Advances in mechanistic and clinical research on Duhuo Jisheng decoction for the treatment of ankylosing spondylitis by regulating Th17/Treg balance and related cytokines
Li Xinyue
Wang Limin
Zhang Lin
Abstract：Ankylosing spondylitis(AS)is an autoimmune disease characterized by immune disorder,chronic inflammation and abnormal bone metabolism,with the imbalance of T helper 17(Th17)/regulatory T(Treg)cells as the core,and its main clinical manifestations include inflammatory back pain and spinal ankylosis.This article systematically reviews relevant domestic and foreign literatures to explore the theoretical basis and mechanism of Duhuo Jisheng decoction in intervening AS.From the perspective of traditional Chinese medicine theory,this prescription is derived from Beiji Qianjin Yaofang,with the core effects of dispelling wind-dampness,relieving arthralgia,tonifying the liver and kidney,and nourishing Qi and blood,which is consistent with the pathogenesis of AS that"kidney deficiency and Du meridian insufficiency are the root cause,and wind-cold-dampness stasis are the superficial factors".From the perspective of modern mechanism,it repairs the Th17/Treg balance through the synergistic effect of multiple components and multiple targets:it not only downregulates the proportion of Th1 7 cells and the expression of retinoic acid receptor-related orphan receptor γt,and reduces the secretion of the proinflammatory factor interleukin-17(IL-17),but also upregulates the proportion of Treg cells and the expres-sion of forkhead box P3,and increases the release of the anti-inflammatory factor IL-10.Meanwhile,it targets and regulates upstream signaling pathways such as Janus kinase/signal transducer and activator of transcription and nuclear factor-κB,thereby inhibiting the inflammatory cascade reaction and improving pathological bone metabolism.However,current studies still have problems such as the disconnection between mechanism and clinical transformation and insufficient level of clinical evidence.In the future,it is necessary to promote its precise application through multi-center,large-sample randomized controlled trials and the construction of individualized diagnosis and treatment models,so as to provide a theoretical basis for the integrated Chinese and Western medicine treatment of AS.
Keywords：Ankylosing spondylitisT helper cell 17/regulatory T cell balanceDuhuo Jisheng decoc-tionCytokinesJanus kinase/signal transducer and activator of transcription signaling pathwayNuclear factor-κB signaling pathway
Publication Date：2026-03-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 476-480 )