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抗氧化疗法作为类风湿关节炎中新兴的辅助治疗手段:针对氧化应激以提高治疗效果。

Antioxidant Therapies as Emerging Adjuncts in Rheumatoid Arthritis: Targeting Oxidative Stress to Enhance Treatment Outcomes.

作者信息

Bilski Rafał, Nuszkiewicz Jarosław

机构信息

Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 24 Karłowicza St., 85-092 Bydgoszcz, Poland.

出版信息

Int J Mol Sci. 2025 Mar 21;26(7):2873. doi: 10.3390/ijms26072873.

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent inflammation and progressive joint destruction. Recent data underscore oxidative stress as a primary factor in the pathophysiology of rheumatoid arthritis, intensifying inflammatory processes and tissue damage via the overproduction of reactive oxygen species (ROS) and compromised antioxidant defenses. Current therapies, including disease-modifying antirheumatic drugs (DMARDs), primarily target immune dysregulation but fail to address oxidative stress, necessitating novel adjunctive treatment strategies. This review explores the potential of antioxidant-based therapies as complementary approaches to RA management. Natural compounds such as curcumin, resveratrol, sulforaphane, and propolis exhibit strong anti-inflammatory and antioxidative properties by modulating redox-sensitive pathways, including nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase (HO-1). N-acetylcysteine (NAC) replenishes intracellular glutathione, enhancing cellular resilience against oxidative stress. Additionally, molecular hydrogen (H) selectively neutralizes harmful ROS, reducing oxidative damage and inflammation. The role of vitamin supplementation (D, B12, C, and K) in regulating immune responses and protecting joint structures is also discussed. This review aims to evaluate the efficacy and potential clinical applications of antioxidant therapies in RA, emphasizing their role in mitigating oxidative damage and improving treatment outcomes. While preliminary findings are promising, further clinical trials are needed to establish standardized dosing, long-term safety, and their integration into current RA treatment protocols.

摘要

类风湿关节炎(RA)是一种慢性自身免疫性疾病,其特征为持续炎症和进行性关节破坏。最近的数据强调氧化应激是类风湿关节炎病理生理学中的一个主要因素,通过活性氧(ROS)的过度产生和抗氧化防御受损加剧炎症过程和组织损伤。目前的治疗方法,包括改善病情抗风湿药(DMARDs),主要针对免疫失调,但未能解决氧化应激问题,因此需要新的辅助治疗策略。本综述探讨了基于抗氧化剂的疗法作为类风湿关节炎管理补充方法的潜力。姜黄素、白藜芦醇、萝卜硫素和蜂胶等天然化合物通过调节氧化还原敏感途径,包括活化B细胞核因子κB(NF-κB)和核因子红细胞2相关因子2(Nrf2)/血红素加氧酶(HO-1),表现出强大的抗炎和抗氧化特性。N-乙酰半胱氨酸(NAC)补充细胞内谷胱甘肽,增强细胞对氧化应激的抵抗力。此外,分子氢(H)选择性地中和有害的ROS,减少氧化损伤和炎症。还讨论了维生素补充剂(D、B12、C和K)在调节免疫反应和保护关节结构中的作用。本综述旨在评估抗氧化疗法在类风湿关节炎中的疗效和潜在临床应用,强调其在减轻氧化损伤和改善治疗结果中的作用。虽然初步研究结果很有前景,但需要进一步的临床试验来确定标准化剂量、长期安全性以及它们纳入当前类风湿关节炎治疗方案的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8062/11989177/78a12e6c23e7/ijms-26-02873-g001.jpg

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