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Tripterygium wilfordii
• Thundergod Vine, Lei Gong Teng
Tripterygium is a climbing vine with a long history of use in traditional Chinese herbal medicine . It is used in mixtures intended for the treatment of 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 to excess. Extracts made with ethyl acetate or chorloroform-methanol came into use in China in the 1970s, and were said to be less toxic. However, the safety of these extracts has not been conclusively established, and we recommend against using tripterygium except in the context of a scientific trial.
What is Tripterygium wilfordii Used for Today?
In animal, test-tube, and preliminary human trials, trypterygium has shown immunosuppressive and anti-inflammatory affects. 1-7 Because drugs with these properties are useful for conditions in which the immune system is overactive, such as rheumatoid arthritis and lupus , trypterygium has been proposed for similar use. However, as yet there is only minimal evidence that it is effective.
One double-blind, placebo-controlled study performed in China in 1997 evaluated the topical use of a tripterygium extract in 61 people with rheumatoid arthritis. 8 The extract was applied 5–6 times daily to the affected joints. The results appeared to indicate that use of the herbal tincture over 6 weeks significantly reduced rheumatoid arthritis symptoms as compared to 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 compared placebo to oral trypterygium extract, taken in a low or high dose for 20 weeks. 9 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.
At most, therefore, current evidence regarding tripterygium for rheumatoid arthritis remains preliminary. The U.S. National Institutes of Health (NIH) is currently conducting a much larger study on this herb that should provide more definitive information.
No other potential uses of tripterygium have undergone meaningful controlled clinical trials. Weak evidence hints that it might offer promise as a contraceptive for men. 10
Dosage
At present, we recommend that trypterygium should only be used in the context of a scientific trial.
Safety Issues
Trypterygium is a toxic herb: various components of trypterygium can cause liver injury, genetic damage, and birth defects. 11-15 It is thought, but not proven, that certain chemical extracts of trypterygium are safe if used within proper dosage limits. 15 All forms of the herb should be avoided by pregnant or nursing women, young children, and those with kidney or liver disease.
References
1. Wang X, Gao W, Yao Z et al. Immunosuppressive sesquiterpenes from Tripterygium wilfordii . Chem PharmBull (Tokyo) . 2005;53:607–10.
2. Wan Y, Gu L, Suzuki K, et al. Multi-glycoside of Tripterygium wilfordii Hook f. ameliorates proteinuria and acute mesangial injury induced by anti-Thy1.1 monoclonal antibody. Nephron Exp Nephrol . 2005;99:e121–9.
3. Liu Q, Chen T, Chen H, et al. Triptolide. Biochem Biophys Res Commun . 2004;319:980–6.
4. Ho LJ, Lai JH. Chinese herbs as immunomodulators and potential disease-modifying antirheumatic drugs in autoimmune disorders. Curr Drug Metab . 2004;5:181–92.
5. Wu Y, Wang Y, Zhong C, et al. The suppressive effect of triptolide on experimental autoimmune uveoretinitis by down-regulating Th1-type response. Int Immunopharmacol . 2003;3:1457–65.
6. Hu Y, Zhao W, Qian X, et al. Effects of oral administration of type II collagen on adjuvant arthritis in rats and its mechanisms. Chin Med J (Engl) . 2003;116:284–7.
7. Tao X, Lipsky PE. The Chinese anti-inflammatory and immunosuppressive herbal remedy Tripterygium wilfordii Hook F. Rheum Dis Clin North Am . 2000;26:29–50, viii.
8. Cibere J, Deng Z, Lin Y, et al. A randomized double blind, placebo controlled trial of topical Tripterygiumwilfordii in rheumatoid arthritis: reanalysis using logistic regression analysis. J Rheumatol . 2003;30:465–7.
9. Tao X, Younger J, Fan FZ, et al. Benefit of an extract of Tripterygium wilfordii Hook F in patients with rheumatoid arthritis: a double-blind, placebo-controlled study. Arthritis Rheum . 2002;46:1735–43.
10. Wang L, Ye W, Hui L, Liu X, Guo Y. Male contraception of triptonide and its function mechanism [in Chinese]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao . 2000;22:223–6.
11. Peng B, Miao MS, Wang YL, et al. Initial discussion of mice acute hepatic injury caused by tripterygium glycosides [in Chinese]. Zhongguo Zhong Yao Za Zhi . 2004;28:1067–70.
12. Takei A, Nagashima G, Suzuki R, et al. Meningoencephalocele associated with Tripterygium wilfordii treatment. Pediatr Neurosurg . 1997;27:45–48.
13. Chan WY, Ng TB. Adverse effect of Tripterygium wilfordii extract on mouse embryonic development. Contraception . 1995;51:65–71.
14. Xu W, Ziqing L, Yinrun D, et al. Tripterygium hypoglaucum (level) Hutch induces aneuploidy of chromosome 8 in mouse bone marrow cells and sperm. Mutagenesis . 2004;19:379–82.
15. Tao X, Lipsky PE. The Chinese anti-inflammatory and immunosuppressive herbal remedy Tripterygium wilfordii Hook F. Rheum Dis Clin North Am . 2000;26:29–50, viii.
Last reviewed April 2009 by EBSCO CAM Review Board
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