天然活性化合物干预类风湿关节炎的多靶点机制与转化研究进展
Multi-target Mechanisms and Translational Advances of Natural Bioactive Compounds in Rheumatoid Arthritis
谭彬龄 1王纯 1唐冬英1
作者信息
- 1. 湖南大学隆平农学院，长沙 410000
- 折叠
摘要
类风湿关节炎（Rheumatoid arthritis，RA）是一种以持续性滑膜炎、软骨损伤、骨侵蚀及功能受限为主要特征的慢性自身免疫性疾病。传统合成改善病情抗风湿药（csDMARD）、生物制剂（bDMARD）及靶向合成DMARD（tsDMARD）虽已显著改善RA预后，仍有患者存在残余疾病活动、疼痛、疲乏、功能受限或长期用药相关风险。天然活性化合物因抗炎、免疫调节、抗氧化及潜在骨保护作用而受到广泛关注。本文围绕临床证据、作用机制和转化可行性，对天然活性化合物在RA中的研究进展进行综述，重点梳理T细胞-肠道菌群、巨噬细胞-NLRP3炎症小体、滑膜成纤维细胞（FLS）-MEK/ERK及破骨细胞-氧化应激四条线索。现有小样本人体研究提示，水飞蓟素、姜黄素制剂、虾青素及维生素D可能具有辅助治疗信号；番茄碱、紫草素、柚皮芸香甙、大戟因子-L2、杜仲雄花醇提物及Majoon Chobchini等目前仍处于前临床阶段；氧化苦参碱、葫芦素B、白藜芦醇、白蜡树皮苷、异槲皮苷及Osmundacetone等研究进一步丰富了相关机制线索。总体而言，天然活性化合物目前应定位为标准DMARD背景下的辅助干预手段或新药先导化合物，而非替代性疾病修饰治疗。
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovitis, cartilage damage, bone erosion, and functional impairment. Although conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologic DMARDs (bDMARDs), and targeted synthetic DMARDs (tsDMARDs) have significantly improved the prognosis of RA, a substantial proportion of patients still experience residual disease activity, pain, fatigue, functional limitation, or long-term medication-related risks. Natural bioactive compounds have attracted widespread attention due to their anti-inflammatory, immunomodulatory, antioxidant, and potential bone-protective effects. This review summarizes the research progress of natural bioactive compounds in RA, focusing on clinical evidence, mechanisms of action, and translational feasibility. Four key mechanistic axes are highlighted: the T cell-gut microbiota axis, the macrophage-NLRP3 inflammasome axis, the fibroblast-like synoviocyte (FLS)-MEK/ERK axis, and the osteoclast-oxidative stress axis. Existing small-scale human studies suggest that silymarin, curcumin formulations, astaxanthin, and vitamin D may show signals of adjunctive therapeutic benefit. Compounds including tomatidine, shikonin, narirutin, Euphorbia factor L2, the ethanol extract of Eucommia ulmoides male flowers, and Majoon Chobchini remain at the preclinical stage. Studies on oxymatrine, cucurbitacin B, resveratrol, fraxetin, isoquercitrin, and osmundacetone have further enriched the mechanistic landscape. Overall, natural bioactive compounds should currently be positioned as adjunctive interventions under standard DMARD therapy or as lead compounds for novel drug development, rather than as alternative disease-modifying treatments.关键词
药理学/类风湿关节炎/天然活性化合物/炎症信号通路/破骨细胞分化/药物转化Key words
Pharmacology/Rheumatoid arthritis/Natural bioactive compounds/Inflammatory signaling pathways/Osteoclast differentiation/Drug translation引用本文复制引用
谭彬龄,王纯,唐冬英.天然活性化合物干预类风湿关节炎的多靶点机制与转化研究进展[EB/OL].(2026-09-18)[2026-09-24].http://www.paper.edu.cn/releasepaper/content/202609-30.学科分类
药学
