The American journal of Chinese medicine最新文献

{"title":"Silybin for Liver Diseases via Anti-Oxidative Stress: A Comprehensive Review.","authors":"Chao Cui, Jingfei Shi, Yu Sun, Shuai Gao, Kai Wang","doi":"10.1142/S0192415X25500910","DOIUrl":"10.1142/S0192415X25500910","url":null,"abstract":"<p><p>Liver diseases pose a significant challenge in global public health, and scientific prevention and treatment strategies have become particularly crucial. Silybin, a flavonoid and active ingredient extracted from the traditional Chinese medicinal herb milk thistle, is the most critical effective component in silymarin, and has clearly demonstrated potent anti-oxidative stress capabilities. This unique attribute makes it a highly promising drug candidate for treating acute hepatitis, chronic hepatitis, cirrhosis, liver cancer, and other liver diseases. In the progression of liver diseases, silybin exerts significant therapeutic effects via dual anti-oxidant and anti-inflammatory mechanisms through which it alleviates the inflammatory response in acute hepatitis, stabilizes the progression of chronic hepatitis, and promotes the benign transition from decompensated to compensated cirrhosis. This study comprehensively reviews research findings on silybin in treating liver diseases via this anti-oxidative stress mechanism over the past few decades, and offers a particular focus on the development of novel drug formulations based on the oxidative stress pathogenesis of liver diseases. These formulations target the CD44 receptor, retinol/vitamin A, CXCR4 receptor, glycyrrhetinic acid receptor, GLUT4 protein, NS5B protein, and SPARC. It also examines the current status of the anti-oxidant and anti-inflammatory applications of silybin formulations in global liver disease treatments. However, more high-quality, detailed experimental studies are needed to explore its exact efficacy and safety so as to provide a stronger scientific basis for the widespread application of silybin in liver disease treatment.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"1-34"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Effectiveness and Safety of Chinese Herbal Enema for Ulcerative Colitis: An Evidence-Based Study.","authors":"Zhijun Bu, Jinchen Chong, Jiaze Ma, Yimeng Ma, Feng Jiang, Yugen Chen","doi":"10.1142/S0192415X26500047","DOIUrl":"10.1142/S0192415X26500047","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a common, chronic, and nonspecific inflammatory bowel disease which significantly impair patients' quality of life, and is characterized by a prolonged disease course and frequent relapses. Due to their localized therapeutic action and low incidence of adverse effects, Chinese herbal enemas have garnered increasing attention in clinical settings. This study aims to systematically evaluate the therapeutic potential of Chinese herbal enemas in UC management. Randomized controlled trials (RCTs) evaluating Chinese herbal enemas for UC, published up to April 19, 2025, were systematically searched. A network meta-analysis was performed using Stata 17.0, and the combined effect sizes were reported as the mean difference or relative risk with corresponding 95% confidence intervals. A total of 41 RCTs involving 2883 UC patients were ultimately included, and data on the risk of bias assessment were reported. When compared with mesalazine (MES) monotherapy, combination therapies, such as MES combined with Qingbai Guanchang Ye or MES combined with Qingchi San, and monotherapies including Huangkui Lianchang Tang and Baitouweng Tang, demonstrated statistically significant improvements in clinical outcomes. Subgroup analyses were also conducted. The clinical effectiveness of these interventions was also influenced by Traditional Chinese Medicine (TCM) syndrome differentiation and disease severity, which underscores the importance of individualized, stratified treatment approaches. Our study data showed that Chinese herbal enema therapy appears to be both clinically effective and safe in the management of UC, and supported both stratified TCM therapy and the refinement of UC treatment guidelines. Future research is needed to prioritize high-quality, large-scale RCTs to validate these findings.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"117-138"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota as Neuroimmune Modulators in Myasthenia Gravis: Mechanistic Insights from the Gut-Brain Axis to Therapeutic Innovations.","authors":"Jie Lv, Ruichen Liu, Zhan Sun, Jing Zhang, Yingna Zhang, Xue Zhao, Jing Liu, Xinyue Zhou, Mengdi Zhang, Qian Liu, Feng Gao","doi":"10.1142/S0192415X26500023","DOIUrl":"10.1142/S0192415X26500023","url":null,"abstract":"<p><p>Myasthenia gravis (MG) is a chronic autoimmune disorder characterized by an immune-mediated attack on neuromuscular junction acetylcholine receptors (AChRs), and its pathogenesis is closely linked to immune dysregulation. Emerging evidence has highlighted the pivotal role of the gut microbiota in the pathophysiology of MG through immunomodulation, microbial metabolite signaling, and gut-brain axis interactions. This review combines 16S rRNA sequencing, metagenomic, and metabolomic data to reveal distinct gut microbial signatures in patients with MG. These signatures include reduced α-diversity, depletion of beneficial taxa like <i>Bacteroides</i> and <i>Bifidobacterium</i>, enrichment of pathobionts such as <i>Escherichia</i> and <i>Enterococcus</i>, and diminished levels of the short-chain fatty acids (SCFA), which were inversely correlated with disease severity. Experimental models have demonstrated that fecal microbiota transplantation (FMT) and probiotic supplementation with strains like <i>Bifidobacterium</i> ameliorate symptoms by restoring Th17/Treg equilibrium, suppressing the expression of pro-inflammatory cytokines including IL-6 and TNF-α, and enhancing intestinal barrier integrity. Mechanistically, gut dysbiosis exacerbates autoimmunity via NF-αB pathway activation, disrupts tryptophan metabolism and impairs gut-brain signaling. While existing studies have established microbiota-MG associations, further causal validation, personalized therapeutic strategies, and multi-omics integration remain critical priorities. Microbiota-targeted interventions, including precision FMT and metabolite delivery, hold translational potential, but their validation via large-scale randomized controlled trials and interdisciplinary approaches like AI-driven microbiota profiling is essential if they are to advance precision medicine for MG management.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"65-85"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Mechanisms of Traditional Chinese Medicine in Treating Osteoarthritis.","authors":"Yaohong Lu, Haidong Zhou, Hui Luo, Wentao Hu, Liangshen Hu, Jiefei Xie, Xinping Wu, Bo Li, Junjie Zhou, Shaoyong Fan, Jichun Shan, Yuwen Chen, Fengting Zhang","doi":"10.1142/S0192415X2650028X","DOIUrl":"10.1142/S0192415X2650028X","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by chronic inflammation, cartilage degradation, and disrupted cellular homeostasis. Traditional Chinese medicine (TCM) has been widely applied in OA management, and exhibits distinct therapeutic advantages due to its multi-component and multi-target pharmacological properties. This review summarizes the molecular mechanisms by which TCM exerts therapeutic effects in OA, and offers a particular focus on the modulation of key signaling pathways involved in inflammation, apoptosis, autophagy, oxidative stress, and cartilage metabolic balance. Relevant studies were retrieved from the PubMed, Web of Science, Embase, and ScienceDirect databases, from their inception up to November 2025, and systematically analyzed. Evidence from experimental studies involving representative active compounds (e.g., Icariin, Geniposide, Ginsenoside Rb1, and Bilobalide) and classical formulas (such as Duhuo Jisheng Decoction, Yougui Pills, and Osteoking) indicates that TCM alleviates inflammation by inhibiting NF-κB, MAPK, and JAK/STAT signaling; promotes autophagy and metabolic homeostasis through regulation of the PI3K/Akt and AMPK pathways; attenuates oxidative stress via activation of the Nrf2 pathway; and maintains cartilage matrix equilibrium by modulating Wnt/β-catenin, TGF-β/Smad, and Notch signaling. TCM therefore exerts disease-modifying effects in OA through coordinated regulation of multiple signaling pathways, which both highlights its ethnopharmacological value and supports the rational development of TCM-based therapeutic strategies for OA.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"763-793"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Effects of Licorice (<i>Glycyrrhiza</i> spp.) and Its Bioactive Constituents: The Perspective of Intestinal Microbiota.","authors":"Xiaoyu Ji, Cai Zhang","doi":"10.1142/S0192415X26500187","DOIUrl":"10.1142/S0192415X26500187","url":null,"abstract":"<p><p>Licorice (<i>Glycyrrhiza</i> spp.) is a traditional medicinal plant whose roots and rhizomes possess multiple pharmacological effects. Its core active components include flavonoids, triterpenoids such as glycyrrhizin, and polysaccharides. This paper focuses on licorice's gut microbiota-mediated mechanisms of action. Licorice enhances intestinal barrier integrity and protects gastrointestinal mucosa by upregulating tight junction proteins, activating repair pathways like epidermal growth factor receptor/extracellular regulated protein kinases (EGFR/ERK), and modulating inflammatory signaling via the tumor necrosis factor/nuclear factor-κB (TNF/NF-κB) pathway. At the systemic level, licorice modulates core pathways like Toll-like receptor 4 (TLR4)/NF-κB and farnesoid X receptor/Takeda G protein-coupled receptor 5 (FXR/TGR5) through cross-organ axes such as the gut-immune, gut-liver, and gut-adipose axes to improve conditions including inflammatory bowel disease (IBD), obesity, type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD). However, licorice poses dose-dependent risks which raise concerns regarding its safety. Long-term high-dose use may induce pseudohyperaldosteronism and interactions with multiple medications, and thus necessitates strict clinical dose control. This study reveals the gut microbiota's central mediating role in licorice's efficacy, and thereby provides theoretical support for its rational clinical application.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"509-528"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tanshinone IIA Alleviates Pyroptosis through SIRT1/NLRP3 Pathway to Improve Diabetic Nephropathy.","authors":"Wencong Tian, Peng Song, Junhao Zang, Jia Zhao, Chuntao Wang, Yanhong Liu, Hong Fang, Hongzhi Wang, Xiaojie Tian, Jiawei Zhang, Ziang Chen, Yang Gao, Yongjie Zhao, Lei Cao","doi":"10.1142/S0192415X26500102","DOIUrl":"10.1142/S0192415X26500102","url":null,"abstract":"<p><p>Diabetic nephropathy (DN) is a serious complication of diabetes mellitus, and the efficacy of standard clinical therapies is presently limited. Evidence has shown that pyroptosis-mediated cell death promotes several diabetic complications including DN. Tanshinone IIA (Tan IIA), the main fat-soluble component of <i>S. miltiorrhiza</i> Bunge, possesses anti-inflammatory and anti-oxidant properties. However, its impact on pyroptosis in DN progression and the underlying molecular mechanisms remain unclear. The aim of this study was to investigate the effect of Tan IIA on pyroptosis in DN. To establish a DN mouse model, STZ was administered to the mice for five consecutive days via injection. The mice in the treatment group then received Tan IIA by gavage for 10 weeks. Our data revealed that Tan IIA inhibited caspase-1 and gasdermin D (GSDMD)-mediated pyroptosis and thereby alleviated renal injury. Compared with that of the DN mice or high glucose-evoked HK-2 cells, the silent information regulator 1 (SIRT1) expression was significantly elevated, and the NLR family pyrin domain containing 3 (NLRP3) expression was dramatically decreased following Tan IIA treatment. Most importantly, the suppression of SIRT1 remarkably abrogated both the protective effects of Tan IIA against DN and its inhibition on pyroptosis-related molecules. Collectively, our results suggest that Tan IIA protects against DN by inhibiting caspase-1 and GSDMD-mediated pyroptosis through the SIRT1/NLRP3 pathway.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"285-301"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Mechanisms and Therapeutic Potentials of Triptolide in Autoimmune Diseases: Advances and Challenges.","authors":"Junning Zhang, Fangying Huang, Yujiao Xu, Jinfang Xie, Yinping Lei, Zipeng Hu, Yong Dai, Xianliang Hou","doi":"10.1142/S0192415X26500072","DOIUrl":"https://doi.org/10.1142/S0192415X26500072","url":null,"abstract":"<p><p>The global incidence and prevalence of autoimmune diseases are increasing, and there is thus a need to develop novel, effective, and affordable therapeutic agents for autoimmune diseases. Triptolide (TP), a bioactive diterpenoid epoxide isolated from <i>Tripterygium wilfordii</i> Hook F, exhibits potent immunosuppressive and anti-inflammatory activities, and can be a potential therapeutic for multiple autoimmune diseases. The therapeutic effects of TP can be attributed to multiple mechanisms, including the inhibition of T cell and B cell activation, the restoration of T helper 17 cell/regulatory T cell balance, the suppression of pro-inflammatory cytokines, and the modulation of critical signaling pathways like the NF-κB, JAK/STAT, and PI3K/Akt pathways. TP alleviates pathological conditions by regulating oxidative stress responses and influencing gut microbiota composition. However, the clinical application of TP is limited due to severe dose-dependent and time-dependent toxic effects on the liver, kidneys, reproductive system, and other organs. Recent studies have highlighted several strategies, such as chemical structure modification, nanocarrier-based delivery systems, engineered exosomes, and combination pharmacotherapy, to both improve therapeutic efficacy and mitigate systemic toxicity. To provide insights for its safe clinical translation, this review systematically summarizes the pharmacological mechanisms, therapeutic potential, and toxicological challenges of TP in autoimmune diseases.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":"54 1","pages":"201-228"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phytochemical Insights into <i>Panax</i> Genus Metabolites: Evidence-Based Fatigue Intervention via Ethnopharmacological and Biomedical Perspectives.","authors":"Huong-Giang Le, Thi Luu Kim Huong Huynh, Thanh Hao Huynh, Ngoc-Thac Pham, Bo-Rong Peng, Mohamed El-Shazly, Lo-Yun Chen, Lung-Shuo Wang, Pei-Tzu Yen, Kuei-Hung Lai","doi":"10.1142/S0192415X26500060","DOIUrl":"10.1142/S0192415X26500060","url":null,"abstract":"<p><p>Traditional Chinese Medicine (TCM) has a longstanding history in the treatment of fatigue-related conditions, and is increasingly recognized as a foundation for novel therapeutic approaches. The <i>Panax</i> genus, extensively utilized in the fundamental TCM principles to enhance vitality, modulate immune function, and stimulate Yang energy, is a key resource in managing both physiological and pathological fatigue. This study provides a comprehensive synthesis of recent advancements in plant-derived metabolites from various <i>Panax</i> species with an emphasis on their structural diversity and structure-activity relationships. Notably, this represents the first systematic exploration of <i>Panax</i> metabolites with potential antifatigue effects. A systematic literature review was conducted using major scientific databases such as PubMed, Google Scholar, and ScienceDirect. The search query \"(scientific name of herbal medicine in the <i>Panax</i> genus) AND (\"antifatigue\")\" was employed. Additionally, classical herbals, botanical literature, and pharmacopoeias were reviewed to contextualize the findings. Comprehensive analysis of 105 studies elucidated 16 predominant metabolites exhibiting antifatigue activity. These metabolites primarily originated from <i>Panax ginseng</i>, <i>Panax quinquefolium</i>, and <i>Panax notoginseng</i>. Ginsenosides Rb1 and Rg1 demonstrated the most substantial pharmacological efficacy in experimental models, in particular by ameliorating metabolic perturbations and mitigating oxidative stress <i>in vivo</i>. Clinical trials predominantly relied on subjective patient-reported measures, such as the Multidimensional Fatigue Inventory (MFI) and Visual Analogue Scale (VAS), and yielded largely positive outcomes. These findings substantiate fundamental TCM principles and reinforce the therapeutic potential of <i>Panax</i> species in fatigue management. The integration of traditional knowledge with contemporary biomedical research enhances the understanding and clinical applicability of <i>Panax</i> species in addressing fatigue-related disorders.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"171-200"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emodin Inhibitsg Hepatocellular Carcinoma Invasion and Migration by Regulating the HDAC4/NF-κB (p65)/CXCL12 Signaling Axis and Suppressing M2 Macrophage Polarization.","authors":"Yi-Qiong Zhang, Yong-Jie Xu, Hai-Zhi Li, Shuang Wang, Cheng-Cheng Li, Chang-Yu-Dong Huang, Ya-Chun Shi, Xing Li, Shu-Yun Zhao, Li-Ying Zhu, Wei Pan","doi":"10.1142/S0192415X26500369","DOIUrl":"10.1142/S0192415X26500369","url":null,"abstract":"<p><p>This study aims to investigate how emodin, an active component of <i>Polygonum multiflorum</i>, regulates macrophage polarization through the HDAC4/NF-κB/CXCL12 pathway and impacts the progression of hepatocellular carcinoma (HCC). The inhibitory effect of emodin on M2 polarization was assessed by collecting conditioned cell culture medium from HepG2 cells and treating macrophages with emodin. Network pharmacology and other experiments were used to identify HDAC4 as a key target, and this was further validated through molecular docking, surface plasmon resonance (SPR), and Western blot analysis. Additional validation of the HDAC4/NF-κB(p65)/CXCL12 axis regarding HCC progression was conducted using single-cell RNA sequencing and an <i>in vivo</i> HCC model. The results demonstrate that macrophages with HepG2 supernatant after treating, including emodin, tetrahydroxy stilbene glucoside and physcion, were added to reduce macrophage M2 polarization and inhibit HepG2 invasion and migration. Network pharmacology and protein analysis were used to discover the role of HDAC4 as the target of three drugs in HCC. The feasibility of emodin as a drug target for HDAC4 was explored through molecular docking simulation and SPR, and then verified through Western blot and nuclear plasma separation analysis. Likewise, the HDAC4/NF-κB (p65) pathway reduces M2 polarization and inhibits the invasion and migration of HepG2. By using a single-cell sequencing database to predict the high expression of chemokines in HCC, and verifying the effect of emodin's ability to reduce M2 polarization and inhibit HepG2 invasion and migration via the HDAC4/NF-κB (p65)/CXCL12 pathway, the results were likewise validated <i>in vivo</i>. This study elucidates the novel role of emodin in HCC progression and macrophage polarization, and demonstrates how emodin-mediated HDAC4 inhibition effectively attenuates HCC invasion and migration.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"975-1007"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoring Homeostatic Balance: Advances in Traditional Chinese Medicine for Rheumatoid Arthritis.","authors":"Yuhong Xiang, Aihong Yang, Cong Guo, Jintang Cheng, Jun Zhang, Chang Chen, Sha Chen, Jinzhu Jiang, Jipeng Di, Xianju Liu, Siyuan Li, An Liu, Yan Liu, Qingxia Xu","doi":"10.1142/S0192415X26500278","DOIUrl":"10.1142/S0192415X26500278","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune disease with inflammation-mediated joint damage. Its pathogenesis involves synergistic impairment of multiple physiological balances, including immune cell subset dysregulation, abnormal inflammation, oxidative stress, pathological angiogenesis, bone homeostasis disorder and gut microbiota dysbiosis. Conventional therapies have high costs and adverse effects. Traditional Chinese medicine (TCM) follows a holistic balance-restoring concept and is a promising alternative, with <i>Tripterygium wilfordii</i>, Wutou Decoction and <i>Toddalia asiatica</i> extract as evidence-based representatives. This review summarizes 2020-2025 <i>in vitro</i> and <i>in vivo</i> studies on anti-RA TCM. Its core therapeutic mechanism is multi-target, network-based regulation. It rectifies various pathological imbalances simultaneously: modulating immune cell polarization, rebalancing inflammatory factors, scavenging ROS, inhibiting abnormal angiogenesis, regulating osteoblast-osteoclast crosstalk and reshaping gut microbiota. Single TCM agents act on multiple balance networks, showing complex pharmacological properties. TCM's unique advantage for RA is reestablishing the body's dynamic homeostasis by targeting interconnected pathological balances. Further research is needed to clarify TCM components' synergistic regulatory mechanisms and promote their clinical translation.</p>","PeriodicalId":94221,"journal":{"name":"The American journal of Chinese medicine","volume":" ","pages":"733-762"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}