Impact of Polysaccharides from Traditional Chinese Medicine on Rheumatoid Arthritis via Gut Microbiota Alteration: A Systematic Review of Animal Studies

By
Suhai Qian
Yibo Jin
Chao Hu
Yuanyuan Luo
Runyu Chang
Jingyi Wu
Xinghong Ding
April 23, 2026
0 min

Frontiers In Immunology

Overview

This systematic review evaluates the effects of Traditional Chinese medicine polysaccharides (TCMPs) on rheumatoid arthritis (RA) through gut microbiota modulation. Findings indicate that TCMPs significantly alleviate RA symptoms and enhance gut microbiota diversity, which correlates with improved clinical outcomes.

Background

Rheumatoid arthritis (RA) is a common autoimmune disorder affecting approximately 1% of the global population, leading to significant morbidity if untreated. Current therapies often have adverse effects, necessitating the exploration of alternative treatments with lower toxicity. Traditional Chinese medicine, particularly polysaccharides, has shown promise in modulating gut microbiota and improving RA symptoms.

Data Highlights

Study	Effect on RA Symptoms	Microbiota Changes
Study 1	Reduced paw swelling	Increased Lactobacillus
Study 2	Improved arthritis scores	Increased Bifidobacterium
Study 3	Enhanced bone quality	Changes in 9 phyla

Key Findings

TCMPs significantly alleviate RA symptoms, including paw swelling and arthritis scores.
TCMPs induce changes in nine phyla and 65 genera of gut microbiota.
Increased abundance of beneficial genera such as Dubosiella and Faecalibaculum post-treatment.
Correlation between microbial shifts and reduced pro-inflammatory cytokines (e.g., IL-1β, TNF-α).
Short-chain fatty acids (SCFAs), particularly butyrate and propionate, are elevated following TCMP treatment.
TCMPs enhance intestinal barrier function and regulate immune homeostasis via microbiota-derived metabolites.

Clinical Implications

The findings suggest that TCMPs could serve as a complementary therapy for RA by modulating gut microbiota and enhancing gut health. Clinicians should consider the potential of TCMPs in managing RA, particularly for patients who experience adverse effects from conventional therapies.

Conclusion

This review highlights the therapeutic potential of TCMPs in alleviating RA through gut microbiota modulation. Future research should focus on rigorous study designs to validate these findings and explore clinical applications.