Multi-Target Therapeutic Effects of YuPingTongQiao (YPTQ) in Allergic Rhinitis: A Traditional Chinese Medicine Restoring Dysregulated TFR Cells and Reinforcing Epithelial Barrier Integrity

Yongquan Jiang,1,* Hao Chen,1,* Yanan Guo,1,* Zhuowei Yao,1 Jiali Shi,1 Silin Shen,1 Chenxing Lai,1 Li Dai,1,2 Wanxin Cao,1 Jiping Li1 1Department of Otolaryngology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of China; 2Department of Otology and Skull Base Surgery, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wanxin Cao, Email [email protected] Jiping Li, Email [email protected]: Allergic rhinitis (AR) is a prevalent chronic inflammatory disease characterized by immune dysregulation and epithelial barrier dysfunction. Conventional therapies are often limited by side effects and insufficient efficacy in addressing the underlying pathophysiology. To explore alternative approaches, this study investigated the potential of YuPingTongQiao (YPTQ), a novel Traditional Chinese Medicine (TCM) formulation, as a multi-target treatment for AR.Methods: An ovalbumin-induced AR rat model was established. Nasal allergic symptoms were assessed using a standardized scoring system. Histopathology, FC, RT-qPCR, and ELISA were performed to assess epithelial integrity, cell infiltration, cytokine expression, and immune cell phenotypes.Results: YPTQ significantly alleviated AR symptoms, including nasal rubbing, sneezing, and rhinorrhea, in a dose-dependent manner. The high-dose YPTQ (YPTQ-H) group demonstrated superior efficacy compared to Loratadine. Mechanistically, YPTQ suppressed TH 2 cytokines (IL-4, IL-5, IL-13) and IL-33, restored follicular regulatory T (TFR) cell balance, and increased CTLA4 expression, thus mitigating IgE-mediated immune responses. Additionally, YPTQ enhanced epithelial barrier integrity by upregulating Claudin1 and reduced mucus hypersecretion by suppressing MUC2 expression. Histological analysis revealed decreased infiltration of eosinophils, mast cells, and goblet cells in the nasal mucosa.Conclusion: YPTQ offers a safe, effective, and multi-target therapeutic option for AR, addressing both immune dysregulation and epithelial dysfunction. Its superior efficacy compared to Loratadine and excellent safety profile highlight its potential as a novel alternative or adjunct to conventional treatments for AR.Keywords: allergic rhinitis, traditional Chinese medicine, multi-target therapy