Digestive Diseases and Sciences

, Volume 52, Issue 8, pp 1790–1797 | Cite as

Efficacy of T2 in Active Crohn’s Disease: A Prospective Study Report

  • Jianan RenEmail author
  • Qingsong Tao
  • Xinbo Wang
  • Zhiming Wang
  • Jieshou Li
Original Paper


To date few therapies have been shown to reliably prevent the evolution of Crohn’s disease (CD). The traditional Chinese medicine, Tripterygium wilfordii Hook F (TWHF), has both immunomodulatory and anti-inflammatory activities. Our aim was to investigate the potential efficacy of T2, the major constituent of extracts of TWHF, in inducing remission of active CD. Twenty adult patients with active CD were enrolled to be treated with T2 pills (60 mg daily) for 12 weeks. Plasma levels of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and interleukin (IL)-1β were measured at entry and every 2 weeks thereafter until week 12. At each visit the CD Activity Index (CDAI) was calculated. The CD Endoscopic Index of Severity was measured at entry and week 12. Sixteen patients completed the study. A significant decrease in serum levels of CRP, TNF-α, and IL-1β occurred rapidly after commencement of treatment. CDAI scores showed a rapid decline during the first 8 weeks and reached their lowest at week 10. Endoscopic improvements were observed at week 12. In conclusion, T2 appears to be effective for the treatment of mildly or moderately active CD. Further controlled studies are warranted for this promising drug.


Tripterygium wilfordii Crohn’s disease Crohn’s disease activity index Crohn’s Disease Endoscopic Index of Severity Tumor necrosis factor-α Interleukin-1β 



This study was supported by the National Natural Science Foundation of China (No. 30571797). We thank Moli Zhang for her help in editing the manuscript.


  1. 1.
    Travis SP, Stange EF, Lemann M, Oresland T, Chowers Y, Forbes A, D’Haens G, Kitis G, Cortot A, Prantera C, Marteau P, Colombel JF, Gionchetti P, Bouhnik Y, Tiret E, Kroesen J, Starlinger M, Mortensen NJ, European Crohn’s and Colitis Organisation (2006) European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut 55 (Suppl 1):i16–i35PubMedCrossRefGoogle Scholar
  2. 2.
    Singleton JW, Law DH, Kelley ML Jr, Mekhjian HS, Sturdevant RA (1979) National Cooperative Crohn’s Disease Study: adverse reactions to study drugs. Gastroenterology 77:870–882PubMedGoogle Scholar
  3. 3.
    Carter MJ, Lobo AJ, Travis SP, IBD Section, British Society of Gastroenterology (2004) Guidelines for the management of inflammatory bowel disease in adults. Gut 53 (Suppl 5):V1–V16PubMedCrossRefGoogle Scholar
  4. 4.
    Tao XL, Lipsky PE (2000) The Chinese anti-inflammatory and immunosuppressive herbal remedy Tripterygium wilfordii Hook F. Rheum Dis Clin North Am 26:29–50PubMedCrossRefGoogle Scholar
  5. 5.
    Lipsky PE, Tao XL (1997) A potential new treatment for rheumatoid arthritis: thunder god vine. Semin Arthritis Rheum 26:713–723PubMedCrossRefGoogle Scholar
  6. 6.
    Tao XL, Davis L, Hashimoto K, Lipsky PE (1996) The Chinese herbal remedy, T2, inhibits mitogen-induced cytokine gene transcription by T cells, but not initial signal transduction. J Pharmacol Exp Ther 276:316–325PubMedGoogle Scholar
  7. 7.
    Qiu D, Zhao G, Aoki Y, Shi L, Uyei A, Nazarian S, Ng JC, Kao PN (1999) Immunosuppressant PG490 (triptolide) inhibits T-cell interleukin-2 expression at the level of purine-box/nuclear factor of activated T-cells and NF-kappaB transcriptional activation. J Biol Chem 274:13443–13450PubMedCrossRefGoogle Scholar
  8. 8.
    Huang FC, Chan WK, Moriarty KJ, Zhang DC, Chang MN, He W, Yu KT, Zilberstein A (1998) Novel cytokine release inhibitors. Part I: triterpenes. Bioorg Med Chem Lett 8:1883–1886PubMedCrossRefGoogle Scholar
  9. 9.
    Li XW, Weir MR (1990) Radix Tripterygium wilfordii—a Chinese herbal medicine with potent immunosuppressive properties. Transplantation 50:82–86PubMedCrossRefGoogle Scholar
  10. 10.
    Krakauer T, Chen X, Howard OM, Young HA (2005) Triptolide attenuates endotoxin- and staphylococcal exotoxin-induced T-cell proliferation and production of cytokines and chemokines. Immunopharmacol Immunotoxicol 27:53–66PubMedCrossRefGoogle Scholar
  11. 11.
    Allison AC, Cacabelos R, Lombardi VR, Alvarez XA, Vigo C (2001) Celastrol, a potent anti-oxidant and anti-inflammatory drug, as a possible treatment for Alzheimer’s disease. Prog Neuropsychopharmacol Biol Psychiatry 25:1341–1357PubMedCrossRefGoogle Scholar
  12. 12.
    Jin HZ, Hwang BY, Kim HS, Lee JH, Kim YH, Lee JJ (2002) Antiinflammatory constituents of Celastrus orbiculatus inhibit the NF- kappaB activation and NO production. J Nat Prod 65:89–91PubMedCrossRefGoogle Scholar
  13. 13.
    Chen L, Wang HJ, Zhao ZQ (2005) Effects of the extract of a Chinese herb Tripterygium wilfordii Hook F on rat pituitary gland. Am J Chin Med 33:945–955PubMedCrossRefGoogle Scholar
  14. 14.
    Ma TY, Iwamoto GK, Hoa NT, Akotia V, Pedram A, Boivin MA, Said HM (2004) TNF-alpha-induced increase in intestinal epithelial tight junction permeability requires NF-kappaB activation. Am J Physiol Gastrointest Liver Physiol 286:G367–G376PubMedCrossRefGoogle Scholar
  15. 15.
    Katz KD, Hollander D, Vadheim CM, McElree C, Delahunty T, Dadufalza VD, Krugliak P, Rotter JI (1989) Intestinal permeability in patients with Crohn’s disease and their healthy relatives. Gastroenterology 97:927–931PubMedGoogle Scholar
  16. 16.
    Pinna GF, Fiorucci M, Reimund JM, Taquet N, Arondel Y, Muller CD (2004) Celastrol inhibits pro-inflammatory cytokine secretion in Crohn’s disease biopsies. Biochem Biophys Res Commun 322:778–786PubMedCrossRefGoogle Scholar
  17. 17.
    Lennard-Jones JE (1989) Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl 170:2–6PubMedGoogle Scholar
  18. 18.
    Best WR, Becktel JM, Singleton JW, Kern F Jr (1976) Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study. Gastroenterology 70:439–444PubMedGoogle Scholar
  19. 19.
    Sandborn WJ, Feagan BG, Hanauer SB, Present DH, Sutherland LR, Kamm MA, Wolf DC, Baker JP, Hawkey C, Archambault A, Bernstein CN, Novak C, Heath PK, Targan SR, CDP571 Crohn’s Disease Study Group (2001) An engineered human antibody to TNF (cdp571) for active Crohn’s disease: a randomized double-blind placebo-controlled trial. Gastroenterology 120:1330–1338PubMedCrossRefGoogle Scholar
  20. 20.
    Mary JY, Modigliani R, for the Groupe d’Etudes Therapeutiques des Affections Inflammatoires duTube Digestif (GETAID) (1989) Development and validation of an endoscopic index of the severity for Crohn’s disease: a prospective multicentre study. Gut 30:983–989PubMedGoogle Scholar
  21. 21.
    Ho LJ, Lai JH (2004) Chinese herbs as immunomodulators and potential disease-modifying antirheumatic drugs in autoimmune disorders. Curr Drug Metab 5:181–192PubMedCrossRefGoogle Scholar
  22. 22.
    Gu WZ, Banerjee S, Rauch J, Brandwein SR (1992) Suppression of renal disease and arthritis, and prolongation of survival in MRL-lpr mice treated with an extract of Tripterygium wilfordii Hook F. Arthritis Rheum 35:1381–1386PubMedGoogle Scholar
  23. 23.
    Kao NL, Richmond GW, Moy JN (1993) Resolution of severe lupus nephritis associated with Tripterygium wilfordii Hook F ingestion. Arthritis Rheum 36:1751–1752PubMedCrossRefGoogle Scholar
  24. 24.
    Schreiber S, Nikolaus S, Hampe J, Hamling J, Koop I, Groessner B, Lochs H, Raedler A (1999) Tumour necrosis factor alpha and interleukin 1beta in relapse of Crohn’s disease. Lancet 353:459–461PubMedCrossRefGoogle Scholar
  25. 25.
    Jiang L, Xia B, Li J, Ye M, Yan W, Deng C, Ding Y, Luo H, Hou W, Zhao Q, Liu N, Ren H, Hou X, Xu H (2006) Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan city, central China. Inflamm Bowel Dis 12:212–217PubMedCrossRefGoogle Scholar
  26. 26.
    Thomsen OO, Cortot A, Jewell D, Wright JP, Winter T, Veloso FT, Vatn M, Persson T, Pettersson E (1998) A comparison of budesonide and mesalamine for active Crohn’s disease. N Engl J Med 339:370–374PubMedCrossRefGoogle Scholar
  27. 27.
    Singleton JW, Hanauer SB, Gitnick GL, Peppercorn MA, Robinson MG, Wruble LD, Krawitt EL (1993) Mesalamine capsules for the treatment of active Crohn’s disease: results of a 16-week trial. Pentasa Crohn’s Disease Study Group. Gastroenterology 104:1293–1301PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Jianan Ren
    • 2
    • 1
    Email author
  • Qingsong Tao
    • 1
  • Xinbo Wang
    • 1
  • Zhiming Wang
    • 1
  • Jieshou Li
    • 1
  1. 1.Department of General SurgeryJinling Hospital, Clinical School of Nanjing UniversityNanjingP.R. China
  2. 2.Department of General SurgeryJinling HospitalNanjingP.R. China

Personalised recommendations