Advances in the effect of gut-joint axis dysfunction on rheumatoid arthritis and the intervention of natural products

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory malady that predominantly affects the joints. Emerging evidence highlights the perturbation of intestinal microflora and its resultant metabolites as potential instigators of disruptions within the "gut-joint axis". These disruptions subsequently trigger localized or systemic immune responses, culminating in joint inflammation and consequent impairment. While the efficacy of natural compounds in managing RA has been increasingly recognized, the precise mechanisms underlying their actions within the 'gut-joint axis' remain incompletely elucidated. The primary objective of this comprehensive investigation is to assess the effects of the intestinal barrier, gut microbiota, and metabolites on the pathogenesis of RA. Moreover, it aims to delineate the mechanisms through which natural products exert their therapeutic effects on the treatment of RA, all within the framework of the 'gut-joint axis'.