HMN 2025: How Combined remedy integrates Chinese herb Astragalus and methotrexate to handle drug resistance in autoimmune ailments

Researchers on the School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong (HKUMed), have discovered that combining the lively ingredient extracted from the standard Chinese medication Astragalus membranaceus (huang qi) with the broadly used Western drug methotrexate (MTX) can successfully cut back continual irritation in autoimmune ailments comparable to systemic lupus erythematosus and Sjögren’s illness.

Their analysis supplies a possible resolution to handle drug resistance and the unwanted side effects attributable to long-term remedy. The analysis findings had been printed in two journals, Acta Pharmacologica Sinica and the Journal of Leukocyte Biology, where they had been featured as cowl tales.

Autoimmune ailments are troublesome to handle over the long run. These circumstances happen when the sufferers’ immune system mistakenly assaults the physique’s personal wholesome cells, leading to harm to numerous tissues and organs.

Patients typically require steady remedy to manage signs. Although MTX is usually prescribed as a first-line therapy and is efficient in easing irritation, extended use inevitably results in drug resistance, and excessive doses could lead to extreme unwanted side effects, comparable to liver toxicity.

In a complete evaluation of 1,640 conventional Chinese medication formulation used over bygone days 40 years to deal with 5 widespread autoimmune ailments, the HKUMed analysis crew, led by Professor Lin Xiang and Professor Shen Jiangang from the School of Chinese Medicine at HKUMed, discovered that Astragalus membranaceus is probably the most ceaselessly prescribed medicinal herb.

Using a self-developed mouse model and scientific information from sufferers, the crew grew to become the primary to display that Astragalus membranaceus can inhibit “T follicular helper cells (Tfh cells),” a sort of immune cell identified to assault wholesome tissues in rheumatic ailments.

Interestingly, whereas MTX is broadly utilized in scientific settings, the review discovered that it doesn’t successfully suppress Tfh cells and will even trigger a rise of their quantity.

In distinction, Astragalus membranaceus has proven a outstanding potential to successfully regulate Tfh cell exercise, highlighting its important therapeutic potential in managing autoimmune ailments.

In addition, the analysis crew was the primary to efficiently isolate a bioactive compound known as calycosin from Astragalus membranaceus, which may successfully inhibit Tfh cell responses in each people and mice.

They additionally discovered that calycosin is the primary inhibitor to inhibit BATF, a core protein that controls the differentiation of Tfh cells. Since BATF is sort of similar in people and mice —sharing 99% structural similarity—these findings lay a significant basis for cross-species therapeutic functions.

Calycosin can exactly inhibit the perform of BATF, thereby suppressing Tfh cell activation and lowering autoantibody manufacturing. Importantly, calycosin addresses the therapeutic limitations of MTX.

When utilized in mixture, calycosin and MTX display important synergistic results, enhancing therapy outcomes. Even through the continual section of irritation in mice with experimental Sjögren’s illness, the mixed remedy supplies important safety to the affected goal organs.

Professor Lin Xiang, Assistant Professor of the School of Chinese Medicine, HKUMed, said, “Combining calycosin from Astragalus membranaceus with MTX permits us to successfully cut back drug toxicity whereas enhancing therapeutic effectiveness. This method considerably lowers the required dosage of MTX with out compromising its efficacy, thereby enhancing the general security of therapy.

“The analysis crew just lately filed a global patent for using calycosin within the therapy of autoimmune ailments, marking a milestone within the modernization of conventional Chinese medication analysis.”

This analysis holds nice potential for scientific translation and is predicted to beat the drug resistance attributable to long-term MTX remedy. In the close to future, this remedy may very well be prolonged to sufferers with different autoimmune ailments, offering evidence-based help for the modernization of lively substances in conventional Chinese medication.

Furthermore, the analysis crew has developed a “humanized mouse model of Sjögren’s illness,” which precisely recapitulates immune dysregulation in sufferers.

Using this model, they validated the efficacy of the mixed remedy in humanized mice with Sjögren’s illness, offering robust proof to help future scientific trials.

The findings had been introduced on the 2025 European Alliance of Associations for Rheumatology (EULAR) Annual Congress and had been printed within the Annals of the Rheumatic Diseases.