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International Journal of Phytomedicine and Phytotherapy

Table 2 Phytochemicals used in the treatment of rheumatoid arthritis

From: Flavonoids, alkaloids and saponins: are these plant-derived compounds an alternative to the treatment of rheumatoid arthritis? A literature review

Compound Chemical structure Mechanism of action Effect References
Flavonoids
 Quercetin Decreased expression of IL-17 A, IL-21, and TNF-α.
Decreased migration of Th17 lymphocytes.
Increased expression of IL-10.
Decreased morning pain.
Anti-inflammatory activity.
[6,7,8, 38]
 Hesperidin Decreased expression of TNF-α.
Decreased osteoclastogenesis.
Anti-inflammatory activity.
Decreased destruction of joint cartilage.
[39]
 Baicalin
Aglycone
** Decreased ROS and cyclooxygenase production.
Decreased activation of the NFkB signaling pathway.
Anti-inflammatory and antioxidant activity. [9]
 Gentakwanin
Hydroxygenkwanin
Luteolin
Apigenin
** Decreased NO and ROS production.
Decreased production of TNF-α, IL-6, INF-γ, and IL-2.
Anti-inflammatory, immunomodulatory, and antioxidant activity. [40, 41]
 Icariin Decrease in osteoclastogenesis markers.
Decrease in Th17 lymphocyte population.
Decreased destruction of bones and cartilage.
Anti-inflammatory activity.
[42]
 Liquiritin Decreased BCL-2/BAX rate.
JNKI/P38 phosphorylation.
Anti-inflammatory activity.
Angiogenic activity.
[43]
 Oroxylin A Decreased rates of IL-1β, IL-6, TNF-γ, and IL-17. Anti-inflammatory activity [44]
 Kaempferol Decreased invasion, proliferation, and invasion of fibroblast-like synoviocytes.
Decreased production of TNF-α.
Anti-inflammatory activity.
Reduction of cellular infiltrate.
[45, 46]
Alkaloids
Sinomenine Regulation of IL-6, IL-12, INF-γ, TNF-α, IL-1β, and Il-10. Anti-inflammatory activity. [13, 47, 48]
Nicotine Decreased rates of rheumatoid factor, C-reactive protein, NO, and myeloperoxidase.
Reduced levels of IL-1 and IL-17.
Anti-inflammatory activity [49]
Naloxone Not specified. Decreased joint pressure. [50]
Koumine Immunomodulation. Attenuating RA progression. [51]
Berberine Decreased production of IL-6 and IL-17.
Increased production of IL-10 and TGF-β.
Reduces synovial hyperplasia.
Anti-inflammatory activity.
[52]
Fangchinoline Decreased production of TNF-α, IL-6, NO, uric acid, and cerulopasmin.
Decreased proliferation of chondrocytes.
Anti-inflammatory activity.
Reduction of cartilage degradation.
[53]
Oxymatrine Decreased production of IL-6 and IL-8.
Decreased migration and invasion of fibroblast-like synoviocytes.
Activation of the NFkB signaling pathway.
Decreased Th17 lymphocyte population.
Increased regulatory T lymphocyte population.
Anti-inflammatory activity. [54]
Ellipticine Inhibition of fibroblast-like synoviocytes proliferation.
Induction of apoptosis.
Anti-inflammatory and pro-apoptotic activity. [55]
Saponins
Araloside A Decreased proliferation of fibroblast-like synoviocytes.
Induction of apoptosis.
Decreased production of IL-6, IL-8, Prostaglandin E2, and NO.
Activation of NFkB signaling pathway.
Anti-inflammatory and pro-apoptotic activity. [10]
Asperosaponin VI Inhibits osteoclastogenesis, by inducing the expression of several genes and markers that lead to osteoclast proliferation. Decreased bone destruction. [15]
Tubeimoside I Decreased production of IL-1β, IL-6, IL-8, and TNF-α.
Decreased expression of MMP9.
Attenuation of fibroblast-like synoviocytes phenotypes.
Anti-inflammatory activity. [16]
Pedunculoside Decreased migration and activation of fibroblast-like synoviocytes.
Decreased production of IL-1β, IL-6, IL-8, and TNF-α.
Activation of p38 protein.
Anti-inflammatory and pro-apoptotic activity. [56]
Medecassoside Decreased migration and invasion of fibroblast-like synoviocytes.
Decreased production of IL-1β.
Activation of NFkB signaling pathway.
Anti-inflammatory and pro-apoptotic activity. [57]
Hecogenin Decreased migration and invasion of fibroblast-like synoviocytes.
Induces apoptosis by increasing caspases 3, 8, and 9.
Anti-inflammatory and pro-apoptotic activity.  
Platycodin D Decreased production of IL-6 and TNF-α. Anti-inflammatory activity.  
  1. *All chemical structures of the described compounds were obtained on PubChem platform, of the National Library of Medicine (available at: https://pubchem.ncbi.nlm.nih.gov)
  2. **Chemical structure formed by more than one phytochemical compound