[Effect of Xinfeng Capsule on Improving Pulmonary Function in Rheumatoid Arthritis Patients]

To observe the effect of Xinfeng Capsule (XFC) on pulmonary function, peripheral blood B and T lymphocyte attenuator (BTLA), and oxidative stress in rheumatoid arthritis (RA) patients.

Totally 100 RA patients were assigned to the treatment group and the control group according to random digit table, 50 in each group. Patients in the treatment group took XFC (0. 5 g/pill, 3 pills each time, 3 times per day) , while those in the control group took Leflunomide (LEF) Tablet (0. 1 g/tablet 1, tablet each time, once every evening). The therapeutic course for all was 90 days. Pulmonary functions were detected including forced vital capacity (FVC), forced expiratory volume in one second (FEV1) , peak expiratory flow (PEF), 25% maximal expiratory flow-volume (MEF25), 50% maximal expiratory flow-volume (MEF50), 25% -75% maximal expiratory flow-volume (MEF25 -75). Levels of erythrocyte sedimentation rate (ESR) and high-sensitivity C-reactive protein (hs-CRP) were observed. The disease activity was assessed using disease activity score in 28 joints (DAS28). The ex- pression of BTLA, levels of methane dicarboxylic aldehyde (MDA) , reactive oxygen species (ROS) , superoxide dismutase (SOD) , total antioxidant capacity (TAOC) , and related cytokines (IL-17, TNF-α, IL- 4, IL-35) were also detected. Results Compared with before treatment in the same group, post-treatment FEV1, PEF, MEF25-75, MEF50, and MEF25 were all increased (P <0. 05, P <0. 01) ; ESR, hypersensi- tive C reactive protein (hs-CRP) , and DAS28 were all decreased (P <0. 01) , peripheral blood levels of BTLA +, CD19 +, CD24 +, CD19 + CD24 +, CD24 + BTLA +, SOD, TAOC, IL-4, and IL-35 all increased (P < 0. 01, P <0. 05) ; levels of ROS, MDA, TNF-α, and IL-17 all decreased (P <0. 01 , P <0. 05) in the two groups. Compared with the control group, levels of FVC, MEF25-75, MEF50, and MEF25 all increased (P <0. 05, P <0. 01) , and levels of ESR, hs-CRP, and DAS28 all decreased (P <0. 05, P <0. 01 ) in the treatment group after treatment. Peripheral blood levels of BTLA+ , CD24 +, CD19 + CD24 + , TAOC, and TNF-α all increased (P<0. 05), and levels of CD24 CD19 +, ROS, and MDA all decreased (P<0. 01, P < 0. 05) in the treatment group after treatment.

Decreased pulmonary function and attenua- ted BTLA expression generally exist in RA patients. Besides, its disease activity was closely related with attenuated expression of BTLA and imbalanced oxidative stress. XFC could not only improve joint symptoms of RA patients, but also improve lung function by elevating BTLA expression, attenuating tissue damage from immunological inflammation and oxidative stress.