REN Nina,MA Wukai,LING Yi,et al.Effects of Jishe Qushi Capsule (脊蛇祛湿胶囊) on Serum NETs Levels and Macrophage Polarization in Collagen-Induced Arthritis Model Rats[J].Journal of Traditional Chinese Medicine,2026,67(01):60-68.
REN Nina,MA Wukai,LING Yi,et al.Effects of Jishe Qushi Capsule (脊蛇祛湿胶囊) on Serum NETs Levels and Macrophage Polarization in Collagen-Induced Arthritis Model Rats[J].Journal of Traditional Chinese Medicine,2026,67(01):60-68.DOI: 10.13288/j.11-2166/r.2026.01.010.
Effects of Jishe Qushi Capsule (脊蛇祛湿胶囊) on Serum NETs Levels and Macrophage Polarization in Collagen-Induced Arthritis Model Rats
(脊蛇祛湿胶囊, JQC) in treating rheumatoid arthritis (RA) from the perspective of macrophage polarization mediated by neutrophil extracellular traps (NETs).
Methods
2
Twenty-four female SD rats were randomly divided into four groups, blank control group, model group, JQC group, and peptidylarginine deiminase 4 (PAD4) inhibitor group with 6 rats in each group. All groups but the blank control group were subjected to the induction of collagen-induced arthritis (CIA). After successful model establishment, rats in the JQC group received intragastric administration of JQC 1.47 g/kg daily; rats in the PAD4 inhibitor group received intraperitoneal injections of the PAD4 inhibitor 4 mg/kg weekly. Rats in the blank, model, and PAD4 inhibitor groups received 2 ml of pure water daily by gavage. All treatments lasted 4 weeks. Joint lesions of each group were assessed on day 7, 14, 21, 28, and 35 after model establishment, and arthritis index (AI) scores were recorded. At 24 h after the final administration, histopathology of knee joints, including HE staining, safranin O-fast green staining, and TRAP staining, was performed. Flow cytometry was used to detect the counts of M1 and M2 macrophages in peripheral blood. ELISA was used to determine serum levels of TRACP, NETs, TNF-α, IL-1β, and iNOS. Western Blotting and qRT-PCR were used to measure MPO, NE, RANKL, OPG, and p65 protein and mRNA expression in knee cartilage tissue.
Results
2
Compared with the blank control group, the model group showed increased AI scores (
P
<0.05), marked synovial inflammatory infiltration, angiogenesis, and bone-cartilage destruction, increased TRAP-positive osteoclasts, increased M1 macrophages and decreased M2 macrophages, elevated serum TRACP, NETs, TNF-α, IL-1β, and iNOS (
P
<0.05), elevated MPO, NE, RANKL, and p65 protein/mRNA expression and decreased OPG protein/mRNA expression in knee cartilage tissue (
P
<0.05). Compared with the model group, the JQC group exhibited improved synovial inflammation, angiogenesis, and bone-cartilage damage, reduced AI scores on day 21, 28, and 35, decreased osteoclast counts, decreased M1 macrophages and increased M2 macrophages, reduced serum TRACP, NETs, TNF-α, IL-1β, and iNOS (
P
<0.05), decreased MPO, NE, RANKL, and p65 protein/mRNA expression and increased OPG expression (
P
<0.05). Compared with the PAD4 inhibitor group, the JQC group showed significantly lower AI scores, reduced M1 macrophages, increased M2 macrophages (
P
<0.05), reduced serum TRACP, TNF-α, IL-1β, and iNOS, decreased MPO, RANKL, and p65 expression, and increased OPG levels (
P
<0.05).
Conclusion
2
The therapeutic mechanism of JQC for RA may involve inhibition of NETs formation, downregulation of the RANKL/NF-κB signaling pathway, and regulation of macrophage M1/M2 polarization imbalance, thereby suppressing osteoclastogenesis and inflammatory bone destruction.
CARMONA-RIVERA C , CARLUCCI PM , GOEl RR , et al . Neutrophil extracellular traps mediate articular cartilage damage and enhance cartilage component immunogenicity in rheumatoid arthritis [J]. JCI Insight , 2020 , 5 ( 13 ): e139388 .
SCHNEIDER AH , TAIRA TM , PÚBLIO GA , et al . Neutrophil extracellular traps mediate bone erosion in rheumatoid arthritis by enhancing RANKL-induced osteoclastogenesis [J]. Br J Pharmacol , 2024 , 181 ( 3 ): 429 - 446 .
YAN QQ , LIU HX , ZHU RY , et al . Contribution of macrophage polarization in bone metabolism: a literature review [J]. Cytokine , 2024 , 184 : 156768 . doi: 10.1016/j.cyto. 2024.156768 http://dx.doi.org/10.1016/j.cyto.2024.156768 .
LING Y , YANG YZ , REN NN , et al . Jinwu Jiangu capsule attenuates rheumatoid arthritis via the SLC7A11/GSH/GPX4 pathway in M1 macrophages [J]. Phytomedicine , 2024 , 135 : 156232 . doi: 10.1016/j.phymed.2024. 156232 http://dx.doi.org/10.1016/j.phymed.2024.156232 .
LARSSON P , KLEINAU S , HOLMDAHL R . Homologous type Ⅱ collagen-induced arthritis in rats.Characterization of the disease and demonstration of clinically distinct forms of arthritis in two strains of rats after immunization with the same collagen preparation [J]. Arthritis Rheum , 1990 , 33 ( 5 ): 693 - 701 .
WEN Y , ZHANG S , MENG X , et al . Water extracts of Tibetan medicine Wuweiganlu attenuates experimental arthritis via inducing macrophage polarization towards the M2 type [J]. J Ethnopharmacol , 2024 , 318 ( pt a ): 116934 .
XIANG XC , XIN XR , HOU YB , et al . Diosgenin alters LPS-induced macrophage polarization by activating PPARγ/NF-κB signaling pathway [J]. Int Immunopharmacol , 2024 , 126 : 111270 . doi: 10.1016/j.intimp.2023. 111270 http://dx.doi.org/10.1016/j.intimp.2023.111270 .
O'NEIL LJ , BARRERA-VARGAS A , SANDOVAL-HEGLUND D , et al . Neutrophil-mediated carbamylation promotes articular damage in rheumatoid arthritis [J]. Sci Adv , 2020 , 6 ( 44 ): eabd2688 .
LIN YJ , ANZAGHE M , SCHÜLKE S . Update on the pathomechanism,diagnosis, and treatment options for rheumatoid arthritis [J]. Cells , 2020 , 9 ( 4 ): 880 .
TAKEI H , ARAKI A , WATANABE H , et al . Rapid killing of human neutrophils by the potent activator phorbol 12-myristate 13-acetate (PMA) accompanied by changes different from typical apoptosis or necrosis [J]. J Leukoc Biol , 1996 , 59 ( 2 ): 229 - 240 .
BRINKMANN V , REICHARD U , GOOSMANN C , et al . Neutrophil extracellular traps kill bacteria [J]. Science , 2004 , 303 ( 5663 ): 1532 - 1535 .
BEDINA S , MOZGOVAYA E , TROFIMENKO A , et al . Ab0073 neutrophil extracellular traps: coupling with rheumatoid arthritis flares and anti-citrulline autoanti-bodies persistence [J]. Ann Rheum Dis , 2022 , 81 ( s1 ): 1168 - 1169 .
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