1756789

Authors: Weidong Liang, Liuting Chen, Yadan Zhang, Jianhong Peng

Institution: Guangzhou University of Chinese Medicine

Language: English

Topic: Rheumatoid Arthritis Research and Therapies

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801