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Tougu Xiaotong capsule is a traditional Chinese medicine herbal compound primarily used for the treatment of osteoarthritis, particularly knee osteoarthritis. The formulation consists of extracts from Morinda officinalis, Radix Paeoniae Alba (white peony root), Rhizoma Chuanxiong (Ligusticum chuanxiong), and Sarcandra glabra. Its pharmacological effects include the reduction of inflammation, alleviation of cartilage and meniscal degeneration, protection and regulation of chondrocyte autophagy (notably via Atg12/LC3), and modulation of both the p38 mitogen-activated protein kinase (MAPK) and endoplasmic reticulum stress (ERS) pathways. Preclinical and in vitro studies demonstrate reversal of markers associated with cartilage degeneration, inflammation (especially IL-1β, TNF-α, and IL-6), and osteoblast damage. These effects are related to the downregulation of p-p38 MAPK, activation of autophagy genes (Atg family, Beclin 1, LC3), inhibition of endoplasmic reticulum stress-induced apoptosis, normalization of miR-211, and improved subchondral bone remodeling. The drug has been widely used in China for over two decades and is primarily administered orally for osteoarthritis symptom relief and chondroprotection[1][2][3][4][5][7].
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