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Tripterygium wilfordii

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Tripterygium wilfordii
Scientific classification
Kingdom:
Plantae
(unranked):
Angiosperms
(unranked):
Eudicots
(unranked):
Rosids
Order:
Celastrales
Family:
Celastraceae
Genus:
Tripterygium
Species:
T. wilfordii
Binomial name
Tripterygium wilfordii

Tripterygium wilfordii, or lei gong teng (Mandarin) (Chinese:雷公藤, Japanese: raikōtō), sometimes called Thunder God Vine, is a vine used in traditional Chinese medicine for treatment of fever, chills, edema and carbuncle. Tripterygium wilfordii recently has been investigated as a treatment for a variety of disorders including rheumatoid arthritis, chronic hepatitis, chronic nephritis, ankylosing spondylitis, polycystic kidney disease as well as several skin disorders. It is also under investigation for its apparent antifertility effects, which it is speculated, may provide a basis for a Male oral contraceptive.[1]

Pharmacology

The plant contains many active compounds, at least six of which have male anti-fertility effect (triptolide, tripdiolide, triptolidenol, tripchlorolide, 16-hydroxytriplide and a compound known as T7/19, whose structure is unpublished). The mechanism by which they affect fertility is not yet understood. What is known is that daily doses of these compounds reduce sperm counts and also severely affect the formation and maturation of sperm, causing them to be immotile.

Scientific research into medical effects

Contraception

Certain extracts from Tripterygium wilfordii, as well as from Tripterygium hypoglaucum (now considered identical to T. regelii) and Tripterygium regelii, were discovered in the 1980s to have temporary antifertility effects, which has led to research on its potential as a contraceptive.

"Tripterygium wilfordii Hook.f., known as Leigongteng (Thunder God Vine) in traditional Chinese medicine, has attracted much attention for its applications in relieving autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus, and for treating cancer. Molecular analyses of the ITS and 5S rDNA sequences indicate that T. hypoglaucum and T. doianum are not distinct from T. wilfordii, while T. regelii should be recognized as a separate species. The results also demonstrate potential value of rDNA sequence data in forensic detection of adulterants derived from Celastrus angulatus in commercial samples of Leigongteng."[2]

Not enough is known about T. wilfordii to actually test it as a contraceptive. Research thus far has dealt with establishing the mechanism by which the plant affects fertility, and investigating toxicity and side effects. What has been learned is encouraging, however: in both animals and humans, low doses of various Tripterygium extracts can produce significantly lowered sperm density and motility indices without major side effects. When the treatment was ended in the various trials, all indices returned to normal within months.

T. wilfordii could be an effective pharmaceutical alternative to contraceptives based on hormonal manipulation. Further research may shed light on its functional mechanisms, and determine whether it could be used at low enough doses to avoid unpleasant side effects.

Kidney function

The Nanjing University School of Medicine is conducting (2012) a clinical trial of Tripterygium wilfordii to determine its possible beneficial effects on kidney volume and kidney function for polycystic kidney disease (PKD) patients. [3]

Immunosuppression

More recently, a small molecule Triptolide derived from T. wilfordii has been shown to disrupt mitochondrial function in cells and is under investigation as an anti-tumor agent or to suppress auto-immune disorders.

The August 18th 2009 Edition of the Annals of Internal Medicine published an article showing Tripterygium wilfordii was more effective than sulfasalazine in treating rheumatoid arthritis[4],[5]

In China Tripterygium wilfordii has an established history of use in the treatment of rheumatoid arthritis. The herb shows immunosuppressive, cartilage protective, and anti-inflammatory effects.[6],[7], Triptolide, a diterpene triepoxide, is a major active component of extracts derived from Tripterygium wilfordii. Triptolide has multiple pharmacological activities including anti-inflammatory, immune modulation, antiproliferative and ctyproapoptotic activity.[8],

Pancreatic cancer

Two compounds, the diterpenoid epoxide triptolide and the quinone triterpene celastrol found in the plant may have potential as antitumor drugs.[9]

Drugs derived from the plant also show potential for reduction and elimination of pancreatic tumors in mice. Clinical trials may soon begin for the development of a drug for use in humans.[10][11]

Side effects

At medicinal doses, T. wilfordii extract does have significant side effects, including immunosuppression. However, this may not apply to contraceptive use. Many of the side effects are caused by the other active compounds found in the plant, and do not appear when a pure extraction of the anti-fertility agents is used. In addition, the dose required to lower fertility is significantly lower than the standard medicinal dose.

In August 2011 the UK Medicines and Healthcare products Regulatory Agency (MHRA) published a drug safety bulletin advising consumers not to use medicines containing Lei Gong Teng. This was due to concerns over potentially serious side effects. Baidu Baike cautions do not take internally, China State Food and Drug Administration has issued a warning in April 2012 about this medicine, urging caution.[12]

However, a recent review stated that although Tripterygium wilfordii has toxic potential, careful extraction gives an acceptable frequency of adverse reactions, which are largely related to the gastrointestinal tract and amenorrhea. The review found that T. wilfordii extract is useful remedy for postmenopausal rheumatoid arthritis.[13]

See also

Tripterygium wilfordii bioactive compounds as anticancer and anti-inflammatory agents.

Footnotes

  1. ^ Zhen QS, Ye X, Wei ZJ (1995). "Recent progress in research on Tripterygium: a male antifertility plant". Contraception. 51 (2): 121–9. doi:10.1016/0010-7824(94)00018-R. PMID 7750290. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  2. ^ Law et al (2010), p. 21.
  3. ^ http://clinicaltrials.gov/ct2/show/NCT00801268
  4. ^ http://www.annals.org/content/151/4/229.full
  5. ^ Marks W.H., "Tripterygium wilfordii Hook F. versus Sulfasalazine in the treatment of rheumatoid arthritis: A well-designed clinical trial of a botanical demonstrating effectiveness." Fitoterapia 2011 82:1 (85-87).
  6. ^ Bao J., Dai S.-M. "A Chinese herb Tripterygium wilfordii Hook F in the treatment of rheumatoid arthritis: mechanism, efficacy, and safety" Rheumatology International 2011 (1-7)
  7. ^ Moudgil K.D., Venkatesha S.H., Rajaiah R., Berman B.M. "Immunomodulation of autoimmune arthritis by herbal CAM" Evidence-based Complementary and Alternative Medicine 2011 2011 Article Number 986797
  8. ^ Liu Q. "Triptolide and its expanding multiple pharmacological functions" International Immunopharmacology 2011 11:3 (377-383)
  9. ^ Liu Z, Ma L, Zhou GB. "The main anticancer bullets of the Chinese medicinal herb, thunder god vine." Molecules. 2011;16(6):5283-97
  10. ^ http://www.bloomberg.com/news/2012-10-17/drug-from-chinese-thunder-god-vine-slays-tumors-in-mice.html
  11. ^ Drug From Chinese ‘Thunder God Vine’ Slays Tumors in Mice
  12. ^ http://mdfujita.sblo.jp/article/54828939.html
  13. ^ Bao J., Dai S.-M.,"A Chinese herb Tripterygium wilfordii Hook F in the treatment of rheumatoid arthritis: Mechanism, eficacy, and safety." Rheumatology International. 31 (9) (pp 1123-1129), September 2011. [Journal: Review]

References

  • Downloadable PDF - "Molecular analyses of the Chinese herb Leigongteng (Tripterygium wilfordii Hook.f.)" (2010). Sue Ka-Yee Law et al. Phytochemistry 72 (2011) 21–26, Elsevier.[1]
  • Adv Exp Med Biol. 2007;599:139-46.
  • Journal of Andrology 1998; vol 19 no 4, pp 479-486.
  • Contraception 1995; vol 51, pp 121-129.
  • Contraception 1995; vol 51, pp 121-129.
  • Contraception 1986; vol 36 no 3, pp 335-345.
  • MHRA safety bulletin
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