{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:14:15Z","timestamp":1773389655337,"version":"3.50.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic synovitis. The \u201cgut-joint axis\u201d proposes gut microbiota and metabolites modulate RA inflammation via mucosal and systemic immune responses. Botanical drugs (Traditional Chinese Medicine, TCM) and plant metabolites offer multi-target potential. However, most studies remain descriptive, demonstrating concurrent microbial shifts but lacking causal designs to verify mechanistic necessity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This scoping review examines TCM and plant metabolite interventions on RA gut microecology (2015\u20132025), focusing on the \u201cmicrobiota\u2013metabolite\u2013immune\u201d axis. It aims to classify evidence based on causal design rigor and identify steps to advance research from correlation to causality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched PubMed, Embase, and Web of Science (2015\u20132025). Studies reporting RA outcomes and gut microbiota changes following TCM interventions were included. We established a hierarchical classification system based on design rigor: antibiotic depletion (ABX), fecal microbiota transplantation (FMT), metabolite rescue, and blocking. Evidence was stratified: Level A (Closed-loop: ABX + FMT + rescue\/blocking), Level A+ (plus\n                      <jats:italic>in vitro<\/jats:italic>\n                      blocking), Level B (Partial: ABX\/FMT alone), and Level C (Correlational).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 25 included studies (24 animal, 1 clinical), only 2 were Level A, 1 Level A+, 3 Level B, and 19 Level C. While TCM improved RA phenotypes and altered microbiota, complete closed-loop verification remains rare. Short-chain fatty acids (SCFAs) show promise but inconsistent trends due to heterogeneity. Bile acids and tryptophan metabolites correlate with reduced inflammation, yet their mechanistic necessity remains largely untested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Botanical drugs and plant metabolites demonstrate potential in modulating gut microbiota to improve RA. However, definitive causal links remain underexplored. Future research should prioritize \u201cshortest closed-loop\u201d strategies, including targeted quantification, rescue, and necessity validations. Longitudinal designs and systemic immune metrics are essential to transition from correlations to translatable mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1790536","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T05:26:34Z","timestamp":1773379594000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Traditional Chinese medicine and plant metabolites for rheumatoid arthritis via modulating gut microbiota: a scoping review evaluating the transition from correlation to causality"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiadong","family":"Yang","sequence":"first","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Niu","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian","family":"Lan","sequence":"additional","affiliation":[{"name":"Xiyuan Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shouze","family":"Ren","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Liang","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Ma","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1007\/s10238-025-01777-x","article-title":"Immunomodulatory properties of the gut microbiome: diagnostic and therapeutic potential for rheumatoid arthritis","volume":"25","author":"Abebaw","year":"2025","journal-title":"Clin. Exp. Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"4213","DOI":"10.1039\/d2fo02707k","article-title":"Hesperetin attenuates sepsis-induced intestinal barrier injury by regulating neutrophil extracellular trap formation via the ROS\/autophagy signaling pathway","volume":"14","author":"Chen","year":"","journal-title":"Food Funct."},{"key":"B3","doi-asserted-by":"publisher","first-page":"116727","DOI":"10.1016\/j.jep.2023.116727","article-title":"Therapeutic effects of columbianadin from angelicae pubescentis radix on the progression of collagen-induced rheumatoid arthritis by regulating inflammation and oxidative stress","volume":"316","author":"Chen","year":"","journal-title":"J. Ethnopharmacol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"123249","DOI":"10.1016\/j.jchromb.2022.123249","article-title":"Combined 16S rRNA gene sequencing and metabolomics to investigate the protective effects of Wu-tou decoction on rheumatoid arthritis in rats","volume":"1199","author":"Cheng","year":"2022","journal-title":"J. Chromatogr. B Anal. Technol. Biomed. Life Sci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1007\/s11739-023-03374-w","article-title":"Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review","volume":"19","author":"Di Vincenzo","year":"2024","journal-title":"Intern Emerg. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"136250","DOI":"10.1016\/j.ijbiomac.2024.136250","article-title":"Polysaccharides from Gaultheria leucocarpa Var. yunnanensis (DBZP) alleviates rheumatoid arthritis through ameliorating gut microbiota","volume":"281","author":"Dong","year":"2024","journal-title":"Int. J. Biol. Macromol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"156270","DOI":"10.1016\/j.phymed.2024.156270","article-title":"Cannabidiol regulates L-carnitine and butyric acid metabolism by modulating the gut microbiota to ameliorate collagen-induced arthritis","volume":"136","author":"Geng","year":"2025","journal-title":"Phytomedicine"},{"key":"B8","doi-asserted-by":"publisher","first-page":"104459","DOI":"10.1016\/j.phrs.2019.104459","article-title":"Saponins from Clematis mandshurica rupr. Regulates gut microbiota and its metabolites during alleviation of collagen-induced arthritis in rats","volume":"149","author":"Guo","year":"2019","journal-title":"Pharmacol. Res."},{"key":"B9","doi-asserted-by":"publisher","first-page":"149469","DOI":"10.1016\/j.ijbiomac.2025.149469","article-title":"Achyranthes bidentata polysaccharides alleviates rheumatoid arthritis via the gut microbiota-barrier-metabolite axis in vitro and in vivo","volume":"340","author":"Guo","year":"2025","journal-title":"Int. J. Biol. Macromol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"eabm1511","DOI":"10.1126\/sciadv.abm1511","article-title":"Intestinal butyrate-metabolizing species contribute to autoantibody production and bone erosion in rheumatoid arthritis","volume":"8","author":"He","year":"2022","journal-title":"Sci. Adv."},{"key":"B11","doi-asserted-by":"publisher","first-page":"115109","DOI":"10.1016\/j.jpba.2022.115109","article-title":"Metabonomics and 16S rRNA gene sequencing to study the therapeutic mechanism of danggui sini decoction on collagen-induced rheumatoid arthritis rats with cold Bi syndrome","volume":"222","author":"He","year":"2023","journal-title":"J. Pharm. Biomed. Anal."},{"key":"B12","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/1471-2288-14-43","article-title":"SYRCLE\u2019s risk of bias tool for animal studies","volume":"14","author":"Hooijmans","year":"2014","journal-title":"BMC Med. Res. Methodol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/19490976.2021.1882927","article-title":"The contribution of gut bacterial metabolites in the human immune signaling pathway of non-communicable diseases","volume":"13","author":"Hosseinkhani","year":"2021","journal-title":"Gut Microbes"},{"key":"B14","doi-asserted-by":"publisher","first-page":"117121","DOI":"10.1016\/j.jpba.2025.117121","article-title":"Integrative analysis of gut microbiome and serum metabolomics explores the therapeutic mechanism of tongfeng qingxiao prescription in treating gouty arthritis","volume":"266","author":"Huang","year":"2025","journal-title":"J. Pharm. Biomed. Anal."},{"key":"B15","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s12016-025-09051-4","article-title":"Exploring gut microbiota in systemic lupus erythematosus: insights and biomarker discovery potential","volume":"68","author":"Jin","year":"2025","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1159\/000450907","article-title":"Disease-associated changes in bile acid profiles and links to altered gut microbiota","volume":"35","author":"Joyce","year":"2017","journal-title":"Dig. Dis."},{"key":"B17","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/bs.irn.2016.08.006","article-title":"Intestinal barrier and behavior","volume":"131","author":"Julio-Pieper","year":"2016","journal-title":"Int. Rev. Neurobiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2839","DOI":"10.3390\/nu7042839","article-title":"Dietary gut microbial metabolites, short-chain fatty acids, and host metabolic regulation","volume":"7","author":"Kasubuchi","year":"2015","journal-title":"Nutrients"},{"key":"B19","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1038\/s41575-019-0258-z","article-title":"Gut microbiota-derived metabolites as key actors in inflammatory bowel disease","volume":"17","author":"Lavelle","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"154462","DOI":"10.1016\/j.phymed.2022.154462","article-title":"Ershiwuwei lvxue pill alleviates rheumatoid arthritis by different pathways and produces changes in the gut microbiota","volume":"107","author":"Li","year":"","journal-title":"Phytomedicine"},{"key":"B21","doi-asserted-by":"publisher","first-page":"828920","DOI":"10.3389\/fphar.2022.828920","article-title":"Traditional Tibetan medicine twenty-five wei'er tea pills ameliorate rheumatoid arthritis based on chemical crosstalk between gut microbiota and the host","volume":"13","author":"Li","year":"","journal-title":"Front. Pharmacol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/S1875-5364(21)60080-8","article-title":"Integrating 16S sequencing and metabolomics study on anti-rheumatic mechanisms against collagen-induced arthritis of wantong jingu tablet","volume":"20","author":"Li","year":"","journal-title":"Chin. J. Nat. Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"101981","DOI":"10.1016\/j.arr.2023.101981","article-title":"Prevention and treatment of inflammatory arthritis with traditional Chinese medicine: underlying mechanisms based on cell and molecular targets","volume":"89","author":"Li","year":"2023","journal-title":"Ageing Res. Rev."},{"key":"B24","doi-asserted-by":"publisher","first-page":"10849","DOI":"10.2147\/JIR.S493892","article-title":"Unveiling the therapeutic potential of berberine in rheumatoid arthritis: a comprehensive study of network pharmacology, metabolomics, and intestinal flora","volume":"17","author":"Li","year":"2024","journal-title":"J. Inflamm. Res."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1233994","DOI":"10.3389\/fimmu.2023.1233994","article-title":"Prevention and treatment of rheumatoid arthritis through traditional Chinese medicine: role of the gut microbiota","volume":"14","author":"Liang","year":"2023","journal-title":"Front. Immunol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"103001","DOI":"10.1016\/j.jaut.2023.103001","article-title":"Gut microbiota in pre-clinical rheumatoid arthritis: from pathogenesis to preventing progression","volume":"141","author":"Lin","year":"2023","journal-title":"J. Autoimmun."},{"key":"B27","doi-asserted-by":"publisher","first-page":"2228","DOI":"10.3389\/fimmu.2018.02228","article-title":"Sinomenine inhibits the progression of rheumatoid arthritis by regulating the secretion of inflammatory cytokines and monocyte\/macrophage subsets","volume":"9","author":"Liu","year":"2018","journal-title":"Front. Immunol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e2205645","DOI":"10.1002\/advs.202205645","article-title":"ASPS exhibits anti-rheumatic effects by reprogramming gut microbiota and increasing serum gamma-Glutamylcysteine level","volume":"10","author":"Liu","year":"2023","journal-title":"Adv. Sci. (Weinh)"},{"key":"B29","doi-asserted-by":"publisher","first-page":"114752","DOI":"10.1016\/j.intimp.2025.114752","article-title":"Tinosporine alleviates collagen-induced arthritis in rats via modulating the gut microbiota-metabolome-immunity axis","volume":"157","author":"Liu","year":"","journal-title":"Int. Immunopharmacol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s13020-025-01123-z","article-title":"Fuzi alleviates cold-related rheumatoid arthritis via regulating gut microbiota and microbial bile acid metabolism","volume":"20","author":"Liu","year":"","journal-title":"Chin. Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"114561","DOI":"10.1016\/j.jep.2021.114561","article-title":"Role of Glutamine-Glutamate\/GABA cycle and potential target GLUD2 in alleviation of rheumatoid arthritis by Tripterygium hypoglaucum (levl.) hutch based on metabolomics and molecular pharmacology","volume":"281","author":"Long","year":"2021","journal-title":"J. Ethnopharmacol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/1462-2920.13589","article-title":"Formation of propionate and butyrate by the human colonic microbiota","volume":"19","author":"Louis","year":"2017","journal-title":"Environ. Microbiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1414675","DOI":"10.3389\/fphar.2024.1414675","article-title":"Ephedra sinica polysaccharide regulate the anti-inflammatory immunity of intestinal microecology and bacterial metabolites in rheumatoid arthritis","volume":"15","author":"Ma","year":"2024","journal-title":"Front. Pharmacol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1717671","DOI":"10.3389\/fimmu.2025.1717671","article-title":"Neutrophil extracellular traps in rheumatoid arthritis: pathogenic mechanisms and therapeutic potential","volume":"16","author":"Mao","year":"2025","journal-title":"Front. Immunol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1056\/NEJMra1004965","article-title":"The pathogenesis of rheumatoid arthritis","volume":"365","author":"McInnes","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"704089","DOI":"10.3389\/fimmu.2021.704089","article-title":"Sustained drug treatment alters the gut microbiota in Rheumatoid arthritis","volume":"12","author":"Mei","year":"2021","journal-title":"Front. Immunol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"148405","DOI":"10.1016\/j.ijbiomac.2025.148405","article-title":"Effect of polysaccharides from Aconitum pendulum bush on rheumatoid arthritis","volume":"331","author":"Meng","year":"2025","journal-title":"Int. J. Biol. Macromol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"114026","DOI":"10.1016\/j.jep.2021.114026","article-title":"Effects of rhizome of Atractylodes koreana (nakai) kitam on intestinal flora and metabolites in rats with rheumatoid arthritis","volume":"281","author":"Pang","year":"2021","journal-title":"J. Ethnopharmacol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"156531","DOI":"10.1016\/j.phymed.2025.156531","article-title":"Integrating serum pharmacochemistry, network pharmacology, metabolomics and 16S rRNA sequencing to explore the mechanism of total flavonoids from Flemingia philippinensis in treating collagen induced arthritis rats","volume":"139","author":"Qiu","year":"2025","journal-title":"Phytomedicine"},{"key":"B40","doi-asserted-by":"publisher","first-page":"123096","DOI":"10.1016\/j.jchromb.2021.123096","article-title":"Yaobitong capsules reshape and rebalance the gut microbiota and metabolites of arthritic rats: an integrated study of microbiome and fecal metabolomics analysis","volume":"1190","author":"Shi","year":"2022","journal-title":"J. Chromatogr. B Anal. Technol. Biomed. Life Sci."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1001\/jama.2022.0786","article-title":"What is rheumatoid arthritis?","volume":"327","author":"Smith","year":"2022","journal-title":"Jama"},{"key":"B42","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1016\/s0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"388","author":"Smolen","year":"2016","journal-title":"Lancet"},{"key":"B43","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/ard-2022-223356","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update","volume":"82","author":"Smolen","year":"2023","journal-title":"Ann. Rheum. Dis."},{"key":"B44","doi-asserted-by":"publisher","first-page":"e22841","DOI":"10.1097\/md.0000000000022841","article-title":"Effect of downregulation of serum MMP-3 levels by traditional Chinese medicine ingredients combined with methotrexate on the progression of bone injury in patients with rheumatoid arthritis: a protocol for a systematic review and meta-analysis","volume":"99","author":"Sun","year":"2020","journal-title":"Med. Baltim."},{"key":"B45","doi-asserted-by":"publisher","first-page":"157249","DOI":"10.1016\/j.phymed.2025.157249","article-title":"Siweixizangmaoru decoction attenuates collagen-induced arthritis via gut microbiota-dependent SCFA restoration and immunomodulation","volume":"148","author":"Sun","year":"2025","journal-title":"Phytomedicine"},{"key":"B46","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1111\/odi.12472","article-title":"The microbiome-systemic diseases connection","volume":"22","author":"van der Meulen","year":"2016","journal-title":"Oral Dis."},{"key":"B47","doi-asserted-by":"publisher","first-page":"793","DOI":"10.3390\/cells12050793","article-title":"Gut-microbiota-derived metabolites maintain gut and systemic immune homeostasis","volume":"12","author":"Wang","year":"2023","journal-title":"Cells"},{"key":"B48","doi-asserted-by":"publisher","first-page":"e12281","DOI":"10.1002\/advs.202512281","article-title":"Structure-tailoring cerium nanozymes with self-cascade ROS scavenging catalysis modulate the microbiota-gut-joint axis for rheumatoid arthritis therapy","volume":"12","author":"Wang","year":"","journal-title":"Adv. Sci. (Weinh)"},{"key":"B49","doi-asserted-by":"publisher","first-page":"119160","DOI":"10.1016\/j.jep.2024.119160","article-title":"Jingfang granules alleviates the lipid peroxidation induced ferroptosis in rheumatoid arthritis rats by regulating gut microbiota and metabolism of short chain fatty acids","volume":"339","author":"Wang","year":"","journal-title":"J. Ethnopharmacol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"156976","DOI":"10.1016\/j.phymed.2025.156976","article-title":"HDAC\/NF-kappaB signaling pathway mediates gut microbiota dysbiosis in rheumatoid arthritis: intervention mechanisms of fengshining decoction","volume":"145","author":"Wen","year":"2025","journal-title":"Phytomedicine"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1038\/nbt.3353","article-title":"A catalog of the mouse gut metagenome","volume":"33","author":"Xiao","year":"2015","journal-title":"Nat. Biotechnol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"153522","DOI":"10.1016\/j.phymed.2021.153522","article-title":"Wutou decoction ameliorates experimental rheumatoid arthritis via regulating NF-kB and Nrf2: integrating efficacy-oriented compatibility of traditional Chinese medicine","volume":"85","author":"Xie","year":"2021","journal-title":"Phytomedicine"},{"key":"B53","doi-asserted-by":"publisher","first-page":"4348709","DOI":"10.1155\/2020\/4348709","article-title":"Efficacy and safety of integrated traditional Chinese medicine and Western medicine on the treatment of rheumatoid arthritis: a meta-analysis","volume":"2020","author":"Xing","year":"2020","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"e2507054","DOI":"10.4014\/jmb.2507.07054","article-title":"Er miao san attenuates collagen-induced arthritis mice by regulating gut microbiota and its metabolites","volume":"35","author":"Xu","year":"2025","journal-title":"J. Microbiol. Biotechnol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s13020-024-00878-1","article-title":"Regulation of polysaccharide in Wu-tou decoction on intestinal microflora and pharmacokinetics of small molecular compounds in AIA rats","volume":"19","author":"Yang","year":"2024","journal-title":"Chin. Med."},{"key":"B56","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1038\/s41584-021-00585-3","article-title":"The gut-joint axis in rheumatoid arthritis","volume":"17","author":"Zaiss","year":"2021","journal-title":"Nat. Rev. Rheumatol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"e33706","DOI":"10.1016\/j.heliyon.2024.e33706","article-title":"Chinese traditional medicine DZGP beneficially affects gut microbiome, serum metabolites and recovery from rheumatoid arthritis through mediating NF-kappaB signaling pathway","volume":"10","author":"Zhao","year":"2024","journal-title":"Heliyon"},{"key":"B58","doi-asserted-by":"publisher","first-page":"115494","DOI":"10.1016\/j.biopha.2023.115494","article-title":"Suppressive effect of Tripterygium hypoglaucum (levl.) hutch extract on rheumatoid arthritis in mice by modulating inflammasome and bile acid metabolism","volume":"167","author":"Zheng","year":"2023","journal-title":"Biomed. Pharmacother."},{"key":"B59","doi-asserted-by":"publisher","first-page":"145306","DOI":"10.1016\/j.ijbiomac.2025.145306","article-title":"Polyporus umbellatus polysaccharide ameliorates rheumatoid arthritis via inhibiting inflammation and regulating gut microbiota","volume":"318","author":"Zheng","year":"2025","journal-title":"Int. J. Biol. Macromol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1038\/s41586-019-1291-3","article-title":"Mapping human microbiome drug metabolism by gut bacteria and their genes","volume":"570","author":"Zimmermann","year":"2019","journal-title":"Nature"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1790536\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T05:26:35Z","timestamp":1773379595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1790536\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":60,"alternative-id":["10.3389\/fphar.2026.1790536"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1790536","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]},"article-number":"1790536"}}