Tripterygium extract triptolide helpful in autoimmune conditions, benefit and side effects by Ray Sahelian, M.D.
Feb 12 2014

Tripterygium wilfordii Hook is a perennial vine growing in southern China. The herb, also called Lei Gong Teng (Thunder God Vine or "three-wing nut"), has been used in Chinese medicine for treatment of fever, edema, and carbuncles for centuries. Tripterygium has anti-inflammatory and immunosuppressive activity. Tripterygium contains triptolide and tripdiolide and numerous other compounds.

Potential clinical uses and benefit of Tripterygium herbal extract
Rheumatoid arthritis symptoms may be eased. Visit the web page for additional options on treating rheumatoid arthritis.
Lupus erythematosus
Leiomyomas (uterine fibroids)
Pancreatic cancer in rodents. A drug extracted from a plant known as “thunder god vine,” or lei gong teng, killed pancreatic tumors in mice who showed no signs of tumors after 40 days or after discontinuing the treatment, according to researchers at the University of Minnesota’s Masonic Cancer Center.
Polycystic kidney disease
Uveitis, an eye condition

Trypterygium side effects and caution
Tripterygium has anti- fertility effect in male rats and in men after oral administration at dose levels not showing apparent toxicity or side effects. Fertility appears to be reversible after cessation of treatment.
Tripterygium therapy may cause amenorrhea in women
Long-term administration could decrease bone mineral density levels in women.

Tripterygium Herbal extract may help rheumatoid arthritis
This Chinese herb may be more effective than the anti-inflammatory drug sulfasalazine. Dr. Raphaela Goldbach-Mansky, from the National Institutes of Health, Bethesda, Maryland says that physicians often prescribe sulfasalazine or other anti-inflammatory drugs for the initial treatment of rheumatoid arthritis. However, many patients discontinue the drugs due to lack of improvement or side effects. This herbal remedy, also known as "lei gong teng" has shown promise in treating other "autoimmune" disorders and inflammatory conditions.I n the current study, Dr. Raphaela Goldbach-Mansky randomly assigned 121 patients with rheumatoid arthritis to take either Tripterygium wilfordii three times daily or sulfasalazine two times daily for 24 weeks. Among those who continued treatment for 24 weeks, improvement in joint symptoms was greater with the herbal remedy (67%) than with sulfasalazine (36%) and adverse effects were similar. Annals of Internal Medicine, 2009.

A small study suggests that an herb used for many years in traditional Chinese medicine may help ease the symptoms of rheumatoid arthritis. The herb is called Tripterygium wilfordii Hook F, known also by the Chinese translation for "thunder god vine." Chinese medicine practitioners use extracts from the vine to treat arthritis and other disorders of the immune system. Dr. Xuelian Tao of the National Institutes of Health and colleagues report that patients who took capsules of different doses of Tripterygium were more likely to experience a reduction in their symptoms of rheumatoid arthritis than those given pills containing inactive ingredients. Rheumatoid arthritis is a chronic disease in which the body's own immune system attacks the tissue lining the joints. It is more common in women, tends to strike between the ages of 36 and 50, and results in chronic destruction and deformity of the joints. In the current study, published in the July issue of Arthritis & Rheumatism, Tao and colleagues compared the effects of an extract of Tripterygium to an inactive drug, or placebo, in 35 patients with rheumatoid arthritis. Patients were given placebo, a low dose of Tripterygium (180 milligrams) or a high dose of the extract (360 milligrams) each day for 20 weeks. Fourteen of the original patients withdrew from the study before the end of the 20 weeks, citing various reasons, the authors note. One patient dropped out of each of the three treatment groups due to side effects. Of the patients who completed the trial, 8 who were given the high dose of the treatment, and 4 given the low dose, experienced at least a 20% improvement in their symptoms. None of the patients given a placebo drug experienced a similar improvement, Tao and colleagues note. Six patients taking the low dose of Tripterygium and 5 of those taking the high dose reported side effects as a result of the treatment, the authors add, which included hair loss, heartburn, and, most commonly, diarrhea. However, Tao and colleagues write, another 4 patients taking placebo also reported side effects similar to some of those noted in the treatment group, suggesting that Tripterygium may not be the cause of many of the concurrent ailments." Many of the side effects were noted in patients treated with placebo as well as in those treated with the extract, suggesting that the side effects may not be specifically associated with administration of the drug," the authors write. Based on the findings, Tao and colleagues suggest that Tripterygium herb may alleviate the symptoms of rheumatoid arthritis by both suppressing immune system activity and reducing inflammation. Arthritis and Rheumatism 2002.

Polycystic kidney disease
Tripterygium extract appears to slow cyst growth and progression of polycystic kidney disease in vitro and in a murine model. Triptolide is the first agent identified and developed in the laboratory with the potential to halt this currently untreatable disease. Triptolide is derived from Tripterygium wilfordii Hook F, also known as the "Thunder God Vine." Triptolide induces apoptosis, arrests cell growth and down-regulates expression of genes that promote inflammation and cellular growth. A tea made from the vine, Li Gong Teng, is used in traditional Chinese medicine as a treatment for inflammation, cancer and auto-immune diseases. Dr. Craig M. Crews of Yale University in New Haven, Connecticut, and colleagues have identified "an as-yet undescribed mechanism of the action of triptolide and an ability to stimulate calcium ion release, arrest cell growth and reduce cyst progression in a murine model" of polycystic kidney disease. PNAS Early Edition 2007.

Nephrotic syndrome
Cochrane Database Syst Rev. August 2013. Tripterygium wilfordii Hook F (a traditional Chinese medicine) for primary nephrotic syndrome. TwHF may have an add-on effect on remission in patients with primary NS. There was insufficient evidence to assess if TwHF was as effective as prednisone or CPA. More methodologically sound and sufficiently powered studies, with adequate follow-up would help to better inform management options for the use of TwHF for primary NS. TwHF should be further directly compared with other widely used immunosuppressive agents after the superiority over placebo or no treatment has been clearly established.

Research
Triptolide, an active compound identified in a traditional Chinese herb, induces apoptosis of rheumatoid synovial fibroblasts.
BMC Pharmacol. 2004.
Extracts of Tripterygium wilfordii, a traditional Chinese herb, have been reported to show efficacy in patients with rheumatoid arthritis (RA). Since RA is not only characterized by inflammation but also by synovial proliferation in the joints, we examined whether triptolide (a constituent of tripterigium) could influence the proliferation of rheumatoid synovial fibroblasts (RSF) by induction of apoptosis. RSF were obtained from RA patients during surgery and were treated with triptolide under various conditions. Triptolide decreased viability, inhibited proliferation, and induced apoptosis of RSF in a concentration-dependent manner at very low (nM) concentrations. Caspase-3 activity was increased by treatment with triptolide and was suppressed by caspase inhibitors. The mechanism of action remains to be studied; however, triptolide may possibly have a disease-modifying effect in patients with RA.

Triptolide, a Chinese herbal extract, protects dopaminergic neurons from inflammation-mediated damage through inhibition of microglial activation.
J Neuroimmunol. 2004.
Mounting lines of evidence have suggested that brain inflammation participates in the pathogenesis of Parkinson's disease. Triptolide is one of the major active components of Chinese herb Tripterygium wilfordii Hook F, which possesses potent anti-inflammatory and immunosuppressive properties. We found that triptolide concentration-dependently attenuated the lipopolysaccharide (LPS)-induced decrease in [3H]dopamine uptake and loss of tyrosine hydroxylase-immunoreactive neurons in primary mesencephalic neuron/glia mixed culture. Triptolide also blocked LPS-induced activation of microglia and excessive production of TNFalpha and NO. Our data suggests that triptolide may protect dopaminergic neurons from LPS-induced injury and its efficiency in inhibiting microglia activation may underlie the mechanism.

Trypterygium supplier
Email received in 2007 - On your website you asked for anyone to let you know if they came across a supplier for tripterygium wilfordii extract. I have found a supplier that says they can provide the following ingredients:

1) Triptolide 99% Min (HPLC)
2) Wilforlide A 98% Min (HPLC)
3) Celastrol 98% Min (HPLC)

However, not being a biochemist, I am not sure how much of what or which I should ask for! I am sure other patients would be in the same situation. I am currently in the middle of doing a three-month trial with other herbs. After evaluation, and depending upon outcomes, I would still be quite interested in conservatively testing the above. Do you know where I can find out about ratios and quantities of ingredients in relation to fibroids? I don't want to poison myself in the process! :) From my research so far, tripterygium wilfordii is quite toxic. Here are the suppliers details below:

www. tazhonghui dot com

  Answer by Dr. Sahelian: I have no idea how to use this herb. You may wish to ask the supplier regarding the proper dosage and then your first time take a fifth or so of what they recommend.

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