Molecular Mechanisms of Polysaccharides in Regulating Immune Function and Treating Rheumatoid Arthritis Through Modulation of Gut Microbiota

OBJECTIVE: To clarify the core mechanisms by which polysaccharides treat rheumatoid arthritis (RA) via gut microbiota modulation, and to systematically summarize their regulatory network and therapeutic potential. Methods: This study adopted a systematic review approach to synthesize existing evidence on polysaccharides in RA, focusing on their structural features, interactions with the gut microbiota, and downstream effects on host immunity and metabolism. RESULTS: ) by 15%-30%. They also promoted the production of short-chain fatty acids (SCFAs, such as acetate and propionate) through microbial degradation, increasing intestinal concentrations of these metabolites by more than 20%. These changes further regulated host metabolism and immune function, including restoring the balance between regulatory T cells (Treg) and T helper 17 cells (Th17), and inhibiting the nuclear factor-kappa B (NF-κB) signaling pathway to alleviate joint inflammation. LIMITATIONS: Current research has critical clinical translation barriers: most evidence relies on in vitro experiments and animal models (e.g., collagen-induced arthritis (CIA) mice), while human clinical trials are restricted by small sample sizes and a lack of long-term follow-up data. CONCLUSIONS: Targeted interactions between polysaccharides and the gut microbiota represent a crucial pathway for RA intervention. Future research should focus on optimizing polysaccharide structural modification technologies, conducting large-scale multicenter clinical trials, and exploring personalized therapeutic strategies to promote the clinical translation of polysaccharides in RA treatment.