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  • A Systemic Review of Treatment of Rheumatoid Arthritis Using Herbal Plants

  • Photo Soni Dhruvi* 1 Photo Khatiya Honey 1 Photo Prajapati Rahul 2

  • 1UG Scholar, Neotech Institute of Pharmacy, Virod, Vadodara- 390022
    2Assistant Professor, Sat Kaival College of Pharmacy, Sarsa, Anand, Gujarat-388365

Abstract

Rheumatoid Arthritis (RA) is a chronic autoimmune disease of unknown aetiology that affects 0.5% of the population and can result in disability owing to joint destruction, characterized by joint synovial inflammation and progressive cartilage and bone destruction resulting in gradual immobility. Rheumatoid arthritis risk factors include genetic, hormonal, environmental and nutritional, and socio-economic factors, age and sex, ethnicity, smoking, infections, and so on. Treatment of inflammatory diseases, such as rheumatoid arthritis is practiced based on traditional medicine in many countries. The greatest disadvantage in the presently available potent synthetic drugs lies in their toxicity and reappearance of symptoms after Discontinuation. With limitations of existing drug molecules herbal drugs are gaining interest among RA Patients. Medicinal plants are plants containing inherent active ingredients used to cure disease or relieve symptoms of arthritis. The present review also focuses on the medicinal plants that interact with the mediators of inflammation and are used in the treatment of rheumatoid arthritis (RA).

Keywords

Rheumatoid Arthritis, RA, Herbal Plants, Rheumatoid Arthritis herbal Plant treatment

Introduction

Rheumatoid arthritis (RA) is a debilitating autoimmune disorder characterized by chronic inflammation of the Synovial joints, leading to pain, swelling, and joint deformities with stiffness, it can also damage both joints and extra-articular organs, including the heart, lung, digestive system, eye, skin and nervous system. Rheumatoid arthritis (RA) is a chronic inflammatory, systemic, progressive, autoimmune disease in which the body’s immune system whose major role is to protect the health by attacking foreign bacteria and viruses are mistakenly, attacking the joints resulting in thickened synovium, pannus formation & destruction of bone, cartilage(1). Many complications can follow such as permanent joint damage requiring arthroplasty, rheumatoid vasculitis and elty’s syndrome requiring splenectomy if it remains unaddressed. Still now researchers are unable to know the exact cause of this disease. However, it is believed that age, gender, genetics and environmental exposure (cigarette smoking, air pollutants and occupational) play a role in development of RA. As there is no cure for RA, the treatment goals are to reduce the pain and stop/slow the further damage. RA aspects between 0.5 And 1% of adults in the developed world with between 5 and 50 per 100,000 people newly developing the condition each year. In autoimmune diseases normally the immune system displays self-tolerance and does not attack the body’s own components. ?Ls self-tolerance Breaks down and leads to an auto-immune disorder. The pathophysiology of RA involves chronic inflammation of the Synovial membrane, which can destroy articular cartilage and juxtaarticular bone. Arthritis is a very common health problem which is cause activity of daily living (ADL)–Related and instrumental activity of daily living (IADL)–related functional disability, Restriction of work and social participation, and fulfilling their life roles. Over 200 diseases may cause arthritis including rheumatoid arthritis, Osteoarthritis, gout, tuberculosis & other infection(2). Most Common types of arthritis are Ankylosing spondylitis, Gout, Juvenile idiopathic arthritis, Osteoarthritis, Psoriatic arthritis, Reactive arthritis, Rheumatoid arthritis, Septic arthritis, Calcium pyrophosphate deposition disease, Crystal arthritis, Bacterial infections, Systemic lupus erythematosus (SLE), Reactive arthritis, Chronic Childhood Arthritis, Fibromyalgia, Lupus, Scleroderma, Post-traumatic arthritis, Hemochromatosis arthritis, Enteropathic arthritis, Vasculitic arthritis, Giant Cell Arteritis, Behçet’s Disease, Relapsing Polychondritis, Gonococcal Arthritis, Pseudogout and Relapsing Polychondritis(3).

Pathophysiology

Rheumatoid arthritis - T lymphocytes (T-cells) binding to antigen and t-cell activation. B cell activation leading to formation of IgM antibody. Antigen-antibody reaction is produce. Formation of Immune complex. The release of Inflammatory chemicals (e.g., IL, NF etc) from inflammatory cells. Inflammatory damage to synovial cavity. Destruction (erosion) of cartilage. Inflammation leads to swelling in synovial membrane and pain around joints(4).

Diagnostic treatment (5)

Medical history

A doctor will ask about your symptoms, any other medical conditions you or your family have, and any medications you are taking.

  • Physical exam: A doctor will check your general health, reflexes, and problem joints.
  • Imaging tests
  • X-rays
  • Ultrasound
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT)
  • Blood tests
  • Antinuclear antibody (ANA) test 
  • Complete blood count (CBC) 
  • Creatinine 
  • Sedimentation rate 
  • Rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody tests 
  • White blood cell count 
  • Uric acid
  • Surgery: Synovectomy is a procedure that removes damaged connective tissue lining a joint cavity.
  • Disease-modifying antirheumatic drugs (DMARDs) can help with symptom remission if started early

Plants Used For Treatment Of Rheumatoid Arthritis

  1. Ginger (6, 7)
  • Synonym: Gingerin, Rhizoma zingiberis, Zingibere, Zingiber, and Zingiberis.
  • Biological source: Ginger comes from the rhizome, or underground stem, of the Zingiber officinale plant.
  • Family: Zingiberaceae
  • Chemical constituents:

Chemical Components

R.

Time (min)

Concentration %

DMT

Concentration %

WLD

Bisacurone epoxide

1.773

16.35215

-

2-Heptanone

5.809

0.36243

-

Heptan-2-ol

6.015

2.31573

-

Alpha-pinene

6.928

5.47721

4.20737

Camphene

7.321

16.93417

0.08067

Beta-Pinene

8.055

0,99324

17.20679

Myrcene

8.359

4.07577

0.49867

Octanal

8.663

0.42944

-

Alpha-Phellandrene

8.781

0.79561

-

Beta- Phellandrene

9,504

11.60409

72.72907

Eucalyptol

9.561

14.99832

0.40929

Butyl 2- methylvalerate

9.76

0.74342

-

Caryophyllene

10.937

 

0.49867

Isocugenol

11.276

 

3.98642

Linalool

11.503

0.7712

-

Citronellal

13.084

0.79028

-

Neral

15.717

2.87096

-

Geranial

16.564

4.13926

-

2-Undecanone

17.198

0.3768

-

Copaene

19.716

0.43628

-

Germacrene D

22.591

0.59153

-

Fenchyl acetate

22.624

7.16701

0.61332

2-Farnesene

23.077

2.81488

-
  • Cultivation: Grow ginger in tropical climates (25-35°C) with fertile, well-drained soil (pH 5.5-6.5). Plant rhizomes 5-7.5 cm deep, spaced 20-30 cm apart. Keep soil moist, fertilize regularly, control weeds and pests, and harvest in 8-10 months when leaves yellow. Dry and store in a cool, dry place.
  • Types:
  • Thai Ginger (Galanga)
  • Blue Ginger (Zingiber zerumbet)
  • Baby Ginger
  • Black Ginger (Kra-Chai)
  • Wild Ginger (Asarum)
  • Jamaican Ginger
  • Finger Ginger
  • Chinese Ginger
  • Australian Ginger
  • White Ginger
  • Red Ginger
  • Sand Ginger
  • Korean Ginger
  • Indonesian Ginger
  • Indian Ginger
  • Spiked Ginger Lily
  • Nepalese Ginger
  • Tumeric Ginger (Curcuma longa)
  • Butterfly Ginger
  • Dose:
  • Here are some common forms of ginger and their corresponding doses:
  • Fresh ginger: 1–2 teaspoons of grated fresh ginger (about 2–5 grams) daily.
  • Ginger powder: 1–3 grams per day, usually divided into smaller doses.
  • Ginger extract: 100–200 milligrams of ginger extract, typically standardized to contain 5% gingerols, taken two or three times per day.
  • Forms:
  • Fresh Ginger
  • Ginger Powder
  • Ginger Extract
  • Ginger Tea
  • Ginger Oil
  • Ginger Supplements
  • Ginger Juice
  • Environmental adaptability:
    1. Climate: Warm and humid tropical/subtropical climates (22°C–30°C).
    2. Humidity: Requires 70–90% relative humidity.
    3. Frost Sensitivity: Cannot tolerate frost; suitable for frost-free regions.
    4. Soil: Well-drained loamy or sandy soil rich in organic matter.
    5. pH: Prefers slightly acidic to neutral soil (pH 5.5–7.0).
  • Commercial products: Ginger Root,Dramamine Non-Drowsy Naturals, Hofels Ginger One A Day,Zingiber, Focalgin-B.
  • Contraindications: Pregnant or breastfeeding women, people with heart conditions, and people with diabetes should not take ginger without talking to their doctors.
  • Clinical evidence: Nausea and vomiting, Bloating and gas, Cancer, Inflammation, Swallowing function,
  • Synergistic combination: Ginger and Barley, ginger and Pomegranate, ginger and Licorice, ginger and Turmeric, Ginger and Ashwagandha and Amla, Ginger and synthetic CBD, Ginger and nifedipine.
  • Analytical methods: Differential Scanning Calorimetry (DSC): Measures the heat flow associated with thermal transitions in ginger, providing information on stability and shelf life. Thermogravimetric Analysis (TGA): Monitors weight changes as a function of temperature, useful for studying moisture content and thermal decomposition. Liquid Chromatography-Mass Spectrometry (LC-MS): Combines liquid chromatography with mass spectrometry for detailed analysis of ginger’s bioactive compounds.  Supercritical Fluid Chromatography (SFC): Utilizes supercritical fluids for the separation of non-volatile and thermally labile compounds in ginger. Direct Analysis in Real-Time Mass Spectrometry (DART-MS): Allows for the direct analysis of ginger samples without extensive preparation.
  • Common uses: Digestion, Blood sugar control, Weight loss, Milk secretion, Anti-inflammatory, Pregnancy, Cardiovascular health
  • Precautions:
  1. Limit to 4g/day to avoid side effects.
  2. Consult if pregnant or on blood thinners.
  3. Stop 2 weeks before surgery.
  4. Avoid with gallstones or allergies.
  5. Can cause stomach upset in excess.
  1. Tumeric (8, 9)
  • Synonyms: Curcuma, Curcuma aromatica, Curcuma domestica, Indian saffron, Haldi, Haridra, Pian jiang huang, Racine de curcuma, Radix curcumae, and Yu jin
  • Biological source: Turmeric is the dried rhizome of Curcuma longa Linn. (syn.C.domestica Valeton).
  • Family: Zingiberaceae
  • Chemical constituents: Curcuminoids (5%): Curcumin I (60%), Curcumin II & III, Dihydrocurcumin. Essential Oil (6%), Major Terpenes: Zingiberene (25%), α-phellandrene, turmerones, ar-turmerone, Other Compounds: Linalool, cineole, camphor, eugenol, curdione, curzerenone., Choleretic Agent: β-tolylmethyl carbinol.

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Photo
Soni Dhruvi
Corresponding author

UG Scholar, Neotech Institute of Pharmacy, Virod, Vadodara- 390022

Photo
Khatiya Honey
Co-author

UG Scholar, Neotech Institute of Pharmacy, Virod, Vadodara- 390022

Photo
Prajapati Rahul
Co-author

Assistant Professor, Sat Kaival College of Pharmacy, Sarsa, Anand, Gujarat-388365

Soni Dhruvi*, Khatiya Honey, Prajapati Rahul, A Systemic Review of Treatment of Rheumatoid Arthritis Using Herbal Plants, Int. J. Sci. R. Tech., 2025, 2 (3), 345-374. https://doi.org/10.5281/zenodo.15066042

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