ReviewFrontiers in pharmacology2026
Advances in traditional Chinese medicine for modulating macrophage polarization in the treatment of rheumatoid arthritis.
Review in Frontiers in 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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Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent synovitis and progressive joint destruction, wherein macrophage polarization constitutes a critical pathogenic mechanism governing both the initiation and perpetuation of synovial inflammation. The conventional M1 and M2 dichotomy has evolved into a continuum model encompassing disease-stage-specific synovial subsets, including remission-associated MerTK-positive populations and pro-inflammatory clusters, reflecting the functional heterogeneity of macrophages in the rheumatoid microenvironment. Modulating macrophage polarization accordingly represents a promising therapeutic strategy; however, pharmacological agents specifically designed to target macrophage phenotypes remain in nascent stages of development. Traditional Chinese medicine (TCM) has emerged as a potential avenue for addressing this therapeutic gap. Extensive experimental evidence has demonstrated that diverse multi-botanical drug formulations and purified bioactive metabolites, including sinomenine, icariin, and curcumin, can effectively modulate macrophage polarization through interconnected pathways involving NF-κB, JAK-STAT, and PI3K-Akt signaling. These interventions further act through metabolic reprogramming between glycolysis and oxidative phosphorylation, operating
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