Thunder god vine (Tripterygium wilfordii)

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Alkaloids, canophyllal, celastrol, chloroform methanol extract, demethylzeylasteral (TZ-93), dihydroagarofuran sesquiterpenes, diterpene, diterpene-lactone compounds, diterpenoid triepoxides, ethyl acetate (EA) extract, euonine, Euonymus sieboldianus Blume, folium Tripterygium wilfordii (TWT), friedelin, glycosides, hydroxyfriedelane, hydroxytriptonide, leigong teng, multiglycosides of TWHF (GTW), neotripterifordin, Pestalotiopsis leucothes, PG490, polyglycosidium, radix Tripterygium wilfordii polycoside tablet, salaspermic acid, sesquiterpene, T. wilfordii, T2 (multiglycosides of T. wilfordii), T4, T7/19, terpenoidlactones, thunder of god vine, thundergod vine, triepoxide triptolide, tripchlorolide (TC), tripterifordin, tripterfrielanon A(1), tripterfrielanon B(2), Tripterygium polyglucoside, Tripterygium wilfordii, Tripterygium wilfordii Complex Ester Tablet Hook F (T II), Tripterygium wilfordii Hook spp., Tripterygium wilfordii multiglycoside, Tripterygium wilfordii Polycoside Tablet (TPT), Tripterygium wilfordii polyglucoside, Tripterygium wilfordii polyglycoside, Tripterygium wilfordii polysaccharide, Tripterygium wilfordii T7, triptobenzene, triptofordin C-2, triptofordin F-2, triptolide, triptolidenol, triptonide, triterpenes, TW, TWG, TWHF, T(whf), TW-SR (sustained-release tablets of Tripterygium wilfordii), wilfordconine, wilforlide A, wilforlide B, wilfornine A, wilfornine B, wilfornine C, wilfornine D, wilfornine E, wilfornine F, wilfornine G, wilfornine H, wilfornine I, wilfornine J.

Background

  • Thundergod vine (Tripterygium wilfordii) has a long history of use. It has reportedly been used continuously in China for more than 2,000 years. Traditionally, thundergod vine has been used as an anticancer drug, male contraceptive, a drug used to suppress the immune system, and as an anti-inflammatory agent.

  • Various clinical trials have indicated the use of thundergod vine as a possible treatment for rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE, a disease of the immune system). There is also evidence suggesting possible benefits of thundergod vine in organ transplantation, asthma, cancer, and kidney, skin, and eye disorders.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Anti-inflammatory

Thundergod vine contains compounds that may affect the immune system or have anti-inflammatory properties. There is currently insufficient evidence to make conclusions about the use of thundergod vine for these uses.

Asthma

There is interest in using thundergod vine to treat conditions such as asthma. More research is needed in this area.

Cancer (uterine leiomyoma)

The effect of thundergod vine in treating uterine leiomyoma (a tumor of the smooth muscle and tissue of the uterus) has been investigated. More research is needed in this area.

Eye disorders (Graves’ ophthalmopathy)

There is interest in using thundergod vine in place of steroids, such as prednisone, in treating Graves’ ophthalmopathy (GO, an eye disease related to an overactive thyroid gland). There is currently insufficient evidence to make a conclusion for against the use of thundergod vine in treating this disease.

Kidney disease (idiopathic nephrotic syndrome, purpuric nephritis)

Thundergod vine has been evaluated for treatment of various types of nephritis (kidney inflammation), including glomerulonephritis (a disease in which part of the kidney is damaged), lupus nephritis (a kidney disorder related to the autoimmune condition lupus), and childhood Henoch-Schönlein purpura nephritis (a disease affecting small blood vessels in the kidney). There is currently insufficient evidence to make conclusions about the use of thundergod vine in treating these disorders.

Organ transplantation

Thundergod vine contains compounds that may affect the immune system. There is currently insufficient evidence to make a conclusion about the use of thundergod vine in controlling transplant rejection and long-term survival.

Rheumatoid arthritis

Thundergod vine has been studied for its effects on symptoms and clinical signs of rheumatoid arthritis (RA). Currently, there are insufficient available data to make a conclusion about the use of thundergod vine in treating RA.

Skin disorders (IgA deposition at the BMZ, pyoderma gangrenosum)

There is currently insufficient evidence to make a conclusion about the use of thundergod vine for treating skin disorders. Additional research is needed in this area.

Systemic lupus erythematosus

There is interest in using thundergod vine as an alternative to traditional treatments for autoimmune disorders such as systemic lupus erythematosus (SLE). At this time there is insufficient evidence to make a conclusion about the use of thundergod vine in the treatment of SLE.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Ankylosing spondylitis (spinal arthritis), antiviral, autoimmune disorders, breast cancer, cancer (glioma), cancer prevention, contraceptive, Epstein-Barr virus, fever, HIV, leukemia, lung cancer, menorrhagia (heavy menstrual bleeding), multiple sclerosis, prostate cancer, stomach cancer.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • For asthma 40 or 60 milligrams of Tripterygium polyglucoside have been taken by mouth daily for four weeks.

  • For eye disorders (Graves’ ophthalmopathy), 30-60 milligrams of Tripterygium wilfordii multiglycoside have been taken by mouth daily for four weeks.

  • For nephritis (kidney inflammation), one milligram per kilogram of body weight of Tripterygium wilfordii polyglucoside (TWP) has been taken by mouth daily.

  • For organ transplantation, one or two milligrams per kilogram of body weight of Tripterygium wilfordii have been taken by mouth daily for five years.

  • For rheumatoid arthritis, 10-60 milligrams of Tripterygium wilfordii multiglycosides have been taken by mouth daily for 12 weeks. Daily doses of 180-570 milligrams of ethyl acetate extract of Tripterygium wilfordii have been taken by mouth for up to 76 weeks. Two tablets of Tripterygium wilfordii Complex Ester Tablet (TWT, a preparation of folium Tripterygium wilfordii), have been taken by mouth three times daily. Two tablets of Tripterygium wilfordii Polycoside Tablet (TPT, a preparation of radix Tripterygium wilfordii) have been taken by mouth three times daily. Two sustained-release tablets of Tripterygium wilfordii have been taken by mouth two or three times daily for four weeks. A tincture containing Tripterygium wilfordii has been applied to painful or swollen joints 5-6 times daily.

  • For systemic lupus erythematosus (SLE), three tablets containing five grams of crude Tripterygium wilfordii (TW) have been taken by mouth three times daily. In addition, 45 grams of crude TW daily or 60 milligrams of TW glycosides have been taken by mouth for up to five years.

Children (under 18 years old)

  • For nephrotic syndrome (damage to the kidneys of unknown cause), one milligram per kilogram of body weight of Tripterygium wilfordii has been taken by mouth daily.

  • For, systemic lupus erythematosus (SLE), Tripterygium wilfordii has been taken by mouth with prednisone following pulsed doses of methylprednisone.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid with known allergy or hypersensitivity to thundergod vine, members of the Celastraceae family, or any of their constituents.

Side Effects and Warnings

  • There appears to be evidence that thundergod vine may be harmful even for healthy individuals. Therefore, in addition to the precautions stated below, precautions should be taken when using this herb in general. The use of sustained-release tablets of thundergod vine may reduce the occurrence of adverse effects.

  • Thundergod vine may cause altered sex gland function in children, anemia, central nervous system problems, changes in female hormone levels, decreased bone mineral density, diarrhea, heart damage, infertility in males, kidney problems, low platelets, low white blood cell counts, rash, or stomach upset.

  • Thundergod vine may cause high blood pressure. Caution is advised in people with blood pressure disorders or in those taking drugs, herbs, or supplements that affect blood pressure.

  • Use cautiously in people with heart conditions, such as heart rhythm disorders, as thundergod vine has reportedly caused irregularly fast heartbeat, heart damage, and shock.

  • Use cautiously in people with liver dysfunction, as thundergod vine has been reported to induce temporary elevation of liver enzyme levels in humans.

  • Use cautiously in people with kidney dysfunction, as thundergod vine has reportedly caused kidney damage in humans.

  • Use cautiously in people with a compromised immune system, autoimmune diseases, and those using agents that affect the immune system, as thundergod vine has been reported to have effects on the immune system.

  • Use cautiously in women, as thundergod vine has been reported to cause menstrual abnormalities, including amenorrhea (stopping of the menstrual period).

  • Avoid in pregnant women, as the use of thundergod vine during pregnancy has been reported to induce central nervous system abnormalities in an infant.

  • Avoid with known allergy or hypersensitivity to thundergod vine, members of the Celastraceae family, or any of their constituents.

Pregnancy and Breastfeeding

  • Avoid in pregnant women, as the use of thundergod vine during pregnancy has been reported to induce central nervous system abnormalities in an infant.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Thundergod vine may cause high blood pressure. Caution is advised in people taking drugs that lower blood pressure.

  • Thundergod vine may interact with anti-inflammatory agents, drugs to treat cancer, antivirals, disease-modifying antirheumatic drugs (DMARDs, such as FK506, cyclosporine, and possibly chloroquine), drugs that may cause kidney damage, hormonal agents (such as luteinizing hormone, follicle-stimulating hormone, estradiol, progesterone, or E2), or agents that affect the immune system.

Interactions with Herbs and Dietary Supplements

  • Thundergod vine may cause high blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

  • Thundergod vine may interact with anticancer herbs and supplements, anti-inflammatory herbs and supplements, antivirals, hormonal herbs and supplements, herbs and supplements that affect the immune system, herbs that may cause kidney damage, or phytoestrogen-containing foods.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Canter PH, Lee HS, Ernst E. A systematic review of randomised clinical trials of Tripterygium wilfordii for rheumatoid arthritis. Phytomedicine 2006;13(5):371-377. View Abstract
  2. Carter BZ, Mak DH, Schober WD, et al. Triptolide induces caspase-dependent cell death mediated via the mitochondrial pathway in leukemic cells. Blood 2006;108(2):630-637. View Abstract
  3. Chang HJ, Kim MH, Baek MK, et al. Triptolide inhibits tumor promoter-induced uPAR expression via blocking NF-kappaB signaling in human gastric AGS cells. Anticancer Res 2007;27(5A):3411-7. View Abstract
  4. Huang HH, Yen DH, Wu ML, et al. Acute Erycibe henryi Prain (“Ting Kung Teng”) poisoning. Clin.Toxicol (Phila) 2006;44(1):71-75. View Abstract
  5. Ji SM, Wang QW, Chen JS, et al. Clinical trial of Tripterygium Wilfordii Hook F. in human kidney transplantation in China. Transplant Proc 2006;38(5):1274-1279. View Abstract
  6. Kusunoki N, Yamazaki R, Kitasato H, et al. Triptolide, an active compound identified in a traditional Chinese herb, induces apoptosis of rheumatoid synovial fibroblasts. BMC Pharmacol 2004;4:2. View Abstract
  7. Panichakul T, Intachote P, Wongkajorsilp A, et al. Triptolide sensitizes resistant cholangiocarcinoma cells to TRAIL-induced apoptosis. Anticancer Res 2006;26(1A):259-265. View Abstract
  8. Setty AR, Sigal LH. Herbal medications commonly used in the practice of rheumatology: mechanisms of action, efficacy, and side effects. Semin Arthritis Rheum 2005;34(6):773-784. View Abstract
  9. Wang J, Wang YT, Shao JQ, et al. Immunosuppressive therapies in patients with Graves’ ophthalmopathy. Zhonghua Nei Ke Za Zhi 2004;43(2):125-127. View Abstract
  10. Wang X, Matta R, Shen G, et al. Mechanism of triptolide-induced apoptosis: Effect on caspase activation and Bid cleavage and essentiality of the hydroxyl group of triptolide. J Mol Med 2006;84(5):405-415. View Abstract
  11. Yan SX, Wang Y. Inhibitory effects of Triptolide on interferon-gamma-induced human leucocyte antigen-DR, intercellular adhesion molecule-1, CD40 expression on retro-ocular fibroblasts derived from patients with Graves’ ophthalmopathy. Clin Experiment Ophthalmol 2006;34(3):265-271. View Abstract
  12. Yang H, Chen D, Cui QC, et al. Celastrol, a triterpene extracted from the Chinese “Thunder of God Vine,” is a potent proteasome inhibitor and suppresses human prostate cancer growth in nude mice. Cancer Res 2006;66(9):4758-4765. View Abstract
  13. Yang JH, Luo SD, Wang YS, et al. Triterpenes from Tripterygium wilfordii Hook. J Asian Nat Prod Res 2006;8(5):425-429. View Abstract
  14. Zhang DH, Marconi A, Xu LM, et al. Tripterine inhibits the expression of adhesion molecules in activated endothelial cells. J Leukoc Biol 2006;80(2):309-319. View Abstract
  15. Zhou X, Zhou Z, Jin M, et al. Clinical study of qingluo tongbi granules in treating 63 patients with rheumatoid arthritis of the type of yin-deficiency and heat in collaterals. J Tradit Chin Med 2004;24(2):83-87. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.