The combination of traditional Chinese medicine and western medicine in the prevention of rheumatoid arthritis

Traditional medicine remains an important part of
healthcare around the world.
Whether people believe in its efficacy or not, its impact cannot be ignored: the World Health Organization reports in its latest report that its 170 (88%) member states have national policies
on traditional and complementary medicine.
In some regions, traditional medicine is the only available healthcare option, and its use is based on the trust of
individual therapists or medical men and women.
In other cases, it is built into the healthcare system and used
in parallel with modern pharmaceuticals.
The latter is the case for many traditional Chinese medicine (TCM) practices, which opens a window
of opportunity for using clinical data as a starting point for drug discovery.

However, its path from traditional medicine to modern medicine is not simple: how to link traditional information to the clinical symptoms of the disease? Which chemical method should be used to extract and isolate any pure compounds responsible for activity, and which bioassays are suitable for detecting active compounds and determining their mechanism of action? In this review, researchers discuss these issues
from the perspective of rheumatoid arthritis (RA).

Effects of herbs on the rheumatoid arthritis (RA) pathway:

TCM has a long tradition
in fighting rheumatoid arthritis (RA).
These recipes are based on a combination of usually 5-10 plants, usually boiled and administered
as a decoction or tea.
Few clinical trials have been conducted, so there is little
clinical evidence.
A basic principle of traditional medicine is the prevention of disease
.
RA is an autoimmune, inflammatory and chronic disease that mainly affects the joints
of 0.
5%-1% of the population.
In two-thirds of cases, patients are characterized by the presence of autoantibodies, such as rheumatoid factor and more disease-specific autoantibodies against citrulline proteins, the so-called "ACPA" (anti-citrullinated protein/peptide antibodies).

ACPA positivity is also strongly associated with
specific variants in the HLA-DRB1 gene, a shared epitope allele.
These factors, along with smoking, are the main risk
of developing rheumatoid arthritis.

Contents of the DA:

Drug discovery based on ethnopharmacology and traditional medicine has met with skepticism – regarding clinical evidence and safety, but also on issues
related to biopiracy, collection and cultivation.
These issues need to be addressed in any natural product-based drug discovery program, but should not prevent research
in the field.
A large number of current medicines are natural products or their derivatives, and there is no doubt that nature will continue to be a source of
future discoveries.
Therefore, continuous research based on the traditional use of plants is highly motivated
.
The researchers believe that strategies to start with traditional medical knowledge and then combine in vivo efficacy evidence with bioassay-guided isolation to understand the chemistry and pathways involved is an effective way
forward.

Jakobsson PJ, Robertson L, Welzel J, Zhang M, Zhihua Y, Kaixin G, Runyue H, Zehuai W, Korotkova M, Göransson U.
Where traditional Chinese medicine meets Western medicine in the prevention of rheumatoid arthritis.
J Intern Med.