Paeonia Lactiflora Extract
Also known as: Paeonia lactiflora Pall., Chinese peony, white peony root extract, Total glucosides of paeony, TGP, Paeonia lactiflora extract
Overview
Paeonia lactiflora extract, commonly known as Chinese peony or white peony root extract, is derived from the dried roots of the Paeonia lactiflora plant. It is primarily standardized for its active constituents, total glucosides of paeony (TGP), with paeoniflorin being the main component. This herbal extract has a long history of use in traditional Chinese medicine, particularly for managing autoimmune and inflammatory conditions, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Modern research, including multiple randomized controlled trials and meta-analyses, supports its role as an adjunctive immunomodulatory and anti-inflammatory agent. While the evidence quality is moderate, it consistently points to its efficacy in reducing disease activity in specific autoimmune diseases. It is typically used to complement conventional therapies, aiming to improve outcomes and potentially mitigate side effects associated with standard treatments.
Benefits
Paeonia lactiflora extract, specifically its standardized form TGP, offers several evidence-based benefits, primarily as an adjunctive therapy for autoimmune diseases. Its most significant effect is the reduction of disease activity scores in conditions like Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). Meta-analyses have shown that TGP, when combined with conventional treatments, significantly lowers SLE Disease Activity Index (SLEDAI) scores compared to conventional treatment alone, with statistically significant mean differences. The evidence is strongest for patients with autoimmune rheumatic diseases, where moderate effect sizes in disease activity reduction have been observed, indicating clinical relevance. Additionally, TGP may help reduce adverse effects associated with conventional therapies, such as hepatic toxicity and leukopenia in RA patients, thereby improving the overall safety profile of treatment regimens. Clinical benefits typically manifest within 1 to 3 months, with most studies showing effects within 8 weeks to 6 months.
How it works
Paeonia lactiflora extract, through its active component TGP, exerts its therapeutic effects primarily by modulating immune function. It achieves this by regulating the production of various cytokines, inhibiting inflammatory pathways, and balancing T cell subsets. Paeoniflorin, the main active compound within TGP, plays a crucial role by affecting the NF-κB signaling pathway, which is central to inflammatory responses. This action leads to a reduction in pro-inflammatory cytokines such as TNF-α and IL-6. Furthermore, TGP may possess antioxidant properties, contributing to the protection against tissue damage commonly observed in autoimmune conditions. While its oral bioavailability is relatively low, it is sufficient to achieve clinical effects when administered at appropriate dosages.
Side effects
Paeonia lactiflora extract (TGP) generally exhibits a favorable safety profile and is well-tolerated in clinical trials. Common side effects, occurring in less than 5% of users, are rare and typically mild, primarily involving transient gastrointestinal discomfort. Uncommon side effects, affecting 1-5% of individuals, may include mild and transient elevations in liver enzymes and minor allergic reactions. Severe adverse events have not been consistently reported in clinical studies, and rare side effects (less than 1%) are not well documented. While no significant drug interactions have been widely reported, caution is advised when TGP is used concurrently with immunosuppressants, and clinical monitoring is recommended. Contraindications are not definitively established, but individuals with known allergies to peony or related plant compounds should avoid its use. Furthermore, there is insufficient safety data for special populations such as pregnant women and children, thus its use in these groups is not recommended without further research.
Dosage
Effective dosages of Paeonia lactiflora extract (TGP) in randomized controlled trials typically range from 600 mg to 1,200 mg per day of the standardized extract. For conditions like Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA), a common and effective dosage observed in clinical studies is 900 mg per day. The maximum safe dose has not been clearly defined, and doses exceeding 1,200 mg per day have not been extensively studied for safety or efficacy. TGP is usually administered orally in divided doses, often taken with meals to enhance tolerability and potentially improve absorption. Standardized TGP capsules or tablets are preferred to ensure consistent dosing. While absorption may be improved with food, no specific cofactors are required. It's important to note that TGP is typically used as an adjunctive therapy and not as a replacement for conventional treatments.
FAQs
Is TGP safe for long-term use?
Current evidence supports TGP's safety for up to 6 months of use. Data on longer-term safety are limited, so extended use should be discussed with a healthcare professional.
Can TGP replace conventional therapy?
No, TGP is used as an adjunctive treatment to complement conventional therapies for autoimmune diseases, not as a standalone replacement.
When do effects appear?
Clinical benefits from TGP typically begin to appear within 1 to 3 months of consistent use, with studies showing effects within 8 weeks to 6 months.
Does TGP interact with immunosuppressants?
No major interactions have been reported, but clinical monitoring is advised when TGP is used concurrently with immunosuppressants due to its immunomodulatory effects.
Is it effective for other autoimmune diseases?
Evidence for TGP's efficacy is primarily strong for Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). Its effectiveness for other autoimmune diseases is less studied.
Research Sources
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.932874/full – This systematic review and meta-analysis of 14 RCTs involving 978 SLE patients found that TGP combined with conventional treatments significantly reduced SLE disease activity scores (SLEDAI) compared to conventional treatment alone. The study also noted a favorable safety profile for TGP, with fewer adverse events reported in the TGP group, despite limitations such as moderate risk of bias and heterogeneity among studies.
- https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-021-03252-y – This meta-analysis of RCTs in RA patients demonstrated that adjunctive TGP therapy reduced the incidence of hepatic adverse effects and leukopenia compared to conventional RA treatment alone. The findings suggest that TGP can improve the safety profile of RA treatment, although the study noted variability in study quality and short follow-up durations as limitations.
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.834947/full – This systematic review protocol and meta-analysis confirmed the immunomodulatory role of TGP in autoimmune diseases, providing moderate-quality evidence for its efficacy in reducing disease activity and improving safety outcomes. The authors emphasized the need for higher-quality randomized controlled trials with standardized methodologies to further solidify the evidence base.