“…Rheumatoid arthritis (RA), a systemic multi-joint chronic inflammation with a high incidence worldwide, can eventually lead to joint deformity and destruction, which brings a heavy burden to individuals, families, and society. − The objective of clinical treatment of RA is to avoid joint disability, reduce inflammatory response, and alleviate systemic symptoms. − Generally, there are four major drugs including nonsteroidal anti-inflammatory drugs, glucocorticoids, disease-modifying anti-rheumatic drugs (DMARDs), and biologics. , Methotrexate (MTX), as a first-line small-molecule DMARD and a dihydrofolate reductase inhibitor, can inhibit the proliferation of macrophages and reduce the levels of inflammatory cytokines in an inflammatory environment. − However, the long-term use and dose escalation of MTX may cause mild (nausea, vomiting, rashes, stomatitis) and severe (hepatic, pulmonary, renal, and bone marrow abnormalities) side effects . These adverse effects are mainly due to their systemic distribution and accumulation in the non-target organs/tissues/cells/sub-cellular domains.…”