Abstract
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disorder, predominantly symmetric, which causes joint inflammation, cartilage degeneration and bone erosion, resulting in deformity and the loss of physical function. Although the management of RA has steadily improved, the pathophysiological mechanism is incompletely elucidated, and therapeutic options are still limited. Due to shortcomings in the efficacy or safety profiles of conventional RA therapies, therapeutic alternatives have been considered. Therefore, natural extracts containing polyphenolic compounds can become promising adjuvant agents for RA global management, due to their antioxidant, anti-inflammatory and apoptotic properties. Polyphenols can regulate intracellular signaling pathways in RA and can generate different immune responses through some key factors (i.e., MAPK, interleukins (ILs 1 and 6), tumor necrosis factor (TNF), nuclear factor light k chain promoter of activated receptor (NF-κB), and c-Jun N-terminal kinases (JNK)). The critical function of the Toll like-receptor (TLR)-dependent mitogen-activating protein kinase (MAPK) signaling pathway in mediating the pathogenic characteristics of RA has been briefly discussed. Oxidative stress can trigger a change in transcription factors, which leads to the different expression of some genes involved in the inflammatory process. This review aims to provide a comprehensive perspective on the efficacy of polyphenols in mitigating RA by inhibiting signaling pathways, suggesting future research perspectives in order to validate their use.
Highlights
Rheumatoid arthritis (RA) is a long-term, autoimmune, and inflammatory disease that mainly affects the synovial joints, which prompts bone and cartilage damage as the RA progresses [1]
Angiogenesis, osteoclast activity and oxidative stress lead to inflammatory processes in synovial joint tissue and have all been linked to the progression and severity of RA, making them ideal targets in the research for therapeutic improvement [3,4,43,45,48]
The literature investigated in this review shows that polyphenolic compounds have very effective anti-inflammatory properties, being cancer prevention agents
Summary
Rheumatoid arthritis (RA) is a long-term, autoimmune, and inflammatory disease that mainly affects the synovial joints, which prompts bone and cartilage damage as the RA progresses [1]. Antibodies (such as anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF)) have been detected in many patients with RA. It reduces patients’ functional capacity while increasing mortality and morbidity ratios [2]. As of 2015, it is estimated that RA affects about 24.5 million people. This number includes 0.5 to 1% of adults in the developed world, with 5 to 50 per 100,000 patients newly added each year [3,4]. Interactions between many factors, including hereditary and natural aspects, cause an incorrect adjustment of the immune response and an inflamed process that damages the synovial membrane
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