Phytochemicals and Novel Nanotherapeutic Approaches in the Management of Rheumatic Diseases

Phytochemicals and Novel Nanotherapeutic Approaches in the Management of Rheumatic Diseases

Ashfaq Ahmad Shah (Graphic Era University (Deemed), India) and Amit Gupta (Graphic Era University (Deemed), India)
Copyright: © 2022 |Pages: 18
DOI: 10.4018/978-1-7998-8251-0.ch009
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Over 100 types of arthritis have been recognized in which the dominating forms are osteoarthritis and rheumatoid arthritis. Joint stiffness, pain, swelling, lowered range of motion of joints affected, redness around joints are the main complications of almost all types of arthritis. Medications like non-steroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, and immunosuppressants are only used to control the symptoms of the disease but are not able to alleviate them properly. However, with the incorporation of disease-modifying antirheumatic drugs (DMARDs) as well as tumor necrosis factor inhibitors (TNFi) in treatment, there are now promising therapeutic options to select from for the management of rheumatoid diseases. Nanotherapeutic approach has enabled us to deliver the disease-modifying agents directly to the inflammation site, thus eschewing off-target and unwanted systemic effects. Therefore, it provides an opportunity to reconsider the therapeutic compounds that were considered too toxic to be administrated via oral or parenteral route.
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The benign immune system in our body plays a cardinal role in defending different types of infectious diseases as well as eliminates the altered cells that may prove fatal. But if any type of exaggeration occurs in the elements of this system, it leads to several fatal disorders. Such disorders range from hypersensitive or allergic reactions to numerous derangements like loss of normal ability to differentiate non-self from self, resulting in immune actions against bodies own tissues and cells called auto-immune disorders (Choudhary et al., 2015). Among some such common disorders like pernicious anemia, myasthenia gravis, serum sickness, etc. rheumatic diseases are also common with almost of unknown etiology (Hajja et al., 2018). Rheumatic diseases mainly affect joints, but some types of arthritis also involve organs. Rheumatic diseases are chronic systemic inflammatory disorders with primary symptoms of pain, swelling, Joint stiffness, lowered range of motion of joints affected, redness around joints, destruction of cartilages and bones which sometimes may lead to permeant disabilities as well as secondary health issues like muscle weakness, fatigue, malaise, tenderness, loss of flexibility, poor sleep, and decreased aerobic fitness. Despite the presence of much more knowledge in the field of immunopathology, the exact etiology of Rheumatic diseases remained a far cry. Rheumatic diseases have become a common reason that people miss work and experience a decreased life quality (Tripathy et al., 2010). These disorders make it difficult for affected individuals to be active physically. More than 100 types of arthritis are known today in which osteoarthritis dominates by affecting more than 3.8% of people followed by Rheumatoid arthritis. According to WHO, rheumatoid arthritis (RA) affects 1-2% of the world population, and females are 3-4 times more susceptible to these disorders than males (Chunxia et al., 2011). Main pathological alterations in rheumatoid arthritis are synovial membrane hyperplasia, inflammation, cell infiltration, and neovascularization which eventually may lead to articular destruction and cartilage erosion. This attack is principally targeted at flexible synovial joints. In this whole pathology, capsule inflammation around the joints and secondary swelling of the synovial cells is triggered which may lead to deformity (Babushetty et al., 2012). Occasionally rheumatoid arthritis can incorporate other internal organs like nerves, lungs, eyes, or heart. Initial symptoms of rheumatoid arthritis can be non-specific like feeling unwell, tired soreness in joints, complications in handling and walking. Gradually it involves more and more joints of the body. Although the precise etiology of this disorder is not known fully, several hypotheses put forth by some immunologists suggest that it is prompted by a combination of immuno-genetic and environmental factors. Some viruses have been also found to trigger rheumatic disorders (Mazumder et al., 2012).

Key Terms in this Chapter

Arthritis: Arthritis is a term that describes around 200 conditions that cause pain in the joints and the tissues surrounding the joints.

Nanodelivery: Delivery of drugs via nano-drug delivery systems (NDDSs) which are different classes of nanomaterials.

Cytokines: Cytokines are small messenger proteins that are crucial in controlling the growth, differentiation and activity of immune system cells.

Flavonoids: Flavonoids are a group of plant secondary metabolites which are supposed to provide health benefits through cell signaling pathways and antioxidant effects.

Nanotechnology: Nanotechnology is science, engineering, and technology conducted at the nanoscale, which is about 1 to 100 nanometers.

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