Herbs and their Bioactive Compound’s Role in the Management of Rheumatoid Arthritis and Related Inflammatory Conditions

Arthritis is the medical term for swelling or inflammation of one or more joints, ligaments, and surrounding tissues. Rheumatoid arthritis (RA) is an inflammatory autoimmune arthritis that is one of the 100 forms of arthritis. Currently, this autoimmune inflammatory arthritis is incurable. Still, treatment is done on an individual basis of symptoms with the primary goal of minimising joint discomfort and inflammation, improving joint performance, and preventing cartilage damage and distortion. Pharmacotherapy of Rheumatoid arthritis includes nonsteroidal antiinflammatory drugs (paracetamol, naproxen sodium, ketoprofen, diclofenac), biological agents (rituximab, adalimumab, tocilizumab), and disease-modifying anti-rheumatic drugs (penicillamine, sulfasalazine, gold), immunosuppressants (methotrexate, cyclophosphamide), and corticosteroids (prednisolone and methylprednisolone) along with physical therapy. The inability to achieve complete remission from chronic diseases, as well as the expensive cost of new treatments, and the long-term side effects and risks of modern medicine, have all contributed to a rise in public interest in alternative medicine in recent years and different approaches to treating arthritis are continually being researched. Dietary changes, nutritional supplements, and the use of botanicals and phytochemicals are some of the more popular alternative treatment options for RA. Dietary phenolic compounds, terpenoids, saponins, flavonoids, carotenoids, and alkaloids have effectively slowed the progression of arthritic disease because of their ability to alter pro-oxidant and pro-inflammatory pathways. In addition to whole herbs and spices and their extract, many isolated phytoconstituents have been discovered to have healing capability in the treatment of rheumatoid arthritis. These compounds include aconite, brucine, kaempferol, tamaractam, andrographolide, artemisinin, asiaticoside A, bufalin, hecogenin, curcumin, swertiamarin, resveratrol, cardamonin celastrol, lapachol, brazilin, thymoquinone, asperosaponin VI, liquiritin, βelemene, oleanolic acid acetate, ellipticine, hesperidin, and sinomenime. The current review outlines the role of medicinal plants, herbs, dietary supplements, and isolated bioactive compounds from plants in the treatment and management of rheumatoid arthritis, as well as their mechanism of pharmacological action.

Keywords: Anti-inflammatory, Cytokines, Immunomodulator, Phytomolecule, Signaling pathway.