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

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.