Mechanisms and Applications of Natural Medicines in the Treatment of Rheumatoid Arthritis

Rheumatoid arthritis (RA), a chronic autoimmune disorder characterized by persistent joint inflammation and bone destruction, has prompted the exploration of natural products and novel therapeutic strategies that integrate anti-inflammatory, immunomodulatory, and osteoprotective properties. This review delves into the bioactive components of Capparis spinosa, Bupleurum and Ligusticum chuanxiong, elucidating the mechanisms in RA management. The active constituents of Capparis spinosa alleviate synovitis and bone erosion by suppressing pro-inflammatory cytokines (e.g.TNF-, IL-6) and modulating signaling pathways such as HIF-1 and PI3K-Akt, while preclinical studies demonstrate their inhibitory effects on osteoclastogenesis. Saikosaponins, the core bioactive compounds in Bupleurum, restore immune equilibrium by blocking the TLR4/NF-B and STAT3 pathways, thereby inhibiting Th17 cell differentiation and IL-17 secretion, while enhancing regulatory T-cell functionality. Clinical evidence further supports the efficacy of compound formulations like Xiao Chaihu Tang in reducing serum inflammatory markers (e.g.IL-1, TNF-) among RA patients. Additionally, ligustrazine (tetramethylpyrazine), the primary component of Ligusticum chuanxiong, mitigates synovial inflammation and cartilage degradation through T-cell activation suppression, downregulation of IL-1 and TNF- expression, and calcium homeostasis regulation. Notably, advancements in transdermal delivery systems have significantly enhanced its localized therapeutic efficiency, optimizing bioavailability and sustained release.