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Advances in Chinese Herbal Medicine for Rheumatoid Arthritis: Clinical Utilization and Efficacy, Mechanism of Action, and Safety

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Medicinal Plants - Recent Advances in Research and Development

Abstract

Rheumatoid arthritis (RA) is a debilitating, systemic autoimmune disease that affects people around the world. The disease is characterized by chronic inflammation of the joints, which eventually results in cartilage and bone damage. An increasing number of patients with RA worldwide are seeking help from complementary and alternative medicine (CAM) to alleviate the severity of the disease and to improve physical conditions. Among these treatments, traditional Chinese medicine (TCM) is regarded as a powerful treatment option, and it has been used for RA therapy for thousands of years in China. TCM is characterized by a holistic theory that emphasizes maintaining the balance of the patient’s whole body using Chinese herbal medicines (CHMs) with multiple bioactive ingredients. Some studies have revealed that many antiarthritic CHMs may exert anti-inflammatory and immunomodulatory effects by regulating the production of pro-inflammatory cytokines and immuno-related pathways. However, the precise molecular mechanisms underlying the anti-RA activities of CHMs have not been fully elucidated. Moreover, safety issues have also blocked the development of CHMs; therefore, it is of great significance for clinicians, researchers, and pharmaceutical companies to share responsibility by regulating the clinical use of CHMs, strengthening the basic toxicology research, and establishing a strict quality control system to ensure the safe use of CHMs and decrease the number of toxic cases. The present chapter illustrates the clinical utilization of CHMs acting on RA, elucidates their mechanisms of action, analyzes their limitations and problems, and discusses their development and application prospects.

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Abbreviations

BGD:

Baihu Guizhi decoction

CAM:

Complementary and alternative medicine

CHMs:

Chinese herbal medicines

COX-2:

Cyclooxygenase-2

CRP:

C-reactive protein

DJD:

Duhuo Jisheng decoction

DMARDs:

Disease-modifying antirheumatic drugs

ESR:

Erythrocyte sedimentation rate

FHD:

Fangji Huangqi decoction

FLS:

Fibroblast-like synoviocytes

GSZD:

Guizhi Shaoyao Zhimu decoction

HLXL:

Huo-Luo-Xiao-Ling Dan

IL:

Interleukin

iNOS:

Inducible nitric oxide synthase

JNK:

Jun N-terminal kinases

MAPKs:

Mitogen-activated protein kinases

MMPs:

Matrix metalloproteinases

MTX:

Methotrexate

NF-kB:

Nuclear transcription-kB

NO:

Nitric oxide

NSAIDs:

Nonsteroidal anti-inflammatory drugs

OPG:

Osteoprotegerin

PGE2:

Prostaglandin E2

RA:

Rheumatoid arthritis

RANK:

Receptor activator of NF-kB

RANKL:

Receptor activator of NF-kB ligand

SIN:

Sinomenine

TCM:

Traditional Chinese medicine

TGP:

Total glucosides of paeony

TIMPs:

Tissue inhibitor of metalloproteinases

TLR:

Toll-like receptor

TNF:

Tumor necrosis factor

TRAF:

TNF receptor-associated factor

TRP:

Transient receptor potential

TRPA:

TRP ankyrin type 1

TRPM8:

TRP melastatin type 8

TRPV1:

TRP vanilloid type 1

TS:

Total saponin

TSW3:

Triterpenoid saponin W3

TWHF:

Tripterygium wilfordii Hook F

VEGF:

Vascular endothelial growth factor

WLY:

Wen Luo Yin

WTD:

Wutou decoction

YLB:

Yi Shen Juan Bi pill

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Authors and Affiliations

  1. Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China

    Xia Mao, Qiuyan Guo, Yanqiong Zhang & Na Lin

  2. School of Chinese Medicine, Hong Kong Baptist University, Kowloon, Hong Kong

    Aiping Lu

Authors
  1. Xia Mao
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  2. Qiuyan Guo
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  3. Aiping Lu
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  4. Yanqiong Zhang
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  5. Na Lin
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Corresponding authors

Correspondence to Yanqiong Zhang or Na Lin .

Editor information

Editors and Affiliations

  1. Department of Applied Chemistry, Chaoyang University of Technology, Taichung, Taiwan

    Hsin-Sheng Tsay

  2. Agricultural Biotechnology Research Center, Taipei, Taiwan

    Lie-Fen Shyur

  3. Department of Applied Chemistry, Chaoyang University of Technology, Taichung, Taiwan

    Dinesh Chandra Agrawal

  4. School of Pharmacy and Chinese Herbal Medicine Research Center, China Medical University, Taichung, Taiwan

    Yang-Chang Wu

  5. College of Agriculture and Natural Resources, Department of Forestry, National Chung Hsing University, Taichung, Taiwan

    Sheng-Yang Wang

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Mao, X., Guo, Q., Lu, A., Zhang, Y., Lin, N. (2016). Advances in Chinese Herbal Medicine for Rheumatoid Arthritis: Clinical Utilization and Efficacy, Mechanism of Action, and Safety. In: Tsay, HS., Shyur, LF., Agrawal, D., Wu, YC., Wang, SY. (eds) Medicinal Plants - Recent Advances in Research and Development. Springer, Singapore. https://doi.org/10.1007/978-981-10-1085-9_16

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