Lei Gong Teng
StarTripterygium wilfordii Hook. f.
Traditionally used for
- Pain & joints
- Skin
Cautions & contraindications
- Pregnancy
- Bleeding disorders
- Liver conditions
- Toxic — professional use only
☯ TCM Properties
Dispels Wind-Dampness; Invigorates Blood and Unblocks the Channels and Collaterals; Reduces Swelling and Alleviates Pain; Kills Parasites and Resolves Toxicity; Clears Heat
Traditional Chinese Uses
Lei Gong Teng (thunder god vine) is a cold, bitter, highly toxic herb used in Chinese medicine for conditions involving severe joint inflammation, autoimmune joint disease, and stubborn skin conditions. Its strong anti-inflammatory and immune-suppressing properties are applied for rheumatoid arthritis-type conditions and certain kidney diseases refractory to other treatments. Due to its extreme toxicity, it must only be used under close medical supervision with careful dose monitoring, and it is contraindicated in pregnancy.
Western Herbalism Properties
Pharmacological Effects
- Immunosuppressive (cellular): TW dose-dependently inhibited lymphocyte transformation, ConA-induced T-cell proliferation and IL-2 production/receptor expression, mainly by blocking activation; reduced T4/T8 ratio in 33 asthmatic children.
- Immunosuppressive (humoral and nonspecific): Suppressed thymus-dependent antibody responses (likely via helper T cells), DTH, and anti-type II collagen immunity; wilfortrine and euonine reduced phagocytosis.
- Active constituents: Triptolide suppressed MLC, DTH and IL-2 and may induce Ts cells; tripterine inhibited IL-1, IL-2 and PGE2 release; tripchlorolide inhibited PGE2 from RA synovial cells.
- Antiarthritic: Extract reduced collagen-induced arthritis in mice, lupus-like disease in MRL-lpr mice and streptococcal cell wall/adjuvant arthritis in rats; inhibited IL-1 from human monocytes.
- Antitumour: Triptolide and tripdiolide active against murine leukemias and KB cells; triptolide prolonged survival of L615 leukemic mice; celacemine antileukemic.
- Antifertility: Crude extract reduced sperm density and motility in rats (10 mg/kg/day orally abolished fertility in 8 weeks, reversible in 5 weeks); stronger in males; diterpene epoxides (triptolide etc.) act on late spermatids.
- Anti-HIV: Tripterifordin and salaspermic acid inhibited HIV replication in H9 lymphocytes in vitro.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 291.
Relationships
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Botanical Description
Tripterygium wilfordii (Celastraceae), thunder god vine or Lei Gong Teng, is a deciduous woody climbing vine reaching 3-12 m, with reddish-brown angled twigs bearing minute warty lenticels. Leaves are alternate, ovate to elliptic, 4-15 cm long, with serrate margins and acuminate tips. Small greenish-white flowers are borne in terminal and axillary panicles 5-15 cm long, followed by distinctive three-winged, papery, reddish-brown samaras 1-2 cm across that give the genus its name. Native to montane scrub and forest margins of southern China, Taiwan, Myanmar, and Vietnam, the root xylem (debarked to reduce toxicity) is the principal medicinal part. The plant is highly toxic, containing triptolide and celastrol. (Sources: POWO; Wikipedia; Chen & Chen)
Active Constituents
Triptolide
Diterpenoid triepoxide (abietane-type)Concentration: The most abundant and most active diterpenoid; also the principal toxic constituent
Potent immunosuppressive and anti-inflammatory agent that inhibits NF-κB, RNA polymerase (XPB/ERCC3), COX-2, matrix metalloproteinases and multiple cytokines. It is largely responsible for both the therapeutic activity and the reproductive, hepatic and hematologic toxicity of the herb.
Tripdiolide
Diterpenoid triepoxideConcentration: Minor diterpenoid
Structurally related to triptolide with similar immunosuppressive and anti-inflammatory activity; contributes to the herb's overall potency and toxicity.
Triptonide
DiterpenoidConcentration: Minor diterpenoid
Immunosuppressive diterpenoid; investigated for anti-fertility and anti-inflammatory effects.
Celastrol (tripterine)
Quinone methide triterpenoidConcentration: Concentrated in the root bark
Anti-inflammatory and anticancer triterpenoid acting on NF-κB, HSP90, proteasome, TLR4/MD2 and endoplasmic-reticulum Ca2+-ATPase; also contributes to toxicity.
Wilforlide A
Triterpenoid (olean-type)Concentration: Used as a quality-control marker of Tripterygium glycoside preparations
Anti-inflammatory triterpenoid; a common analytical marker for standardizing Tripterygium products.
Wilfordine / wilforgine (sesquiterpene alkaloids)
Sesquiterpene pyridine alkaloidsConcentration: Minor alkaloidal constituents
Insecticidal and immunomodulatory alkaloids; part of the complex alkaloid fraction of the root.
Triptophenolide / triptonoterpene
Abietane diterpenoidsConcentration: Minor constituents
Anti-inflammatory diterpenoids reported among the non-triepoxide diterpenoid fraction.
⚠ Drug Interactions
Methotrexate and other DMARDs / immunosuppressants
Tripterygium is itself immunosuppressive; combined with methotrexate or biologic/conventional DMARDs it produces additive immune suppression. Combination therapy has been studied clinically (e.g., TRIFRA) and can raise the risk of infection, cytopenias and liver enzyme elevations.
Clinical note: Combination is used therapeutically in RA but requires close monitoring of blood counts, liver function and for infection; only under specialist supervision.
Hepatotoxic drugs (e.g., acetaminophen, statins, isoniazid)
Triptolide is intrinsically hepatotoxic; concurrent hepatotoxic drugs can compound the risk of drug-induced liver injury.
Clinical note: Avoid or closely monitor liver function when combining; discontinue if transaminases rise.
Strong CYP3A4 inhibitors (e.g., ketoconazole)
Triptolide is metabolized by CYP3A; CYP3A4 inhibition increases triptolide plasma exposure and toxicity in animal models, while CYP3A inducers can lower exposure.
Clinical note: Avoid strong CYP3A4 inhibitors with Tripterygium; the herb has a narrow therapeutic margin.
Anticoagulant / antiplatelet agents
Tripterygium can cause thrombocytopenia and bone-marrow suppression, which may compound bleeding risk with anticoagulants or antiplatelet drugs.
Clinical note: Monitor blood counts and for bleeding when used with anticoagulant/antiplatelet therapy.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| not recommended | Not established for dispensing — see note | Daily | — | — | No ChP monograph. Tripterygium wilfordii is severely toxic — triptolide causes fatal multi-organ failure, and deaths from overdose and from decoctions of the unpeeled root are documented. The therapeutic margin is very narrow and the root bark and leaves are more toxic than the peeled xylem. Used in China only as standardised pharmaceutical preparations under specialist supervision, never as a crude herb dispensed by dose. Contraindicated in pregnancy and in reproductive-age patients (gonadotoxic). |
Preparation Methods
Standardized glycoside tablet / prepared extract (the only forms considered safe)
Parts: root xylem (debarked root)
Modern clinical use relies on standardized 'Tripterygium glycosides' tablets prepared from the debarked root, dosed and monitored medically (commonly reported as ~20 mg three times daily in trials). Lei Gong Teng is a potentially lethal, narrow-margin herb; it must only be used under specialist supervision with monitoring of blood counts, liver and kidney function, and it is contraindicated in pregnancy (documented reproductive toxicity and reported fatalities from overdose).
Topical / external preparation
Parts: root, leaf (traditionally, externally only)
Traditionally applied externally for joint pain and skin conditions. The whole plant (especially leaves, flowers and root bark) is highly toxic if ingested; external use avoids some systemic toxicity but skin absorption still warrants caution.
Evidence Tier
Moderate evidence · 3 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
0
Randomized controlled trial
2
1 verified · 1 unverified
Show 2 studies
- Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial
- The Chinese Herbal Remedy Tripterygium wilfordii Hook F in the Treatment of Rheumatoid Arthritis: A Randomized, Controlled Trial (vs sulfasalazine)
Other clinical trial
0
Observational / case report
0
In vitro / animal
0
Other / unclassified
1
1 verified · 0 unverified
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial
In 207 patients with active RA, Tripterygium wilfordii Hook F monotherapy was not inferior to methotrexate, and the combination of the two achieved higher ACR50 responses than methotrexate alone at 24 weeks.
The Chinese Herbal Remedy Tripterygium wilfordii Hook F in the Treatment of Rheumatoid Arthritis: A Randomized, Controlled Trial (vs sulfasalazine)
A standardized ethanol/ethyl-acetate root extract of Tripterygium wilfordii produced significantly greater ACR20 responses than sulfasalazine in patients with active RA, supporting efficacy of a well-characterized extract.
Extracts of Tripterygium wilfordii Hook F in the Treatment of Rheumatoid Arthritis: A Systemic Review and Meta-Analysis of Randomised Controlled Trials
Pooled RCT data indicated that Tripterygium wilfordii extracts improve RA outcomes, but the review emphasized heterogeneous quality and notable adverse effects, underscoring the need for safety monitoring.
⚠ Safety & Contraindications
- Pregnancy
- Bleeding disorders
- Liver conditions
- Toxic — professional use only
Side Effects
- Common GI effects: nausea, vomiting, abdominal pain, diarrhea, constipation, anorexia
- Mucocutaneous eruption and pigmentation, hemorrhagic erythema, ulceration of lips and mouth, alopecia
- Long-term use may cause infertility, reversible after over half a year off the drug; no effect found on offspring
- Amenorrhea in women after 2–3 months of medication
- Drop in white cell count; damage to heart, liver, kidney and CNS
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 291.
Historical Texts
Bencao Gangmu Shiyi (Supplement to the Compendium of Materia Medica) by Zhao Xuemin
Qing dynasty (1765)Chinese folk / ethnobotanical materia medica of southern China
Qing to modern eraReferences
- Lv QW, Zhang W, Shi Q, et al.. Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial . Annals of the Rheumatic Diseases (2015) [DOI]
- Goldbach-Mansky R, Wilson M, Fleischmann R, et al.. The Chinese Herbal Remedy Tripterygium wilfordii Hook F in the Treatment of Rheumatoid Arthritis: A Randomized, Controlled Trial . Annals of Internal Medicine (2009) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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