{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:37:12Z","timestamp":1776753432561,"version":"3.51.2"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To explore the potential efficacy and identify preliminary metabolic biomarkers of the Jianpi Yishen Zhuanggu Tongluo formula (JPYSZGT) in rheumatoid arthritis (RA) complicated with sarcopenia-osteopenia (SO) using 1H-NMR-based metabolomics and\n                      <jats:italic>in vitro<\/jats:italic>\n                      experiments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this pilot study, forty RA-SO patients were randomly allocated into a treatment group (Group C, n = 20) receiving JPYSZGT plus conventional therapy and a control group (Group D, n = 20) receiving conventional therapy alone for 12 months. Clinical outcomes, including inflammatory markers (CRP, ESR), bone metabolism markers (CTX, PINP), insulin-like growth factor (IGF), cytokines (IL-6, TNF-\u03b1), bone mineral density (BMD), and appendicular skeletal muscle mass index (ASMI), were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to Group D, Group C showed greater improvements in DAS28-ESR, ASMI, and BMD, and greater reductions in ESR, CRP, TNF-\u03b1, CTX, and PINP, along with a significant increase in IGF levels. Metabolomics analysis identified preliminary alterations in 14 pathways involving glucose, lipid, and amino acid metabolisms.\n                      <jats:italic>In vitro<\/jats:italic>\n                      experiments suggested that JPYSZGT may suppress macrophage activation, potentially upregulate PINK1\/PARKIN, downregulate OPG\/RANK pathways, and reduce TNF-\u03b1 and IL-6 secretion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This exploratory study suggests that JPYSZGT may improve bone-muscle metrics in RA-SO and that its potential mechanisms could involve the modulation of the PINK1\/PARKIN, OPG\/RANK, and PI3K\/Akt pathways. It also appears to inhibit macrophage-driven inflammation. These findings warrant further investigation in larger-scale studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>identifier ChiCTR2500106729.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1756789","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:37:29Z","timestamp":1776749849000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Potential efficacy and preliminary mechanistic insights of the Jianpi Yishen Zhuanggu Tongluo formula for rheumatoid arthritis with sarcopenia-osteopenia: an integrated pilot study"],"prefix":"10.3389","volume":"17","author":[{"given":"Weidong","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Dongguan Hospital of Traditional Chinese Medicine","place":["Dongguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liuting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Dongguan Hospital of Traditional Chinese Medicine","place":["Dongguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yadan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Guangzhou University of Chinese Medicine Dongguan Hospital","place":["Dongguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhong","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Dongguan Hospital of Traditional Chinese Medicine","place":["Dongguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1080\/03009742.2024.2392364","article-title":"Plasma haem oxygenase-1 may represent a first-in-class biomarker of oxidative stress in rheumatoid arthritis","volume":"54","author":"Andersen","year":"2025","journal-title":"Scand. 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