Clinical Study of Effects of Jian Ji Ning, a Chinese Herbal Medicine Compound Preparation, in Treating Patients with Myasthenia Gravis via the Regulation of Differential MicroRNAs Expression in Serum
Myasthenia gravis (MG) is an autoimmune disease, of which the pathogenesis has remained unclear. At present, MG does not have any effective treatment with minor side effects. Jian Ji Ning (JJN), a traditional Chinese medicine formula consisting of 11 medicinal plants, has been used in the treatment of MG for many years. The present study aims to determine if the Chinese herbal medicine JJN could lighten the clinical symptoms of patients with MG via the regulation of differential microRNAs (miRNAs) expression in serum. JJN should be orally administered twice a day for 6 months. In the efficacy evaluation adopting the Quantitative Myasthenia Gravis Score (QMG), we found that JJN could improve the clinical symptoms of patients with MG more effectively. Besides, we found that JJN could regulate differential miRNAs expression in serum of patients with MG. Accordingly, we speculate that the effects of JJN on improving clinical symptoms and blood test indicators of patients with MG may be due to its inhibition of apoptotic pathways of some immune cells and its connection with the regulation of serum miRNAs of some patients. In conclusion, we believe that JJN has a reliable curative effect on patients with MG-induced neuropathologic changes. 1. Introduction Myasthenia gravis (MG) is an antibody-mediated neuromuscular transmission chronic disorder, with an incidence rate of 3–30/1,000,000 people per year. The targets are postsynaptic proteins, mainly involving the skeletal muscle acetylcholine receptor (AchR) and the muscle-specific tyrosine kinase (MuSK) [1, 2]. Some studies have shown that genetic factors played an important role in pathogenesis of MG [3]. In addition, infection with viruses or bacteria, such as poliovirus and Escherichia coli, may be involved in the pathogenesis of MG [4, 5]. However, no report has clearly elucidated the fundamental pathogenesis of MG but merely some accepted hypotheses. The main clinical characteristic of this disease is the volatility of skeletal muscle weakness. At present, anticholinesterase drugs, nonspecific immunosuppressants, thymectomy, and plasmapheresis are main treatments for MG [6–8]. Unfortunately, the abovementioned treatments have some serious side effects, such as cardiac arrhythmia, osteoporosis, and hypotension and cannot inhibit the relapse of symptoms of patients with MG and/or achieve complete remission [9]. Therefore, alternative treatments with higher efficacy and fewer side effects are required. Traditional Chinese medicine (TCM) has been practised for many diseases, including cancer, cardiovascular
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