A REVIEW OF HERBAL PLANTS USED IN THE TREATMENT OF RHEUMATOID ARTHRITIS
HTML Full TextA REVIEW OF HERBAL PLANTS USED IN THE TREATMENT OF RHEUMATOID ARTHRITIS
Hira Das *, Debgopal Ganguly, Sayan Hazra, Soumyadip Roy, Subhadip Barui and Sumit Mitra
Seacom Skills University, Kendradangal, Birbhum, West Bengal, India.
ABSTRACT: An inflammatory disorder with an uncertain cause, rheumatoid arthritis (RA), is primarily distinguished by progressive cartilage loss resulting in persistent polyarthritis and joint deformity. Studies indicate that pannus development, which harms the cartilage and the bone, is caused by synoviocyte cellular growth, albeit the exact pathophysiology of the condition has not yet been determined. Recent research further supports free radicals’ significance in the disease's etiology. In addition to the traditional therapy approaches, including glucocorticoids, disease-modifying antirheumatic medicines, and non-steroidal anti-inflammatory drugs, newer and safer drugs are constantly being sought after because prolonged use of these medications has led to adverse side effects. Through this review, we all have tried to explore different ancient Indian ancient Ayurvedic, Unani and Tibbi, as also some Oriental and Korean herbals for their very own potential for the treatment of RA.
Keywords: Rheumatoid arthritis, Pain, Epidemiology, Pathogenesis, Biological treatment, Herbal Drugs, Clinical trials
INTRODUCTION: Joint pain rheumatoid arthritis is a musculoskeletal system dysfunction following mechanical and biological events that destabilize normal joining between degradation and synthesis within coordinate cartilage 1. In other words; it is a persistent, inflamed, symmetrical disease. That can even be called an autoimmune disorder. Initially, it generally influences small joints, moving on to larger articulations. The reason for decreasing is the weakness in the tendon and ligament and also the cause of the breakdown of the cartilage joint and bones breakdown. These kinds of may lead to bone erosion which is often painful for patients and also influences other people's organs like the cardiovascular system, kidney, lungs, sight, etc.
You will find about 100 types of arthritis which the most commonly occurring include osteoarthritis, arthritis rheumatoid, ankylosing spondylitis, systemic lupus erythematous, and teen arthritis 2. Approximately the highest incidents of arthritis are found in Indians adopted by Americans. The particular prevalence of the main two types of arthritis that is osteoarthritis and joint disease rheumatoid in the Indian native population is 22-39% and 5%, correspondingly 3. RA is characterized by immunological dysregulation and inflammation that involves several joints. Smoking, heredity, and female gender are risk factors for RA development.
The presence or absence of antibodies aids in distinguishing RA as a seropositive or a seronegative disease. Seronegative patients initially exhibit greater inflammation, while seropositive patients have increased inflammation and illness, experiencing the worst joint injury 4. Extra-articular symptoms may be seen in cases where the disease is severe or seropositive.
Anti-citrullinated Protein (ACPA) causes pain and bone erosions while sustaining inflammations 5. This disease’s propensity for inflammation eventually results in permanent deformities. In general, RA patients face a significant impairment rate, with 60% unable to work for at least 10 years following the onset of the disease 6. Symptoms of RA include tender, warm and swollen joints and stiffness in the morning 7.
FIG. 1: DIFFERENT HERBAL PLANTS USED IN RHEUMATOID ARTHRITIS
FIG. 2: CINNAMON
FIG. 3: GLYCYRRHIZA
FIG. 4: SAPOSHNIKOVIA
Epidemiology: Among studies reporting the prevalence of RA across the study population, the prevalence ranged from 0.28%-0.7%. In 1996, Chopra et al., a study was conducted in Bhigwan village (Pune, Maharashtra) using a census developed by the World Health Organization-International League of Associations for Rheumatology (WHO-ILAR) Community Oriented Program for Control of Rheumatic Diseases (COPCORD). The report of a prevalence of RA diagnosed by ACR criteria was 0.51% (95%confidence interval, CI: 0.3, 0.7), and the prevalence of clinically diagnosed RA was 0.6% (95% CI) in nearly 6000 individuals, males and females of 16 years or older (2998 males and 3000 females) 8. With COPCORD surveys in Jammu's urban and rural areas, a prevalence of 0.7% was found 9.
A third COPCORD study of over 8000 adults (4010 males and 4135 females) aged 16 years and older living in the metropolitan area of Pune, Maharashtra, was held 10. They found a raw prevalence of RA diagnosed using ACR criteria of 0.28% (95% CI: 0.18, 0.42) and a raw prevalence of clinically diagnosed RA of 0.45% (95% CI: 0.32, 0.63) recorded. The fourth study of five villages in Ballabgarh Township (Haryana) reported a prevalence of 0.75% in approximately 40000 men and women over 15 years of age 11.
Symptoms: RA is an autoimmune disease that primarily affects the joints, and this disease shows several symptoms, which can be mild to severe. Symptoms that can be observed are swollen joints, stiffness (which is severe in the morning), fatigue, loss of appetite, and fever. In some cases, RA patients don’t get affected in joints; they affect other organs like the Skin, Kidney, Lungs, salivary gland, heart, and bone marrow. RA signs and symptoms vary from person to person, and the same with the severity of the disease, and it may come and go. Generally, it can’t be cured, but sometimes the symptoms may disappear.
Pathogenesis of Rheumatoid arthritis: RA's particular pathogenesis is not understood until time. Any external result like infection or even trauma sets away from an autoimmune response, resulting in synovial hypertrophy and persistent joint inflammation employed with the prospect of extra-articular manifestation, which is often theorized to happen in genetically susceptible individuals.
The development and progression of RA can be categorized into phases as follows:
Phase 1: Describes the interaction between genetic and environmental risk factors of RA.
Phase 2: Produce of RA auto-antibodies. e.g., rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP).
Phase 3: Occurrence of arthralgia or joint stiffness.
Phase 4: Development of arthritis in one or two joints.
Phase 5: Fully established RA.
Synovial cell hyperplasia and even endothelial cell account activation are early situations in another technique of RA. Innate factors and resistant system abnormalities bring about disease distribution.
FIG. 5: PATHOGENESIS OF RHEUMATOID ARTHRITIS
Clinical Trials using a Single HERB:
Boswellia Sp: Boswellia, often known as frankincense, has been used in Ayurvedic remedies for millennia. This kind of herb has potent properties, including suppressing microsomal prostaglandin E2 (PGE2) synthase-1 together with 5-lipoxygenase, reducing the production or account activation of inflammatory mediators like matrix metallopr VDFVoteinase (MMP)-9, MMP-13, cyclooxygenase (COX)-2, and nitric oxide (NO) typically, together with analgesic and anti-arthritic effects 12. Boswellia is expected to help with joint pain by reducing osteophytes, improving the knee joint gap, and lowering inflammatory mediators, including C-reactive health proteins and hyaluronic chemicals, that are linked to be able to knee OA 13.
Many researchers have looked at the safety in addition efficacy of Boswelliaserrata. According to Majeed et ing, OA patients who else received oral M. In comparison to the placebo, serrata removed for 8 several weeks improved their Aesthetic Analog Scale (VAS), Japanese Knee Osteoarthritis Measure (JKOM), in addition to Western Ontario in addition to McMaster Universities Osteoarthritis Index (WOMAC) ratings considerably. Another clinical exploration found that using Boswellia extract by mouth for more than 4 months increased physical performance within OA patients simply by lowering pain in addition to stiffness compared to placebo, 14 without producing substantial negative effects. Razavi et al. found out that topical cream administration of Boswellia carterii B. (oliban oil) was connected to a substantial reduction in OA pain and signs and symptoms compared to placebo.
Curcuma Sp: Turmeric is an essence created from the origins of the Curcuma herb. Curcumin is the polyphenol extract associated with turmeric, which has an extended history of use in traditional China and Ayurvedic treatments for its potent and antioxidant attributes 15. Curcuma's anti-inflammatory attributes are linked to a variety of associated processes 16. Curcuma therapy has been proven to reduce the particular production of inflamed mediators substantially, for example, interleukin (IL)-1, tumor necrosis factor-alpha (TNF-), IL-8, NO, and also a range of MMPs simply by inhibiting the service of the NF-B, protein kinase M (Akt), and MAPK signaling pathways 17, 18. Curcuma is proven to inhibit COX-2, ensuing in a reduction in prostaglandin production 19. Recently the anti-osteoarthritic effects of turmeric extract and curcumin have been extensively studied. Kuptniratsaikul et al. demonstrated that patients randomized to Curcuma domestic experienced significant improvement in WOMAC scores compared to baseline within 4 weeks with less abdominal pain and discomfort compared to ibuprofen 20. Another study found that curcumin was as effective as diclofenac but with greater safety and fewer side effects. Curcumin is also associated with weight loss, anti-ulcer benefits, and histamine H2-receptor antagonists (H2 blockers) free 21.
Eremostachys laciniata: Decoctions of Eremostachys laciniata's roots and flowers are commonly utilized to treat inflamed disorders like joint disease 22. It's uncertain exactly how this plant functions. However, a new study found that dealing with rat paws along with crude methanol draw-out or fractions associated with E. laciniate decreased the inflammatory reaction produced by carrageenan 23. The aqueous draw out of E. laciniate has also already been demonstrated to get encourage antioxidant activity, as evidenced by higher DPP radical-scavenging exercise and a decrease in H2O2- or HOCl-luminal chemiluminescence 24.
Eucommia ulmoides: Eucommia ulmoides is the plant that offers recently shown guarantee in remedying OA and RA. E. ulmoides offers been demonstrated to counteract LPS-induced manufacturing of IL-1, IL-6, TNF-, inducible nitric oxide synthase (iNOS), and COX-2 within murine macrophages through regulating the service of toll-like radio (TLR) 4 25, 26. Within OA and RA rat models, E. ulmoides reduced the particular production of IL-17, IL-1, IL-6, MMP-3, and TNF- through inhibiting the service from the phosphoinositol 3-kinase (PI3K)/Aktsignaling path 27, 28. Inside a rat OA model, an aqueous extract of E. ulmoides was reported to reduce serum MMP-1, MMP-3, plus MMP-13 while protecting the annular cartilage 29. Finally, this has been found out that aucubin, the bioactive element associated with E. ulmoides, decreases reactive oxygen varieties 30. Most recently, the combination of eucommia and meloxicam is highly effective in reducing pain, and patient satisfaction compared with the meloxicam monotherapy group 31. Presently, a 12-week, the multicenter, randomized, double-blind, placebo-controlled clinical trial is ongoing to evaluate the safety and efficacy of an E. ulmoides extract in patients with mild OA 32.
Matricaria chamomilla: Matricaria chamomilla, or chamomile, has been applied to relieve shared discomfort for years 33. Historically, the dried-out floral element of the plant has been utilized to alleviate rheumatic pain and inflammation. Chamomile provides now been integrated into the FDA's listing of "generally deemed as safe" plant life. Chamomile will come in 2 varieties: German chamomile and Roman chamomile, both of which can be members of the particular Asteraceae; Compositae loved ones. Herbal teais the most typical chamomile preparation. Apigenin, quercetin, patuletin, luteolin and glucosides are usually among the phenolic chemical compounds in chamomile. These types of chemicals have potent properties via reducing cytokines and PGE2, which can be involved in arthritis aetiology 34, 35.
Paeonia lactiflora: Radix Paeonia, the dried-out root of G. lactiflora Pallas, offers been utilized in Chinese language medicine for hundreds of years. Radix Paeoniae decoctions happen to be used to treat RA plus other inflammatory/autoimmune ailments 36. Radix Paeoniae Clarear water/ethanol extracts consist of total glucosides associated with paeony (TGP), mainly paeoniflorin 37. TGP plus paeoniflorin have already been demonstrated to reduce the generation associated with PGE2, leukotriene B4, NO, ROS, plus other-inflammatory mediators in the previous study. Paeonia has furthermore been demonstrated to have anti-inflammatory qualities by lowering microvascular permeability and inflamed cell infiltration. Via suppression of NF-kB, the paeoniflorin component of TGP might also inhibit osteoclast development and TNF-αinduced apoptosis 38, 39.
Withania somnifera: Ayurveda medicine Withania somnifera (Ashwagandha) is recognized because of its anti-inflammatory plus analgesic properties. Watts. somnifera extract has been proven to reduce the service of the NF-B and activator proteins 1 (AP-1) signaling pathways, suppressing the generation associated with TNF-, IL-1, and IL-12 40. Collagenase exercise was inhibited simply by W. somnifera draw out, which reduced the particular degradation of the kind I collagen within bovine Achilles tendons 41. In a collagen-induced arthritic rat design, W. somnifera therapy reduced edema, inflammation, deformity, and ankylosis 42. W. somnifera's anti-arthritic properties are because of its capacity to prevent ROS, TNF-, IL-1B, IL-6, MMP-8, NF-B activation, and increase IL-10 secretion 43.
Zingiber officinale: Turmeric, or Zingiber officinale, has a lengthy good being utilized to treat inflamed symptoms. Ginger's anti-inflammatory qualities have been analyzed extensively in individuals and in-vitro and in-vivo. PGE2, NO, IL-1, IL-12, TNF-, monocyte chemoattractant protein-1 (MCP-1), and regulated upon activation, normal to cell expressed plus secreted (RANTES) had been all reduced right after ginger treatment. Turmeric has also already been proven to reduce the expression associated with MHC class 2 molecules, interferon-gamma (IFN-), and interleukin-2 (IL-2), reducing macrophage antigen-presenting activity plus T cell functionality. Ginger suppressed to cell proliferation plus activation by reducing T-bet expression plus raising GATA-3 activity, according to Aryaeian et al. Turmeric also altered the particular activation of NF-B, COX-1, COX-2, plus peroxisome proliferators, in accordance to research 44, 45, 46.
Clinical Trials Using Herbal Combinations: Any time different herbs usually are combined, there is usually proof of synergistic effects, for example, increased therapeutic outcomes in addition to safety. For sufferers with intermediate leg OA, oral supplements with B. sospensione, N-acetyl-D-glucosamine, and turmeric for six months had been reported to substantially improve pain-free going for walks distance and WOMAC signs/symptoms when compared with common OA care, together with no safety or even tolerability concerns 47. The combination of boswellic acid and methylsulfonylmethane has been shown to improve leg OA pain supervision and functional healing while reducing anti-inflammatory drug employment 48. Curamin significantly increased physical performance checks, and WOMAC shared pain indices inside a 3-month randomized, placebo-controlled trial contrasting the efficacy of curcumin and boswellic acid (Curamin) with curcumin (CuraMed) in addition to placebo. Furthermore, the particular result size regarding the curcuminboswellic intricate was bigger compared to curcumin alone 49. One more study looked at the combined results of C. longa and B. sospensione (CB). CB (500 mg twice daily) was proved to be a lot more effective than celecoxib (100 mg two times daily) in phrases of pain alleviation, going for walks distance, and shared line tenderness, together with results just like celecoxib in terms of crepitus relief in addition to joint range regarding motion. Tolerance had been high in the two curcumin-boswellia combination studies, without significant aspect effects recorded 50.
A new complex of Curcuma longa, Harpagophytum procumbins (Devil's claw), and bromelain reduced VAS ratings from baseline regarding acute and long-term OA patients in addition to providing clinically appropriate joint pain enhancement, with greater tolerability without serious negative events in a new multicenter, open-label examine 51.
Ginger's anti-arthritis rewards have also already been tested in blend with other plant life. After 4 days, some great benefits of a turmeric and Acmella oleracea complex on discomfort and inflammation were examined in new pilot research together with a quasi-experimental style. Significant improvements inside WOMAC, Tegner Lysholm Knee Scoring, exercise, and fat-free bulk were found in your data. In the two knees, there is a new considerable reduction in pain severity 52.
CONCLUSION: The prevailing assessment gives an index of the herbs utilized to treat rheumatoid arthritis symptoms. The application of herbal medicine has been extensively spread among patients. Herbal drugs may just be used to treat arthritis, while older synthetic drugs might result in uncomfortable side effects.
Pharmacological properties and clinical studies have justified using herbal medicines to treat arthritis. Research and development of herbal treatment may pave the way for even more effective treatment of arthritis and its associated symptoms.
ACKNOWLEDGMENT: The authors would like to acknowledge the School of Pharmacy, Seacom Skills University, Kendradangal, Santiniketan, Birbhum, WB, for supporting basic research ideas and resources.
CONFLICTS OF INTEREST: The authors declare no conflict of interest.
REFERENCE:
- Mazur CM, Woo JJ, Yee CS, Fields AJ, Acevedo C, Bailey KN, Kaya S, Fowler TW, Lotz JC, Dang A and Kuo AC: Osteocyte dysfunction promotes osteoarthritis through MMP13-dependent suppression of subchondral bone homeostasis. Bone Research 2019; 7(1): 1-7.
- Ramalingam K, Mathiyalagan A, Subramanian S and Bharathi Rajan UD: Musculo-skeletal joint inflammatory diseases - new vistas from animal model studies - An overview. J Biochem Tech 2009.
- Swärdh E, Thorstensson CA, Khatri S, Kindblom K and Opava CH: Approaches to osteoarthritis: a qualitative study among physical therapists in Maharashtra, India. Physiotherapy Theory and Practice 2022; 1-1.
- Derksen VFAM, Huizinga TWJ and Van Der Woude, D: The role of autoantibodies in the pathophysiology of rheumatoid arthritis. Semin Immunopathol 2017.
- Ruffing, V. Bingham, C. Rheumatoid arthritis signs and symptoms. Retrieved from Johns Hopkins Arthritis Center website. 2016. Available online: http://www.ggpoditary.com (accessed on 9 September 2022).
- Curtis JR and Singh JA: Use of Biologics in Rheumatoid Arthritis: Current and Emerging Paradigms of Care. Clin Ther 2011.
- Victoria LW: Rheumatoid Arthritis: An Autoimmune Disorder. Acta Rheuma 2022; 9(3): 10.
- Chopra A, Patil J, Billempelly V, Relwani J and Tandle HS: Prevalence of Rheumatic diseases in arural population in western India: a WHO-ILAR COPCORD study. J Assoc Physicians India 2001.
- Yadav BS, Roy AN and Fatima SS: A cross-sectional study of different rheumatic diseases and their respective comorbidities at a tertiary care hospital in India. Indian Journal of Rheumatology 2019; 14(1): 42.
- Joshi VL and Chopra A: Is there an urban-rural divide? Population surveys of rheumatic musculoskeletal disorders in the Pune region of India using COPCORD Bhigwan Model 2009.
- Malaviya AN, Kapoor SK, Singh RR, Kumar A and Pande I: Prevalence of rheumatoid arthritis in the adult Indian population 1993.
- Seimoneit U, Koeberle A, Dehm F, Verhoff M, Reckel S, Maier TJ, Jauch J, Northoff H and Bernhard F: Inhibition of microsomal prostaglandin E2 synthase-1 as a molecular basis for the anti-inflammatory actions of bosewellic acids from frankincense. Br J Pharm 2010.
- Majeed M, Majeed S, Narayanan NK and Nagabhushanam K: A pilot, randomized, double blind, placebo-controlled trial to assess the safety and efficacy of a novel Bosewellia serrata extract in the management of osteoarthritis in the knee. Phytother Res 2019.
- Majeed M, Vaidyanathan P, Natarajan S, Majeed S and Vuppala KK: Effect of Boswellin® Super on knee pain in Japanese adults: A randomized, double-blind, placebo-controlled trial. Eur J Biomed 2016.
- Razavi SZE, Karimi M and Kamalinejad M: The efficacy of topical olibanoil (Boswellia Carterii, B.) in relieving the symptoms of knee osteoarthritis. Phys Med Rehabil Electrodigan 2019.
- Razavi BM, Ghasemzadeh Rahbardar M and Hosseinzadeh H: A review of therapeutic potentials of turmeric (Curcuma longa) and its active constituent, curcumin, on inflammatory disorders, pain, and their related patents. Phytotherapy Res 2021; 35(12): 6489-13.
- Chin KY: The spice for joint inflammation: Anti-inflammatory role of curcumin in treating osteoarthritis. Drug Des Dev Ther 2016.
- Aggarwal BB, Surh YJ and Shishodia S: The Molecular Targets and Therspeutic Use of Curcumin in Health and Disease; Springer science & Business Media: New York, NY, USA 2007; 595.
- Shep D, Khanwelkar C, Gade P and Karad S: Efficacy and combination of curcuminiod complex and diclofenac in knee osteoarthritis. Medicine 2020.
- Daily JW, Yang M and Park S: Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials. Journal of Medicinal Food 2016; 19(8): 717-29.
- Shep D, Khanwelkar C, Gade P and Karad S: Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis; A randomized open-label parallel-arm study. Trials 2019.
- Delazar A, Sarker SD, Nahar L, Jalali SB, Modarresi M, Hamedeyazdan S, Babaei H, Javadzadeh Y, Asnaashari S and Moghadam SB: Rhizomes of Eremostachys lacinata: Isolation and Structure Elucidation of Chemical Constituents and a Clinical Trial on Inflammatory diseases. Adv Pharm Bull 2013.
- Khan S, Nisar M, Rehman W, Khan R Eremostachyslacinata Nasir F: Anti-inflammatory study on crude methanol extract and different fractions of Eremostachys lacinata. Pharm Biol 2010.
- Erdemoglu N, Turan NN, Cakoco I, Sener B Eremostachyslacinata Aydon A: Antioxidant activities of some Lamiaceae plant extracts. Phytother Res 2006.
- Koh W, Shin J, Kim SJ, Park JB, Kim HL, Kim SY, Ahn K, Jang HJ, Lee SG Eremostachyslacinata Lee KM: Eucommiae Cortex Inhibits TNF-α and IL-6 Through the Suppression of Caspase-1 in Lipopolysaccharide-Stimulated Mouse Peritoneal Macrophages. Am J Chin Med 2012.
- Kim MC, Kim D, Kim SJ, Park JB, Kim SY, Kim HL, Ahn K, Jang HJ, Lee SG and Lee KM: Eucommiae Cortex Inhibits TNF-α and ILF-6 Through the Suppresssion of Caspase-1 in Lipopolysaccharide-Stimulated Mouse Peritoneal Macrophages. Am J Chin Med 2012.
- Xia T, Gao R, Liu J, Li J and Shen J: Trans-Cinnamaldehyde inhibits IL-1β-Stimulated Inflammation in Chrondrocytes by Suppressing NK-kβ and p38-JNK pathways And Exert Chondrocyte Protective Effects in a Rat Model of Osteoarthritis. Biomed Res Int 2019.
- Wang ZY, Shi S, Li SJ, Chen F, Chen H, Lin HZ and Lin JM: Efficacy and Safety of Duloxetine on Osteoarthritis Knee Pain: A Meta-Analysis of Randomized Controlled Trials. Pain Med 2015.
- Lu H, Jiang J, Xie G, Liu W and Yan G: Effects of an aqueous extract of Euccomia on articular cartilage on a rat model of osteoarthritis of the knee. Exp Ther Med 2013.
- Young IC, Chuang ST, Hsu CH, Sun YJ, Liu HC, Chen YS and Lin FH: Protective effects of aucubin on osteoarthritic chondrocyte model induced by hydrogen peroxide and mechanical stimulus. BMC Complement Altern Med 2017.
- Hu CX, Hu KY and Wang JF: Potential role of the compound Eucommia bone tonic granules in patients with osteoarthritis and osteonecrosis: A retrosprctive study. World J Clin Cases 2020.
- Ahn HY, Cho JH, Nam D, Kim EJ and Ha IH: Efficacy and safety of Cortex Eucommiae (Eucommia ulmoides Oliver) extracts in subjects with mild osteoarthrtis. Medicine 2019.
- Shoara R, Hashempur MH, Ashraf A, Salehi A, Dehshahri S and Habibagahi Z: Efficacy and safety of topical Matricaria chamomilla (chamomile) oil for knee osteoarthritis: A randomized controlled clinical trial. Complement. Ther Clin Pract 2015.
- Pirozpanah S, Mahboob S, Sanayei M, Hajaliloo M and Safaeiyan A: The effect of chamomile tea consumption on inflammation among rheumatoid arthritis patients: Randomized Clinical Trial. Prog Nutr 2017.
- Srivastava JK, Shankar E, Gupta S and Chamomile: A herb medicine of the past with a bright future (review). Mol Med Rep 2010.
- Zhang W and Dai SM: Mechanisms involved in the therapeutics effects of Paeonia lactiflora Pallas in rheumatoid arthritis. Int Immunophamacol 2012.
- Li J, Chen C and Shen YH: Effects of total glucosides from paeony (Paeonia lactiflora Pall) roots on experimental atherosclerosis in rats. J Enthopharma 2011.
- Lai X, Wei J and Ding X: Paeoniflorin Antagonizes TNF-α-Induced L929 Fibroblastoma Cells Apoptosis by Inhibiting NF-kBp65 Activation. Dose-Response 2018.
- Xu H, Cai L, Zhang L, Wang G, Xie R, Jiang Y, Yuan Y and Nie H: Paeoniflorin ameliorates collagen-induced arthritis via suppressing nuclear factor-kappa Bsignaling pathway in osteoclast differentiation. Immunology 2018.
- Singh D, Aggarwal A, Maurya R and Naik S: Withania somnifera inhibits NF-kB and AP-1 transcription factors in human peripheral blood and synovial fluid mononuclear cells. Phytotherapy Res 2007.
- Wallace TC: Dietary Bioactives and Bone Health. MDPI AG-Multidisciplinary Digital Publishi Institute 2018; 20.
- Lindler BN, Long KE, Taylor NA and Lei W: Use of herbal medications for treatment of osteoarthritis and rheumatoid arthritis. Medicines 2020; 7(11): 67.
- Khan MA, Ahmed RS, Chandra N, Arora A and Ali A: In-vivo, Extract from Withania somnifera root ameliorates arthritis via Regulation of Key Immune Mediators of Inflammation in Experimental Model of Arthritis. Anti-inflamm. Anti-allergy Agents Med Chem 2019.
- Amorondoljai P, Taneepanichskul S, Niempoog S and Nimmannit U: A Comparative of Ginger Extract In Nanostructure lipid Carrier (NLC) and 1% Diclofenac Gel for Treatment of Knee Osteoarthritis. J Med Assoc Thail Chotmaihet Thangphaet 2017.
- Aryaeian N, Shahram F, Mahmodi M, Tavakoli H, Yousefi B, Arablou T and Karegar SJ: The effect of ginger supplementation on some immunity and inflammation immediate genes expression in patients with active rheumatoid arthritis. Gene 2019.
- Zakeri Z, Izadi S, Bari Z, Soltani F, Narouie B and Ghasemi Rad M: Evaluating the effects of ginger extracts on knee pain, stiffness and difficulty in patients with knee osteoarthritis. J Med Plants Res.2011.
- Bolognesi G, Belcaro G, Feragalli B, Cornelli U, Cotellese R, Hu S and Dugall M: Movardol®(N-acetylglucosamine, Boswelliaserrata, ginger) supplementation in the management of knee osteoarthritis: Preliminary results from a 6 month registry study. Eur Rev Pharmacol Sci 2016.
- Notarnicola A, Maccagnano G, Moretti L, Pesce V, Tafuri, S, Fiore A and Moretti B: Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial. Int J Immunopathol Pharmacol 2015.
- Haroyan A, Mukuchyan V, Mkrtchyan N, Minasyan N, Gasparayn S, Sargsyan A, Narimanyan M and Hovhannisyan A: Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: A comparative, randomized, double-blind, placebo-controlled study. BMC Comomplement Altern Med 2018.
- Kizhakkedath R: Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of osteoarthritis. Mol Med Rep 2013.
- Conrozier T, Mathieu P, Bonjean M, Marc JF, Renevier JL and Balblanc JC: A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain. Altern Ther Health Med 2014.
- Rondanelli M, Riva A, Allegrini P, Faliva MA, Naso M, Peroni G, Nichetti M, Gasparri C, Spadaccini D and Iannello G: The use of a new food-grade lecithin formulation of highly standardized ginger (Zingiber officinale) and Acmellaoleracea extracts for the treatment of pain and inflammation in a group of subjects with moderate knee osteoarthritis. J Pain Res 2020.
How to cite this article:
Das H, Ganguly D, Hazra S, Roy S, Barui S and Mitra S: A review on herbal plants used in the treatment of Rheumatoid arthritis. Int J Pharm Sci & Res 2023; 14(7):3288-95. doi: 10.13040/IJPSR.0975-8232.14(7).3288-95.
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IJPSR
Hira Das *, Debgopal Ganguly, Sayan Hazra, Soumyadip Roy, Subhadip Barui and Sumit Mitra
Seacom Skills University, Kendradangal, Birbhum, West Bengal, India.
hiradas3096@gmail.com
18 October 2022
26 November 2022
30 November 2022
10.13040/IJPSR.0975-8232.14(7).3288-95
01 July 2023