Researchers presented new preclinical data at the 2025 EULAR Congress suggesting that aconitine, an active compound in Aconiti Lateralis Radix Praeparata (Fuzi), exerts both bone-protective and immune-regulating effects in rheumatoid arthritis using a collagen-induced arthritis mouse model.
The study was conducted by investigators from Peking University People’s Hospital and Dongfang Hospital Beijing University of Chinese Medicine.
Aconitine has long been used in Traditional Chinese Medicine, with prior evidence indicating immune-modulating potential. However, its mechanisms in rheumatoid arthritis (RA) remain poorly understood. This study aimed to evaluate aconitine’s biological effects in inflammatory arthritis using a standardized preclinical model.
In the experiment, male DBA/1 mice were induced with collagen to develop arthritis and randomized into three groups: untreated controls, vehicle control (dimethyl sulfoxide [DMSO] at 9 µg/kg per day), and aconitine-treated (30 µg/kg per day dissolved in 0.018% DMSO). Treatment was administered orally for 4 weeks (n = 6 per group).
Arthritis scores were assessed every 2 days. Although the aconitine group showed a decreasing trend in arthritis severity, the difference was not statistically significant compared with controls (P = .089). Histopathologic examination with hematoxylin and eosin staining revealed a nonsignificant reduction in synovial inflammation (P = .367).
Bone erosion, however, was significantly reduced in the aconitine group based on micro–computed tomography (micro-CT) imaging and histologic scoring (P < .001), supporting a bone-protective effect.
Flow cytometry was used to analyze immune cell populations in the spleen and joint-draining lymph nodes (DLNs). Aconitine significantly increased the proportion of CD4⁺ CD25⁺ Foxp3⁺ regulatory T cells (Tregs) in the spleen (P = .004) and DLNs (P = .017). There were no significant changes in follicular helper T cells (CD4⁺ CXCR5⁺ PD1⁺ Bcl6⁺) or germinal center B cells (B220⁺ CD4⁻ CD95⁺ GL-7⁺).
Statistical analyses included two-way ANOVA, one-way ANOVA, and Kruskal-Wallis tests, with significance thresholds of P < .05, P < .01, and P < .001.
The authors reported no conflicts of interest and acknowledged all participating researchers and animal subjects.
These findings support aconitine’s potential as a modulator of immune response and protector of bone integrity in inflammatory arthritis. The data contribute to the growing body of research exploring alternative and complementary therapeutic strategies for RA.
Source: EULAR 2025, Abstract ABS0005: "Aconitine: A Potential Treatment for Rheumatoid Arthritis"