Tripterygium wilfordii

The United Kingdom government does not recommend the use of Tripterygium due to potential side effects. Birth control Evidence is lacking that Tripterygium is either safe or effective as a method of birth control in men. Two trials found less sperm in people taking it for rheumatoid arthritis but these trials were observational in nature. Rheumatoid arthritis In China, T. wilfordii has historically been used as a treatment of rheumatoid arthritis (RA). The National Center for Complementary and Integrative Health has noted tentative evidence that T. wilfordii may improve some RA symptoms. Other bioactive chemicals Wilfortrine is a sesquiterpene alkaloid isolated from T. wilfordii. It has immunomodulatory effects. ==Side effects==

At medicinal doses, T. wilfordii extract can have significant side effects, China State Food and Drug Administration issued a warning in April 2012 about this medicine, urging caution. A 2016 review found gastrointestinal symptoms in 13%, adverse reproductive outcomes in 12%, adverse skin reactions in 8%, hematologic events in 6.5%, cardiovascular events in 5%. Also irregular menstruation OR=4.6. A 2011 review stated that although T. wilfordii has toxic potential, careful extraction gives an acceptable frequency of adverse reactions, which are largely related to the gastrointestinal tract and amenorrhea. The review found that T. wilfordii extract is a useful remedy for postmenopausal rheumatoid arthritis. ==Pharmacology==

Celastrol, a pentacyclic triterpenoid, and triptolide, a diterpene triepoxide, are putative active components of the extracts derived from Tripterygium wilfordii. Triptolide has pharmacological activities including anti-inflammatory, immune modulation, antiproliferative, and proapoptotic activity, but its clinical use is limited by severe toxicity. The biological target of triptolide is believed to be the XPB subunit of the TFIIH protein complex (involved in DNA repair and transcription initiation). Tripfordines are bio-active sesquiterpene pyridine alkaloids of T. wilfordii. The genome of the species has been sequenced to study biosynthetic pathways. A 2020 article reported the genome of T. wilfordi to study the triptolide biosynthetic pathway. In addition, to aid the investigation of pathways related to celastrol, a reference genome of T. wilfordii was sequenced, producing a 340.12 Mb genome with 31,593 structural genes (35 of them, CYP genes involved in the synthesis of the alkaloid active ingredients). ==Footnotes==