Use of flavonoids in experimental therapy of rheumatoid arthritis

Abstract

The review concerns the possibility of potential use of flavonoids in the complex treatment of rheumatoid arthritis (RA). The promising properties of flavonols, flavones, flavanones, flavan-3-ols and isoflavones are analyzed, including anti-inflammatory, antioxidant, antiproliferative, immunomodulatory effects in the absence of pronounced toxicity. The information based on numerous experimental data obtained in vitro studies and using models that adequately reproduce RA in rodents is considered. The antiarthritic effect of flavonoids is based on the ability to suppress the functional activity of immune cells, their recruitment to the site of inflammation of the synovial membrane with inhibition of the release and activation of proinflammatory cytokines and other inflammatory factors due to the effect on the corresponding transcription factors and intracellular signaling pathways. Antioxidant action, as well as inhibition of T- and B-lymphocyte activity by flavonoids, make a significant contribution to the development of the immune inflammation process. An important positive role is played by the suppression of hyperactivity of fibroblast-like synoviocytes and activation of their apoptosis in RA, which weakens the invasiveness of the pathological process and the formation of pannus. Inhibition of the activity of matrix metalloproteinases, which ensure the process of bone resorption in RA, is also important. Promising experimental data have been obtained by combining flavonoids with classical antiarthritic drugs, such as methotrexate. The greatest attention is currently paid to the antiarthritic efficacy of the flavonol quercetin.