Evidence map›Paper›PMID 41910732›Full record

SynthesisNaunyn-Schmiedeberg's archives of pharmacology2026

Immunopharmacological effects of shikonin in experimental rheumatoid arthritis: a systematic review and meta-analysis of in vivo studies.

Muhammad Muzammil Nazir, Saima Muzammil, Muhammad Mujammil Nazir, Sara Nazir, Asma Ashraf

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Naunyn-Schmiedeberg's archives of pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

5 authors.

Muhammad Muzammil NazirDepartment of Zoology, Government College University, Faisalabad, 38000, Pakistan.
Saima MuzammilDepartment of Microbiology, Government College University, Faisalabad, 38000, Pakistan.
Muhammad Mujammil NazirDepartment of Food Science and Technology, Faculty of Agriculture and Environment, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
Sara NazirDepartment of Chemistry, Government Sadiq College Women University, Bahawalpur, 63100, Pakistan.
Asma AshrafDepartment of Zoology, Government College University, Faisalabad, 38000, Pakistan. asmaashraf@gcuf.edu.pk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by dysregulated immune responses, persistent synovial inflammation, and progressive joint destruction. Shikonin (SKN), a bioactive naphthoquinone derived from Lithospermum erythrorhizon and related Boraginaceae species, has demonstrated broad immunomodulatory and anti-inflammatory activities in experimental studies. This systematic review and meta-analysis aimed to critically evaluate the immunopharmacological efficacy and underlying mechanisms of SKN in preclinical in vivo models of RA. A comprehensive literature search was conducted in PubMed, ScienceDirect, and Google Scholar to identify eligible studies published up to November 2025. In vivo studies investigating the effects of SKN in experimental RA models were included. Data extraction was performed using a predefined protocol, and risk of bias was assessed using the SYRCLE tool. Quantitative synthesis was conducted using Review Manager (RevMan) version 5.4, with standardized mean differences (SMDs) and 95% confidence intervals (CIs) calculated for continuous outcomes. Twelve studies met the inclusion criteria, employing collagen-induced, adjuvant-induced, or complete Freund adjuvant arthritis models in mice and rats. SKN was predominantly administered via oral gavage at doses ranging from 1.0 to 5.2 mg/kg. Meta-analysis revealed that SKN significantly reduced paw edema and arthritis scores and improved joint histopathology. Immunopharmacological effects included suppression of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6), enhancement of anti-inflammatory IL-10, and upregulation of FoxP3⁺ regulatory T cells. Mechanistic studies implicated modulation of key immune signaling pathways, including AMPK/mTOR, PI3K/AKT, MAPK, NF-κB, and JAK/STAT. SKN exhibits potent immunomodulatory and anti-arthritic effects in preclinical RA models by targeting multiple cytokine-driven and immune signaling pathways. These findings support its potential as an immunopharmacological agent for autoimmune inflammatory diseases, warranting further translational and safety-focused investigations.

Indexed as

Anti-Inflammatory AgentsArthritis, ExperimentalArthritis, RheumatoidImmunomodulating AgentsNaphthoquinonesAnimalsCytokinesHumansAnti-Inflammatory AgentsCytokinesImmunomodulating AgentsNaphthoquinonesshikoninCollagen-induced arthritisCytokinesInflammationIn vivo modelsMeta-analysisNatural compoundsRheumatoid arthritisShikonin

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.