Natural Products for the Management of Arthritic Disorders

Rheumatoid Arthritis elaborated as Rheumatoid Arthritis is a systemic chronic inflammatory condition that might affect numerous organs and tissues in a human body, but mainly it attacks the synovial joints. These methods result in the inflammatory synovitis (synovium) response. Factors that lead to an increase in the risk of rheumatoid arthritis are age, sex, family history, smoking, obesity, and exposure to pollutants. RA holds the ability to put a person at a higher risk of developing other medical conditions if it is not controlled timely. A syndrome named carpal tunnel is another common condition found in people suffering from rheumatoid arthritis. Trauma, infection, smoking cigarettes are some of the examples of external triggers which can trigger the reaction of the auto-immune system, which results in chronic joint inflammation and synovial hypertrophy in addition to a potential of other manifestations, which will be theorized for going on in people prone genetically. The pathological process of the disease usually results in destructing the articular cartilage as well as the joints ankylosis. Rheumatoid Arthritis could also result in diffusive lung inflammation, sclera, pleura, pericardium, as well as nodular lesions, which are also common in subcutaneous tissue. However, the causes of RA are still not known, the autoimmunity holds an important part in both the progression and chronicity. Rheumatoid Arthritis is a systemic disorder. RA can be prevented by using coldwater, living fish oil, from the herring, cod, mackerel, and salmon fish, which contains omega-3 fatty acids in high amounts, Vitamin-D supplements, and adopting the lifestyle modifications such as avoiding smokingand weight loss. 

Rheumatoid arthritis (RA) is a chronic disorder characterized by inflammation of the synovial membrane of peripheral joints, which may lead to progressive functional impairment. The small joints of hands and feet commonly involved in RA often irregularly cause pain, stiffness, and malfunction of the joints. Treatment of rheumatoid arthritis is a multidisciplinary approach that aims to mitigate pain and inflammation, restore joint functions, and maintain day-to-day operations. In realistic terms, inhibition of inflammation is the target of intensive therapy. This could be frequently achieved with two main classes of medications, namely non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs). NSAIDs and glucocorticoids are suggested for use in the preliminary stages of RA for short-term and symptomatic pain relief. Glucocorticoids are also recommended in patients awaiting a response to DMARD therapy. DMARDs are categorized into conventional or biological types. Biologic DMARDs are highly specific and target a specific pathway of the immune system. This chapter is an attempt to review the traditional therapies which are used in the management and treatment of RA.

Rheumatoid arthritis is a chronic inflammatory condition that mainly affects the joint due to hyperactive immune reactions. The disease involves each component of the joint tissue with varying degrees of inflammation and destruction. The basic pathogenesis includes two key points, i.e., hyperactive immune reaction and inflammation. The phenomenon is driven by biomolecules which form a complex pathophysiological network, resulting in disease development and progression. The biomolecules like cytokines, such as interleukins, tumor necrosis factor-alpha, and interferon, play a fundamental role in joint and cartilage destruction, production of destructive enzymes, inflammatory reaction, and comorbidities related to the disease. From various pre-clinical and clinical researches, various attributes of disease development and progression can be demonstrated by focusing on the biological contribution of mediators, like IL-1, TNF- α, IL-6, IL-15, IL-17, and IL-18. Numerous reports confer the successful treatment of RA that might be possible by blocking the activity of these biomarkers. In this chapter, we discuss the role of biomolecules in the pathology of arthritis. 

Rheumatoid arthritis is a severe systemic autoimmune disorder with limited option available for treatment and no curative therapy available at present. Rheumatoid arthritis manifests clinically through polyarthralgia related to joint dysfunction, which triggers the autoimmune responses associated with antibodies against the selfneoepitopes and causes the chronic arthritic attack. Bone destruction is an important feature to understand the pathology of rheumatoid arthritis, which may lead to a serious concern for the patient for living a quality life. Available drugs for rheumatoid arthritis such as methotrexate, hydroxychloroquine, and sulfasalazine exert effects on bone metabolism in immune cells and cytokines that result in relieving pain, improving the quality of life but still, the chronic teratogenic and toxic effects are challenging in management of anti-arthritic drugs. This chapter reviews the current trend of bioactive compounds for the treatment of rheumatoid arthritis, which may lead to the development of novel anti-rheumatoid arthritis agents. 

Rheumatoid Arthritis is an autoimmune, chronic inflammatory disorder that affects the synovial tissues of the joints. Whilst the standard treatment regimen involves non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic agents and glucocorticoids attenuate the symptoms. However, the long-standing use of all these drugs causes adverse effects, which leads to the research on medicinal plants. History shows that many medicinal plants are an integral part of various traditional medicine systems, thus facilitating an alternative form of therapy in various parts of the world. Since ancient civilization, many of the medicinal plants that used as popular remedies are available abundantly in Asia. In this chapter, we are presenting the information on various medicinal plants found in Asia that are reported to be having anti-arthritic activity. Scientific studies revealed that herbs exert beneficial effects in treating arthritis by numerous cellular mechanisms, including downregulation of proinflammatory cytokines like TNF-α, IL-6, and NF-κB, oxidative stress suppression, suppression of cartilage degradation with degradative metalloproteinases, and increasing antioxidant performance. A variety of phytoconstituents from diverse chemical categories such as flavonoids, lignans, coumarins, terpenes, glycosides, phytoestrogens, sesquiterpene lactones, anthraquinones, alkaloids, and thymoquinone are extracted from these medicinal plants. Additionally, in this chapter, the pharmacological actions of these plants were also discussed. 

 Rheumatoid arthritis (RA) is a chronic inflammatory disease that mostly affects the joints. Inflammation is an immune response of the human body, but an overabundance of such responses is thought to be a key element in the evolution of many other issues, including RA, cancer, and neurological illnesses. The growth and inhibition of RA necessitate the identification of a precise mechanism and target in the body. Interleukins (IL), tumour necrosis factors (TNF-), interferons (INF), and arachidonic acid derivatives are the most important cytokines and inflammatory mediators in rheumatoid arthritis. IL-6 inhibitors, JAK inhibitors, anti-TNF, and currently available disease-modifying anti-rheumatic medications (DMARDs) have all been demonstrated to be effective in the treatment of RA. We have also summarised the inflammatory mediators such as arachidonic acid metabolites and their role in inflammation. This chapter also observed cytokines and other transcription factors that play a role in the disease's onset and progression. The current study includes a wide range of issues, including RA molecular pharmacology, such as cytokines pharmacology, transcription factors, and other active biomolecules. However, the study shows that a number of biomolecules and mediators play a key role in the pathogenesis of RA, and a thorough understanding of the underlying pathways can aid in the creation of new targeted pharmacological therapies that are both safer and more effective in RA.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that leads to an inflammatory reaction, primarily affecting synovial joints and progressive cartilage and bone destruction resulting in gradual joint immobility. Possibly, a diversity of pharmacological intercessions are employed for treating arthritis. But modern treatment is linked with serious adverse outcomes and high expenses. Therefore, alternative therapies have been under examination. Scientific facts on RA have revealed that conventional therapy offers a favourable impact by various actions (cellular) like repression of oxidative stress, down-regulation of pro-inflammatory cytokines, such as IL-6, NF-ƙB, and TNF-α, and inhibiting cartilage degradation. A wide range of active phytoconstituents from the medicinal plants, such as terpenes, anthraquinones, glycosylflavons, flavonols, dihydroflavonols, lignans, coumarins, phytoestrogens, sesquiterpene lactones, thymoquinone, and alkaloids reduced the arthritic manifestations through selecting the pro-inflammatory indicators, which play a role in the pathogeny of the disease (RA). With numerous developments in the last few years regarding functional studies or characterization of plant materials, the phase is put down for extensive scientific trials or using the plants or their products to manage rheumatoid arthritis. The chapter discusses the plants used conventionally with phytoconstituents having anti-inflammatory action. This, in turn, leads to the innovation of new benefits from natural products in the future.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of joints. About 1% of the world's adult population is affected by RA. The commonly used medications for RA are anti-inflammatory and disease-modifying agents. These drugs revise the pathology and restore the quality of life but fail to completely cure the disease. Furthermore, they cause various side effects such as gastrointestinal disorders, cardiovascular toxicity, immunodeficiency, and irreversible organ damage. This has led to greater global interest in herbal medicines due to better tolerance and minimum side effects than synthetic drugs. These herbs are used in traditional forms like vatika, gutika, medicated oils, medicated ghee, or in different modern formulations such as tablets, capsules, gels and ointments. A large segment of RA patients has started adopting herbal formulations and traditional systems of medicines; there is a need to compile the data on herbal formulations used in RA management. This chapter will attempt to review herbal formulations of various systems of medicines used for rheumatoid arthritis. 

Rheumatoid Arthritis (RA) is a chronic autoimmune disease with unknown etiology, characterized by progressive cartilage erosion leading to joint distortion and polyarthritis. Rheumatoid arthritis significantly affects the quality of life. Approximately 1% population of the world suffer from rheumatoid arthritis, and prevalence of RA is increasing day by day. There are many synthetic compounds available for the management and treatment of rheumatoid arthritis but,- these therapeutic agents have significant side effects like diarrhea, rashes, alopecia, stomatitis, infrequent myelosuppression, hepatotoxicity and other toxicities. Moreover, symptoms can reappear after discontinuation of the therapy. Because of these side effects, and limitations of the existing synthetic drug, patients are shifting their interest from synthetic to natural products for the treatment well as management of rheumatoid arthritis.This chapter gives an overview of several plants having medicinal properties with a potent therapeutic value that can be used for the management of rheumatoid arthritis.

 Rheumatoid arthritis (RA) is an autoimmune inflammatory condition that involves the destruction of bone as well as cartilage architecture and induces extensive joint pain, stiffness and swelling. The condition is characterized by the infiltration of inflammatory cytokines, such as IL-1, TNF-α, which results in synovial hyperplasia and pannus formation. Currently, no effective curative treatment is available for RA patients and the existing ones produce numerous unwanted effects. So, phytoconstituents have been considered as a potential source for many such chronic conditions with minimal side effects. Phytomolecules such as Andrographolide, Berberine, Curcumin, Ginsenoside, Hesperidin, Kirenol, Madecassocide and various other polyphenolic compounds are under clinical or pre-clinical trials for their antiarthritic efficacy. Phytochemicals used in the treatment of arthritis target the inflammatory signaling pathway and hyperactive immune reactions. The compounds, in addition to anti-inflammatory activity, also suppress bone erosion and osteoclastic activity. Furthermore, phytomolecules inhibit the release and generation of reactive oxygen species and proinflammatory cytokines.

Rheumatoid arthritis is a disease of the immune system where proinflammatory mediators produce inflammation, swelling, and pain in joints and muscles. Continuous progression may cause damage to articular cartilages, joint tissue, and decaying of bones, which may ultimately lead to disability or mortality. Prevention of the progression of rheumatoid arthritis is a severe challenge for the medical system and scientific community. The present pharmaceutical intervention comprises NSAIDS, steroids, and disease-modifying anti-arthritic drugs (DMARDs). Medical interventions, like surgery and knee replacement, are also available. These synthetic drugs are accompanied by several adverse effects ranging from acute to chronic ones. The use of natural products is an important alternative for the treatment of rheumatoid arthritis. Plants, microbes, and other natural sources involve vital bioactive molecules, which are being employed in the treatment of several diseases. Plant-derived bioactive molecules, like boswellic acid, acetyl-β-boswellic acid, guggulsterone, curcuminoids, etc., are promising components, serving as a therapy for rheumatoid arthritis. These bioactive molecules have been evaluated for their effects on rheumatoid arthritis using different screening methods, and they have shown prospective results. Many plant extracts have been used to halt the disease progression, and promising results have been recorded. Bioactive molecules produced by microorganisms are potential candidates to be used in rheumatoid arthritis, and few microorganisms could be used directly as probiotics to combat the altered immune system. These microbes secrete numerous chemicals into the gut of the host, which are responsible for inhibiting the pro-inflammatory mediators, and helping to prevent the disease.