Effect of Synovial Fibroblasts in Rheumatoid Arthritis and Intervention of Chinese Medicine： A Review / 中国实验方剂学杂志

ABSTRACT

Rheumatoid arthritis （RA） is a common autoimmune disease. Excessive hyperplasia of synovial tissues and osteoclastic bone absorption are two main causes of bone and joint destruction in RA. Synovial fibroblasts in RA （RA-FLS） are important cells in the synovial tissues of RA. The changes in their growth characteristics and inhibition of apoptosis lead to the proliferation of synovial tissues， stimulate inflammatory reactions， damage joint structure， and result in joint dysfunction. Therefore， regulating abnormal proliferation and promoting apoptosis of RA-FLS can interfere with the pathogenesis of RA. At present， there are many studies on the effect of Chinese medicine and its monomer components on the excessive proliferation and apoptosis of RA-FLS. The present study reviewed the effect of RA-FLS in RA and the intervention of Chinese medicinal monomers and compounds by regulating RA-FLS. The results showed that monomer components mainly included terpenoids， flavonoids， alkaloids， and anthraquinones. Despite different types， they can effectively intervene in RA through different approaches. For instance， they can prevent bone and cartilage injury by inhibiting the secretion of inflammatory cytokines and inhibiting the generation of chondrocytes and osteoclasts. They can achieve apoptosis by up-regulating the pro-apoptotic genes B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and cysteinyl aspartate-specific protease （Caspase） in the Fas/FasL， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription protein （STAT）， and p38 mitogen-activated protein kinase （p38 MAPK） signaling pathways， and down-regulating the anti-apoptotic genes Bcl-xl and Bcl-2. They can also inhibit the proliferation of RA-FLS by inhibiting the protein expression of microtubule-associated protein 1 light chain 3Ⅱ（LC3Ⅱ）/LC3Ⅰ and Beclin-1. Although their molecular mechanisms of action and targets are different， they all exert corresponding roles. The above research results provide a scientific basis for elucidating the multi-component and multi-target characteristics of Chinese medicine in the treatment of RA.