Department of Biochemistry and Molecular Biology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, Japan.
Chin J Integr Med. 2011 Oct;17(10):723-30. doi: 10.1007/s11655-011-0871-3.
Rheumatoid arthritis (RA) is characterized as a chronic inflammatory disease in joints and concomitant destruction of cartilage and bone. Cartilage extracellular matrix components, such as type II collagen and aggrecan are enzymatically degraded by matrix metalloproteinases (MMPs) and aggrecanases in RA. Currently, treatments targeting cytokines, including anti-tumor necrosis factor (TNF) α antibodies, soluble TNF receptor, anti-interleukin (IL)-6 receptor antibody, and IL-1 receptor antagonist, are widely used for treating RA in addition to antiantiinflammatory agents and disease-modifying antirheumatic drugs (DMARDs), such as inflmethotrexate, but these treatments have some problems, especially in terms of cost and the increased susceptibility of patients to infection in addition to the existence of low-responders to these treatments. Therefore, therapeutics that can be safely used for an extended period of time would be preferable. Complementary and alternative medicines including traditional Chinese medicines (TCM) have been used for the arthritic diseases through the ages. Recently, there are many reports concerning the anti-arthritic action mechanisms of TCM-based herbal formulas and crude herbal extracts or isolated ingredients. These natural herbal medicines are thought to moderately improve RA, but they exert various actions for the treatment of RA. In this review, the current status of the mechanism exploration of natural compounds and TCM-based herbal formulas are summarized, focusing on the protection of cartilage destruction in arthritic diseases including RA and osteoarthritis.
类风湿关节炎（RA）的特征是关节慢性炎症以及软骨和骨的同时破坏。在 RA 中，软骨细胞外基质成分（如 II 型胶原和聚集蛋白聚糖）被基质金属蛋白酶（MMPs）和聚集蛋白聚糖酶酶解。目前，除了抗炎药和疾病修饰抗风湿药（DMARDs）如甲氨蝶呤外，靶向细胞因子的治疗方法，包括抗肿瘤坏死因子（TNF）α抗体、可溶性 TNF 受体、抗白细胞介素（IL）-6 受体抗体和 IL-1 受体拮抗剂，也被广泛用于治疗 RA，但这些治疗方法存在一些问题，尤其是在成本方面，而且患者更容易感染，此外，这些治疗方法还存在低应答者。因此，能够安全使用较长时间的治疗方法会更好。补充和替代医学，包括传统中药（TCM），自古以来一直用于治疗关节炎疾病。最近，有许多关于 TCM 草药配方和粗草药提取物或分离成分的抗关节炎作用机制的报告。这些天然草药药物被认为可以适度改善 RA，但它们对 RA 的治疗有各种作用。在这篇综述中，总结了天然化合物和 TCM 草药配方的机制探索的现状，重点关注包括 RA 和骨关节炎在内的关节炎疾病中软骨破坏的保护。
