Tripterygium wilfordii's therapeutic uses

DEFINITION: Natural plant product used to treat specific health conditions.

PRINCIPAL PROPOSED USE: Rheumatoid arthritis

OTHER PROPOSED USES: Lupus, male contraceptive, autoimmune diseases, anti-inflammatory, cancer

Overview

Tripterygium wilfordii is a climbing vine with a long history of use in traditional Chinese herbal medicine. It is used in mixtures to treat arthritis, muscle injury, skin diseases, and other problems. The roots, leaves, and flowers are the parts used medicinally.

Tripterygium is thought to be toxic or even fatal if taken in excess. Extracts made with ethyl acetate or chloroform-methanol came into use in China in the 1970s and were said to be less toxic, but the safety of these extracts has not been conclusively established.

Therapeutic Dosages

Experts working in clinical trials have used between 60 and 350 milligrams daily for the treatment of rheumatoid arthritis and between 20 and 30 milligrams daily for male birth control. These dosages have not been recommended outside clinical trials.

Therapeutic Uses

In animal, test-tube, and human trials, tripterygium has shown immunosuppressive and anti-inflammatory effects. Because drugs with these properties are useful for conditions in which the immune system is overactive, such as rheumatoid arthritis and lupus, tripterygium has been proposed for similar use. Further, tripterygium has also been recommended for other autoimmune disorders, including systemic lupus erythematosus, psoriasis, ankylosing spondylitis, nephrotic syndrome, and Behçet's disease. 

One double-blind, placebo-controlled study performed in China evaluated the topical use of a tripterygium extract in sixty-one people with rheumatoid arthritis The extract was applied five to six times daily to the affected joints. The results appeared to indicate that the use of the herbal tincture over six weeks significantly reduced rheumatoid arthritis symptoms compared with placebo. However, due to problems in the study, researchers were compelled to use statistical methods that were somewhat questionable (technically, post hoc analysis). For this reason, the results are only somewhat meaningful.

Another study on rheumatoid arthritis compared placebo to oral tripterygium extract, taken in a low or high dose for twenty weeks. The results appeared to show benefit but so many participants dropped out before the end of the study that the results are difficult to interpret. A study published in 2022 showed that patients supplementing with tripterygium reported significant reductions in their disease symptoms and inflammation.

Tripterygium wilfordii has also been proposed as a treatment for inflammatory diseases, such as ulcerative colitis and Crohn's disease. A double-blind, placebo-controlled trial showed promise for patients supplementing with tripterygium in maintaining remission of their Crohn's disease. Finally, tripterygium has been suggested as an adjuvant therapy for patients undergoing cancer treatment and may have antitumor effects.

Further research investigated tripterygium wilfordii as a contraceptive for men. The herb contains a chemical, triptolide, which was shown in one study to effectively prevent fertility in male mice and primates. Further research and human trials must investigate this use more thoroughly, as other chemicals in the substance are known to be toxic.

Safety Issues

Tripterygium is a toxic herb. Its various components can cause liver injury, genetic damage, and birth defects. It is thought, but not proven, that certain chemical extracts of tripterygium are safe if used within proper dosage limits. Pregnant or nursing women, young children, and those with kidney or liver disease should avoid all forms of the herb.

Bibliography

Chang, Zongliang, et al. "Triptonide is a Reversible Non-Hormonal Male Contraceptive Agent in Mice and Non-Human Primates." Nature Communications, vol. 12, no. 1, 2021, p. 1253, doi:10.1038/s41467-021-21517-5.

Shan, Yu, et al. "A Comprehensive Review of Tripterygium Wilfordii Hook. F. in the Treatment of Rheumatic and Autoimmune Diseases: Bioactive Compounds, Mechanisms of Action, and Future Directions." Frontiers in Pharmacology, vol. 14, 2023, p. 1282610, doi.org/10.3389/fphar.2023.1282610. Accessed 21 Sept. 2024.

Song, Cong-Ying, et al. "Use of Tripterygium Wilfordii Hook F for Immune-Mediated Inflammatory Diseases: Progress and Future Prospects." Journal of Zhejiang University, vol. 21, no. 4, 2020, pp. 280-290, doi:10.1631/jzus.B1900607.

"Thunder God Vine." Drugs, 22 May 2024, www.drugs.com/npp/thunder-god-vine.html. Accessed 21 Sept. 2024.

"Thunder God Vine: Usefulness and Safety." National Center for Complementary and Integrative Health, www.nccih.nih.gov/health/thunder-god-vine. Accessed 21 Sept. 2024.

Wu, Y., et al. "The Suppressive Effect of Triptolide on Experimental Autoimmune Uveoretinitis by Down-Regulating Th1-Type Response." International Immunopharmacology, vol. 3, 2003, pp. 1457-1465.