Anti-inflammatory Effect of Gambier Catechin (Uncaria gambir Roxb) on Rheumatoid Arthritis: A Review

Abstract

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints and varies in severity in patients. Inflammation in the joints causes high levels of systemic pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) which have an impact on permanent damage to the joints. Until now, the treatment of RA is only symptomatic, without being able to prevent the progression of damage to the joints, and this treatment also causes side effects such as gastrointestinal and cardiovascular toxicity. Therefore, many patients are looking for alternative medicine to complement their treatment. METHODS: This research was a narrative review that was performed using PubMed, Science Direct, and Google Scholar using pre-clinical and clinical studies which aim to determine whether the therapeutic mechanism of gambier catechin (Uncaria gambir Roxb) on RA. A literature review is carried out to formulate a scientific basis for innovation. RESULTS: The gambier plant is a typical plant of West Sumatra, which is rich in phytochemicals. The active compounds in gambier are catechins which are classified as flavanols/flavonoids. Catechins are compounds that are well-known as antioxidant, anti-inflammatory compounds, the highest found in gambier plants. Catechins affect the expression of inflammation-related genes and proteins such as TNF-α, IL-1, and show their anti-inflammatory roles. This research is a literature review using secondary data from original research based on in vitro, in vivo, and clinical trials. The results showed that catechins can inhibit the production of IL-1, TNF-α, prostaglandin and increase levels of cyclic adenosine monophosphate in rats. On histological findings, peri-synovial inflammation and cartilage damage decreased in the group given epigallocatechin-3-gallate which showed anti-rheumatic activity and increased CD4+ and CD25+ regulatory T cells, thereby inhibiting the B cell population effectively suppresses inflammation and arthritis pain and shows its therapeutic potential in the treatment of RA. CONCLUSION: It can be concluded that gambier catechins have the potential as a candidate for RA therapy. This, if developed, can certainly improve the health status of the community locally and globally.