Signal pathways in the treatment of Rheumatoid Arthritis with traditional Chinese medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: Rheumatoid arthritis (RA) is a chronic autoimmune disorder of unknown etiology that severely impairs patients' quality of life and may ultimately result in functional disability and increased mortality. Traditional Chinese medicine (TCM) possesses extensive clinical experience and has demonstrated favorable outcomes in managing RA. At present, it has been found that TCM compound and effective active ingredients can effectively treat RA, and its mechanism of action needs further study. Signaling pathways play a crucial role in the onset and development of RA and have become key focuses in both the mechanistic studies of RA and the pharmacological exploration of potential therapies.

AIM OF THE REVIEW: This article explores and analyze the signaling pathways involved in the onset and progression of RA and the mechanism of effective components of TCM regulating RA through signaling pathways. The goal is to provide a theoretical basis for the formulation of TCM treatment strategies and clinical efficacy of RA.

MATERIALS AND

METHODS

This article systematically reviewed studies from the past five years focusing on both in vivo and in vitro investigations of oral TCM in the context of RA, and selected " Rheumatoid arthritis ", " traditional Chinese medicine ", "natural plants" and "medicinal plants" as the main keywords. The literature search was carried out through various online search engines, including PubMed, web of science and other publication resources. All plant names mentioned in this article have been verified through World Flora Online (www.worldfloraonline.org) and MPNS (http://mpns.kew.org). We accessed the data in April 2025 to ensure that all plant names used are consistent with the latest taxonomic information.

RESULTS

The findings suggest that TCM can modulate several signaling pathways involved in the pathogenesis of RA, such as JAK-STAT、MAPK、NF-κB、PI3K/AKT、Nrf2、Wnt、HIF-1α/VEGF, by regulating the inflammatory response, inhibiting synovial inflammatory infiltration, reducing the destruction of cartilage and bone, so as to play an anti-arthritis role.

CONCLUSION

TCM exerts therapeutic effects through multiple active ingredients, diverse biological pathways, and various molecular targets, offering unique benefits in managing RA. TCM and its active ingredients enhance therapeutic efficacy through interactions with multiple targets and pathways. However, given the complex composition of TCM, further studies are needed to clarify the specific mechanisms and molecular targets of TCM in alleviating RA.