Triptolide alleviates rheumatoid arthritis by inhibiting lactate-mediated activation of mTORC1/HIF-1α to restrain Th17 cell differentiation

Background: Triptolide (TP), a diterpenoid isolated from Tripterygium wilfordii Hook. f. (TWHF), has potent anti-inflammatory and immunomodulatory activities and has shown therapeutic efficacy in various autoimmune diseases. However, the mechanism by which TP alleviates rheumatoid arthritis (RA) remains unclear.

Methods: Using a collagen-induced arthritis (CIA) mouse model and an in vitro Th17 differentiation model, we investigated the effects of TP on RA symptoms by examining its regulation of Th17 cell differentiation from the perspective of lactate metabolism. MCT1/CD4 double immunofluorescence staining was performed on ankle joint tissues to assess MCT1 expression and CD4⁺ T-cell infiltration. In addition, exogenous lactate supplementation, the LDHA inhibitor GSK2837808A, and the MCT1 Inhibitor AZD3965 were used to explore the underlying mechanisms.

Results: TP significantly alleviated paw swelling and ameliorated ankle joint pathology in mice accompanied by suppressed Th17 cell differentiation and reduced Th17-related effector cytokines. Th17 cell differentiation was associated with elevated LDHA expression. Pharmacological inhibition of LDHA by GSK2837808A suppressed Th17 cell differentiation by reducing mTORC1 activity (S6K and 4EBP1 phosphorylation) and HIF-1α expression. Importantly, TP combined with GSK2837808A further suppressed the LDHA/mTORC1/HIF-1α signaling axis, thereby enhancing inhibition of Th17 cell differentiation. Exogenous lactate upregulated MCT1 expression, stimulated S6K and 4EBP1 phosphorylation, increased HIF-1α levels, and promoted Th17 cell differentiation. This effect was counteracted by the MCT1 Inhibitor AZD3965. Consistently, MCT1/CD4 double immunofluorescence staining showed that TP markedly reduced MCT1 expression and CD4⁺ T-cell infiltration in ankle joint tissues. Moreover，TP combined with AZD3965 further suppressed MCT1 expression and downstream mTORC1/HIF-1α signaling, thereby inhibiting Th17 cell differentiation.

Conclusion: TP alleviates RA symptoms by reducing lactate accumulation through downregulation of LDHA and MCT1, suppressing mTORC1/HIF-1α signaling, and disrupting its feedback activation, thereby inhibiting Th17 cell differentiation.