In this study, we synthesized hundreds of analogues based on the structure of small-molecule inhibitors (SMIs) that were previously identified in our laboratory with the aim of identifying potent yet safe compounds for arthritis therapeutics. One of the analogues was shown to share structural similarity with quercetin, a potent anti-inflammatory flavonoid present in many different fruits and vegetables. We investigated the immunomodulatory effects of this compound, namely 6-(2,4-difluorophenyl)-3-(3-(trifluoromethyl)phenyl)-2H-benzo[e][1,3]oxazine-2,4(3H)-dione (Cf-02), in a side-by-side comparison with quercetin. Chondrocytes were isolated from pig joints or the joints of patients with osteoarthritis that had undergone total knee replacement surgery. Several measures were used to assess the immunomodulatory potency of these compounds in tumor necrosis factor (TNF-α)-stimulated chondrocytes. Characterization included the protein and mRNA levels of molecules associated with arthritis pathogenesis as well as the inducible nitric oxide synthase (iNOS)–nitric oxide (NO) system and matrix metalloproteinases (MMPs) in cultured chondrocytes and proteoglycan, and aggrecan degradation in cartilage explants. We also examined the activation of several important transcription factors, including nuclear factor-kappaB (NF-κB), interferon regulatory factor-1 (IRF-1), signal transducer and activator of transcription-3 (STAT-3), and activator protein-1 (AP-1). Our overall results indicate that the immunomodulatory potency of Cf-02 is fifty-fold more efficient than that of quercetin without any indication of cytotoxicity. When tested in vivo using the induced edema method, Cf-02 was shown to suppress inflammation and cartilage damage. The proposed method shows considerable promise for the identification of candidate disease-modifying immunomodulatory drugs and leads compounds for arthritis therapeutics.

Patients with autoimmune diseases (AD) are at increased risk of complications, which adversely affect the quality of life and prognosis. Recently, a large amount of literature suggested reduced oxidative stress by hydrogen supplements in reducing inflammation and improving prognosis. In this study, clinical trial NCT05196295, we randomly assigned different dosages (low, medium, and high) of hydrogen-rich coral calcium (HRCC) to patients with autoimmune diseases, including Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) patients in Ming-Sheng Hospital in Taiwan (age 54 years, 80% females). Participants were measured with their baseline health biomarkers including inflammatory indicators, haematologic, urinary biomarkers, and health status prior to the trial. Clinical and follow-up assessments were collected after 1 month of the treatment. We performed analyses to compare the baseline with the changes after the HRCC treatment. Together with the groups treated with different dosages, the treatment demonstrated no adverse effects on participants’ responses to the HRCC. While the primary endpoint of the trial was met, the potential therapeutic effects of HRCC are addressed for future studies. This clinical trial of HRCC in safety response is the first-in-human study.

Background: Uric acid (UA) is linked to gout, renal dysfunction, and cardiovascular disease. Prior studies often assume linear relationships, potentially oversimplifying physiological complexity. Methods: We analyzed data from 5200 healthy Taiwanese men. Demographic, biochemical, lifestyle, and inflammatory variables were assessed using Pearson correlation, multiple linear regression (MLR), and multivariate adaptive regression splines (MARS), an interpretable machine learning method for detecting nonlinear, threshold-based effects. Results: Pearson correlation showed broad linear associations, whereas MARS identified fewer but more physiologically meaningful predictors. Waist-to-hip ratio (WHR) had a strong threshold effect, influencing UA only below 0.969. Creatinine showed a nonlinear impact, becoming substantial above 0.97 mg/dL, suggesting a renal threshold within the “normal” range. Calcium and high-sensitivity C-reactive protein (hs-CRP) each displayed inflection points (9.5 mg/dL and 3.38 mg/L, respectively), indicating range-specific effects. Notably, betel nut exposure, nonsignificant in linear models, emerged in MARS as a predictor with a complex, non-binary association with UA metabolism. Predictive performance was comparable (RMSE: 1.6694 for MARS vs. 1.6666 for MLR), but MARS offered superior interpretability by highlighting localized nonlinear effects. Conclusions: MARS modeling revealed critical nonlinear, threshold-dependent associations between UA and WHR, creatinine, calcium, hs-CRP, and betel nut exposure, which were not captured by conventional methods. These findings underscore the value of interpretable machine learning in metabolic research and suggest precise thresholds for clinical risk stratification.