Metabolomics and Mechanistic Approaches Reveal the Synergistic and Attenuating of Rubus chingii Hu on Tripterygium Glycoside Tablets in the Treatment of Rheumatoid Arthritis.

Tripterygium Glycoside Tablets (TGTs) are primary drugs for rheumatoid arthritis (RA) but pose a risk of nephrotoxicity. Rubus chingii Hu (RCH) may enhance kidney function. This study explores a combined RA treatment by examining RCH's chemical components and using a collagen-induced arthritis (CIA) rat model to test TGTs with or without RCH. RCH boosted the therapeutic impact of TGTs in CIA rats, shown by decreased paw swelling, improved joint condition, and reduced serum TNF-α, IL-6, and IL-1β levels. The normalization of renal markers (BUN and Scr) and oxidative stress indicators (ROS, T-NOS, and T-SOD) may be associated with the Nrf2/NF-κB pathway. Metabolomics indicated that RCH may counteract nephrotoxicity by influencing the metabolism of glycine, serine, threonine, tryptophan, histidine, taurine, and sulfaurine. In summary, RCH synergizes with TGTs to treat RA by inhibiting inflammation, affecting metabolic pathways, reducing oxidative stress, and minimizing kidney toxicity, offering a new treatment strategy for RA.