Phytochemicals and Novel Nanotherapeutic Approaches in the Management of Rheumatic Diseases

Introduction

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).