The bone-protective mechanisms of active components from TCM drugs in rheumatoid arthritis treatment

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease whose hallmarks are synovial inflammation and irreversible bone destruction. Bone resorption resulting from osteoclasts involves the whole immune and bone systems. Breakdown of bone remodeling is attributed to overactive immune cells that produce large quantities of cytokines, upregulated differentiation of osteoclasts with enhanced resorptive activities, suppressed differentiation of osteoblasts, invading fibroblasts and microbiota dysbiosis. Despite the mitigation of inflammation, the existing treatment in Western medicine fails to prevent bone loss during disease progression. Traditional Chinese medicine (TCM) has been used for thousands of years in RA treatment, showing great efficacy in bone preservation. The complex components from the decoctions and prescriptions exhibit various pharmacological activities. This review summarizes the research progress that has been made in terms of the bone-protective effect of some representative compounds from TCM drugs and proposes the substantial mechanisms involved in bone metabolism to provide some clues for future studies. These active components systemically suppress bone destruction via inhibiting joint inflammation, osteoclast differentiation, and fibroblast proliferation. Neutrophil, gut microenvironment and microRNA has been proposed as future focus.

The protective effect of natural medicines in rheumatoid arthritis via inhibit angiogenesis

“…They are also extensively distributed in nature (Bhambhani et al, 2021). Many alkaloids have therapeutic effects on experimental arthritis (Lu et al, 2022), among which sinomenine has been used in clinic.…”

Immunomodulatory Effects of Ethanol Extract of Lime Peel on Phagocytosis Activity and Delayed-Type Hypersensitivity Response

“…The extract groups at doses of 17.5 mg/kgBW, 35 mg/kgBW, and 70 mg/kgBW had larger paw swelling volumes than those obtained in the Levamisole 25 mg/kgBW control group. This is suspected because ethanol extract of lime peel contains many secondary metabolites, one of which is flavonoids that have been extensively studied for their ability to enhance the immune system to stimulate inflammatory reactions and activate Th1 cells, which may proliferate and release cytokines causing increased blood vessel permeability, vasodilation, macrophage accumulation, and ultimately inflammation (Lu et al, 2022). Levamisole itself has no significant effect on T cell or natural killer (NK) cell activation and cannot enhance lymphocyte proliferation but can increase IL-12 and IL-10 production (Asfianti et al, 2022).…”

Advances in the implications of the gut microbiota on the treatment efficacy of disease-modifying anti-rheumatic drugs in rheumatoid arthritis

“…Traditional Chinese medicine (TCM)-based treatments have considerable therapeutic efficacy and cause few side effects in RA ( 56 , 57 ). Moreover, the potential success of TCM in treating RA may be partially attributed to its ability to alter the composition of the gut microbes ( 58 , 59 ). Qingluo Tongbi decoction limits inflammatory responses controlled by the gut microbiota and effectively treats arthritis in AIA mice ( 60 ).…”