Research progress in traditional Chinese medicine regulating pyroptosis for treating rheumatoid arthritis

doi:10.12092/j.issn.1009-2501.2026.07.013

Abstract

Abstract:

Rheumatoid arthritis is a chronic, progressive autoimmune disease. Disease progression can lead to joint swelling, deformity, and loss of function, severely affecting the patients' quality of life in the late stage of disease development. In recent years, it has been shown that pyroptosis, as a form of programmed cell death, plays a key role in the pathogenesis of rheumatoid arthritis. Pyroptosis is triggered by inflammasome activation and participates in the immune inflammatory response of rheumatoid arthritis through regulating the release of pro-inflammatory factors and immune cell activation. Traditional Chinese medicine, with its multi-target and multi-pathway characteristics, can effectively regulate rheumatoid arthritis-related pyroptosis processes. This review systematically summarized the important role of cell pyroptosis in the pathogenesis of rheumatoid arthritis, and the regulatory mechanisms of traditional Chinese medicine on pyroptosis related to rheumatoid arthritis, providing a new entry point for discussing the mechanisms of rheumatoid arthritis and a theoretical basis for developing traditional Chinese medicine treasure house.

Key words: rheumatoid arthritis, pyroptosis, traditional Chinese medicine, NLRP3 inflammasome, signal pathway

CLC Number:

Xixi XU, Qing WANG, Yuanyuan SHI, Qiaoxue WANG, Huan LONG. Research progress in traditional Chinese medicine regulating pyroptosis for treating rheumatoid arthritis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(7): 965-974.

Figures/Tables 3

References 54

1	Di Matteo A, Bathon JM, Emery P. Rheumatoid arthritis [J]. Lancet, 2023, 402(10416): 2019-2033.
2	沈小兰, 刘小曼, 侯晓强, 等. 黄芩苷抑制类风湿关节炎滑膜炎症机制及临床应用的研究进展 [J]. 实用医学杂志, 2024, 40(22): 3256-3261.
3	Diaz-Gonzalez F, Hernandez-Hernandez MV. Rheumatoid arthritis [J]. Med Clin (Barc), 2023, 161(12): 533-542.
4	Liang F, Zhang F, Zhang L, et al. The advances in pyroptosis initiated by inflammasome in inflammatory and immune diseases [J]. Inflamm Res, 2020, 69(2): 159-166.
5	史秀丽, 陈嘉琪, 朱璠, 等. miR-143-3p靶向调控TLR2/NF-κB/NLRP3通路对溃疡性结肠炎细胞焦亡的影响 [J]. 实用医学杂志, 2024, 40(15): 2056-2062.
6	Vasudevan SO, Behl B, Rathinam VA. Pyroptosis-induced inflammation and tissue damage [J]. Semin Immunol, 2023, 69: 101781.
7	陈甲秀, 陈健, 臧海珍, 等. 黄芪桂枝五物汤配合活络效灵丹加减对不同分期类风湿关节炎患者的临床疗效观察 [J]. 现代中药研究与实践, 2024, 38(2): 64-68.
8	李甜, 刘君, 董秋梅. 基于肠道菌群探讨中药防治类风湿关节炎研究进展 [J]. 现代中药研究与实践, 2023, 37(6): 99-102.
9	李吉东, 谢兴文, 李鼎鹏, 等. NLRP3介导细胞焦亡探讨中医药干预痛风性关节炎研究进展 [J]. 中国骨质疏松杂志, 2025, 31(4): 558-563.
10	武君珂, 张芳芳, 黄丽平, 等. 基于NLRP3介导细胞焦亡在类风湿性关节炎中的机制及中医药研究进展 [J]. 中草药, 2024, 55(24): 8632-8643.
11	梁锋, 吴仪, 沈思远, 等. NLRP3炎症小体激活在关节炎性疾病中的研究进展 [J]. 中国临床研究, 2025, 38(1): 155-160.
12	崔馨予, 康惠琴, 贺佩鑫, 等. 中医药干预NLRP3炎症小体治疗类风湿关节炎研究进展 [J]. 时珍国医国药, 2025, 36(1): 1-10.
13	Li Y, Zheng JY, Liu JQ, et al. Succinate/NLRP3 inflammasome induces synovial fibroblast activation: Therapeutical effects of clematichinenoside AR on arthritis [J]. Front Immunol, 2016, 7: 1-11.
14	Gao J, Zhang H, Yang Y, et al. Therapeutic potential of targeting the NLRP3 inflammasome in rheumatoid arthritis [J]. Inflammation, 2023, 46(3): 835-852.
15	Chen S, Luo Z, Chen X. Hsa_circ_0044235 regulates the pyroptosis of rheumatoid arthritis via miR-135b-5p-SIRT1 axis [J]. Cell Cycle, 2021, 20(12): 1107-1121.
16	Ibrahem R, Raghip MA, Abdelwahed MM, et al. Role of some inflammasomes in rheumatoid arthritis patients in Egypt [J]. Mol Biol Rep, 2023, 50(11): 8809-8815.
17	Ippagunta SK, Brand DD, Luo J, et al. Inflammasome-independent role of apoptosis-associated speck-like protein containing a CARD (ASC) in T cell priming is critical for collagen-induced arthritis [J]. J Biol Chem, 2010, 285(16): 12454-12462.
18	Jiang Q, Wang X, Xu X, et al. Inflammasomes in rheumatoid arthritis: a pilot study [J]. BMC Rheumatol, 2023, 7(1): 39.
19	Ren C, Chen J, Che Q, et al. IL-37 alleviates TNF-alpha-induced pyroptosis of rheumatoid arthritis fibroblast-like synoviocytes by inhibiting the NF-kappaB/GSDMD signaling pathway [J]. Immunobiology, 2023, 228(3): 152382.
20	刘一博, 齐丹, 郑冬, 等. 类风湿性关节炎患者超声滑膜IL-18水平及临床意义 [J]. 临床和实验医学杂志, 2025, 24(4): 430-435.
21	Chen Y, Ye Y, Liu H, et al. Interleukin-18 gene polymorphisms and rheumatoid arthritis susceptibility: An umbrella review of meta-analyses [J]. J Immunol Res, 2024, 2024: 6631033.
22	Ye XJ, Tang B, Ma Z, et al. The roles of interleukin-18 in collagen-induced arthritis in the BB rat [J]. Clin Exp Immunol, 2004, 136(3): 440-447.
23	Ruth JH, Park CC, Amin MA, et al. Interleukin-18 as an in vivo mediator of monocyte recruitment in rodent models of rheumatoid arthritis [J]. Arthritis Res Ther, 2010, 12(3): R118.
24	Amin MA, Rabquer BJ, Mansfield PJ, et al. Interleukin 18 induces angiogenesis in vitro and in vivo via Src and Jnk kinases [J]. Ann Rheum Dis, 2010, 69(12): 2204-2212.
25	Zhang W, Cong XL, Qin YH, et al. IL-18 upregulates the production of key regulators of osteoclastogenesis from fibroblast-like synoviocytes in rheumatoid arthritis [J]. Inflammation, 2013, 36(1): 103-109.
26	Rui H, Yan T, Hu Z, et al. The association between caspase-5 gene polymorphisms and rheumatoid arthritis in a Chinese population [J]. Gene, 2018, 642: 307-312.
27	Hong Z, Zhang X, Zhang T, et al. The ROS/GRK2/HIF-1alpha/NLRP3 pathway mediates pyroptosis of fibroblast-like synoviocytes and the regulation of monomer derivatives of paeoniflorin [J]. Oxid Med Cell Longev, 2022, 2022: 4566851.
28	Wang J, Li LL, Zhao ZA, et al. NLRP3 Inflammasome-mediated pyroptosis in acute lung injury: roles of main lung cell types and therapeutic perspectives [J]. Int Immunopharmacol, 2025, 154: 114560.
29	Tenshin H, Teramachi J, Ashtar M, et al. TGF-beta-activated kinase-1 inhibitor LL-Z1640-2 reduces joint inflammation and bone destruction in mouse models of rheumatoid arthritis by inhibiting NLRP3 inflammasome, TACE, TNF-alpha and RANKL expression [J]. Clin Transl Immunol, 2022, 11(1): e1371.
30	Li W, Mao X, Wang X, et al. Disease-modifying anti-rheumatic drug prescription Baihu-Guizhi decoction attenuates rheumatoid arthritis via suppressing Toll-like receptor 4-mediated NLRP3 inflammasome activation [J]. Front Pharmacol, 2021, 12: 743086.
31	Kudelova J, Fleischmannova J, Adamova E, et al. Pharmacological caspase inhibitors: research towards therapeutic perspectives [J]. J Physiol Pharmacol, 2015, 66(4): 473-482.
32	黄婉然, 涂君雪, 乔爱卿, 等. VX765对大鼠骨关节炎和软骨细胞炎症的作用 [J]. 中国修复重建外科杂志, 2024, 38(1): 74-81.
33	Dong X, Zheng Z, Lin P, et al. ACPAs promote IL-1beta production in rheumatoid arthritis by activating the NLRP3 inflammasome [J]. Cell Mol Immunol, 2020, 17(3): 261-271.
34	Rodriguez-Merchan EC. The current role of disease-modifying osteoarthritis drugs [J]. Arch Bone Jt Surg, 2023, 11(1): 11-22.
35	Guha A, Diaz-Pino R, Fagbemi A, et al. Very early-onset IBD-associated IL-18opathy treated with an anti-IL-18 antibody [J]. J Clin Med, 2024, 13(20): 1-8.
36	Fauteux-Daniel S, Merlo PL, Girard-Guyonvarc'HC, et al. The role of interleukin-18 and interleukin-18 binding protein in K/BxN serum transfer-induced arthritis [J]. Front Immunol, 2023, 14: 1215364.
37	Ling Y, Xiao M, Huang ZW, et al. Jinwujiangu capsule treats fibroblast-like synoviocytes of rheumatoid arthritis by inhibiting pyroptosis via the NLRP3/CAPSES/GSDMD pathway [J]. Evid Based Complement Alternat Med, 2021, 2021: 4836992.
38	Ge G, Bai J, Wang Q, et al. Punicalagin ameliorates collagen-induced arthritis by downregulating M1 macrophage and pyroptosis via NF-κB signaling pathway [J]. Sci China Life Sci, 2022, 65(3): 588-603.
39	Xu L, Wang H, Yu QQ, et al. The monomer derivative of paeoniflorin inhibits macrophage pyroptosis via regulating TLR4/ NLRP3/ GSDMD signaling pathway in adjuvant arthritis rats [J]. Int Immunopharmacol, 2021, 101(Pt A): 108169.
40	Li W, Wang K, Liu Y, et al. A novel drug combination of mangiferin and cinnamic acid alleviates rheumatoid arthritis by inhibiting TLR4/NFkappaB/NLRP3 activation-induced pyroptosis [J]. Front Immunol, 2022, 13: 912933.
41	Zhang L, Tan M, Mao J, et al. Natural compound library screening to identify berberine as a treatment for rheumatoid arthritis [J]. Clin Rheumatol, 2024, 43(3): 959-969.
42	沈晓庆, 王晶, 李婷君. 汉黄芩素对胶原诱导性关节炎大鼠的治疗作用及对NLRP3炎症小体的影响 [J]. 中医药导报, 2021, 27(8): 26-30.
43	刘杨, 吕冰清, 吴玉梅, 等. 木犀草素抑制类风湿关节炎大鼠NLRP3炎性小体活化增强关节骨保护作用研究 [J]. 中华中医药杂志, 2021, 36(1): 513-516.
44	刘杨, 段学清, 严福林, 等. 异绿原酸A抑制NLRP3炎性复合体/NF-κB活化减轻胶原诱导型关节炎大鼠炎症反应 [J]. 中国药理学通报, 2019, 35(10): 1415-1419.
45	雷杰, 张志文, 贺梦吟, 等. 淫羊藿苷对类风湿关节炎小鼠NLRP3炎性小体信号通路的影响 [J]. 现代中西医结合杂志, 2020, 29(29): 3206-3211.
46	李楠, 马庆宇, 韩隆胤, 等. 补肾活血法对类风湿关节炎软骨细胞焦亡及HMGB1/NLRP3信号通路的影响[J]. 中华中医药杂志, 2022, 37 (4): 1929- 1933.
47	张铭, 吴天宇, 刘小碣, 等. 甘草附子汤加减方通过抑制GSDMD介导的焦亡治疗CIA大鼠的作用机制研究 [J]. 中国病理生理杂志, 2023, 39(2): 325-334.
48	Wu Y, Zhang Y, Wang Z, et al. Bitongqing attenuates CIA rats by suppressing macrophage pyroptosis and modulating the NLRP3/Caspase-1/GSDMD pathway [J]. J Inflamm Res, 2024, 17: 5453-5469.
49	尚碧月, 姜泉, 夏聪敏, 等. 基于细胞焦亡探讨中药复方对CIA大鼠炎症的影响 [J]. 中国中医基础医学杂志, 2023, 29(4): 593-597.
50	Zhao Y, Chen Y, Wang Z, et al. The method of Yiqi Yangyin Tongluo can attenuate the pyroptosis of rheumatoid arthritis chondrocytes through the ASIC1a/NLRP3 signaling pathway [J]. Ann Transl Med, 2022, 10(3): 145.
51	彭程, 高明利, 于静, 等. 基于NLRP3/caspase-1信号通路影响软骨细胞焦亡探讨独活寄生汤干预类风湿关节炎作用机制 [J]. 辽宁中医药大学学报, 2021, 23(9): 32-36.
52	吴宁, 袁桃花, 姬进忠, 等. 苗药验方四大血对人类风湿性关节炎成纤维样滑膜细胞凋亡和焦亡的影响 [J]. 南方医科大学学报, 2021, 41(10): 1473-1483.
53	王露琳, 汪元, 刘健, 等. 新风胶囊含药血清抑制脂多糖诱导的类风湿关节炎大鼠的滑膜成纤维细胞焦亡 [J]. 南方医科大学学报, 2022, 42(12): 1846-1851.
54	王秋苑, 岳辰, 刘又文, 等. 顽痹清丸对类风湿关节炎湿热痹阻证患者血清细胞焦亡相关因子表达的影响 [J]. 中医杂志, 2023, 64(12): 1240-1247.

No.	Compounds	Description	Model	Treatment	Mechanism	References
1	Punicalagin	Pomegranate peel	CIA mice	10 and 20 mg·kg^?1·d^?1, i.p.	(1) Downregulate the expression of NLRP3 and caspase-1, (2) Decrease the expression of iNOS and proinflammatory cytokines released by M1 macrophages, and increase the expression of Arg-1 and IL-10 released by M2 macrophages.	[38]
2	The monomer derivative of paeoniflorin	Paeoniflorin	AIA rats	50 mg·kg^?1·d^?1, i.g.	Decrease the expressions of TLR4, MyD88, NLRP3, Caspase-1, ASC, and GSDMD-N in macrophage, down-regulate the cytokine levels of IL-18 and IL-1β, and regulate the M1/M2 ratio.	[39]
3	Mangiferin and cinnamic acid	Baihu-Guizhi decoction	AIA-M rats, RAW264.7 cells, MH7A cells	Animal assay: mangiferin 600.912 mg·kg^?1·d^?1, i.g. cinnamic acid 46.652 mg·kg^?1·d^?1, i.g. Cell assay: mangiferin 1.69 ng/mL and cinnamic acid 0.13 ng/mL for 24 h	Inhibit NF-kB via TLR4/PI3K/AKT signaling to suppress the activation of the NLRP3 inflammasome, leading to the downregulation of downstream Caspase-1, the reduced release of IL-1β and IL-18.	[40]
4	Berberine	Coptis chinensis	CIArats, MH7A cells	Animal assay: 200 mg·kg^?1·d^?1, i.g. Cell assay: 10 μmol/L	(1) Inhibit RA-FLS pyroptosis by downregulating of NLRP3 and Caspase-1, (2) ease the pro-inflammatory activities via activating the Hippo signaling pathway.	[41]
5	Wogonin	Scutellaria baicalensis	CIA rats	50, 100 and 200 mg·kg^?1·d^?1, i.g.	Reduce the expression of NLRP3, pro-Caspase-1, Caspase-1 protein, and reduce the levels of IL-1β, TNF-α and IL-18.	[42]
6	Luteolin	Honeysuckle and selfheal, et al.	CIA rats	100 mg·kg^?1·d^?1, i.g.	Decrease the expression of NLRP3, Caspase-1, RANKL, VEGF, HIF-1α protein in voix pedis and enhance the expression of OPG protein in bone tissue.	[43]
7	Isochlorogenic acid A	Honeysuckle et al.	CIA rats	50 and 100 mg·kg^?1·d^?1, i.g.	Decrease the phosphorylation of NF-κB to reduce the expression of NLRP3 and Caspase-1, and reduce the levels of IL-1β, TNF-α and IL-18.	[44]
8	Icariin	Epimedium	CIA mice	10, 20 and 40 mg·kg^?1·d^?1, i.g.	Decrease the expression of NLRP3, Caspase-1, and inhibit the activation of NLRP3 inflammasomes, while inhibiting the expression of IL-1β and IL-18.	[45]

No.	Compounds	Description	Model	Treatment	Mechanism	References
1	Punicalagin	Pomegranate peel	CIA mice	10 and 20 mg·kg^?1·d^?1, i.p.	(1) Downregulate the expression of NLRP3 and caspase-1, (2) Decrease the expression of iNOS and proinflammatory cytokines released by M1 macrophages, and increase the expression of Arg-1 and IL-10 released by M2 macrophages.	[38]
2	The monomer derivative of paeoniflorin	Paeoniflorin	AIA rats	50 mg·kg^?1·d^?1, i.g.	Decrease the expressions of TLR4, MyD88, NLRP3, Caspase-1, ASC, and GSDMD-N in macrophage, down-regulate the cytokine levels of IL-18 and IL-1β, and regulate the M1/M2 ratio.	[39]
3	Mangiferin and cinnamic acid	Baihu-Guizhi decoction	AIA-M rats, RAW264.7 cells, MH7A cells	Animal assay: mangiferin 600.912 mg·kg^?1·d^?1, i.g. cinnamic acid 46.652 mg·kg^?1·d^?1, i.g. Cell assay: mangiferin 1.69 ng/mL and cinnamic acid 0.13 ng/mL for 24 h	Inhibit NF-kB via TLR4/PI3K/AKT signaling to suppress the activation of the NLRP3 inflammasome, leading to the downregulation of downstream Caspase-1, the reduced release of IL-1β and IL-18.	[40]
4	Berberine	Coptis chinensis	CIArats, MH7A cells	Animal assay: 200 mg·kg^?1·d^?1, i.g. Cell assay: 10 μmol/L	(1) Inhibit RA-FLS pyroptosis by downregulating of NLRP3 and Caspase-1, (2) ease the pro-inflammatory activities via activating the Hippo signaling pathway.	[41]
5	Wogonin	Scutellaria baicalensis	CIA rats	50, 100 and 200 mg·kg^?1·d^?1, i.g.	Reduce the expression of NLRP3, pro-Caspase-1, Caspase-1 protein, and reduce the levels of IL-1β, TNF-α and IL-18.	[42]
6	Luteolin	Honeysuckle and selfheal, et al.	CIA rats	100 mg·kg^?1·d^?1, i.g.	Decrease the expression of NLRP3, Caspase-1, RANKL, VEGF, HIF-1α protein in voix pedis and enhance the expression of OPG protein in bone tissue.	[43]
7	Isochlorogenic acid A	Honeysuckle et al.	CIA rats	50 and 100 mg·kg^?1·d^?1, i.g.	Decrease the phosphorylation of NF-κB to reduce the expression of NLRP3 and Caspase-1, and reduce the levels of IL-1β, TNF-α and IL-18.	[44]
8	Icariin	Epimedium	CIA mice	10, 20 and 40 mg·kg^?1·d^?1, i.g.	Decrease the expression of NLRP3, Caspase-1, and inhibit the activation of NLRP3 inflammasomes, while inhibiting the expression of IL-1β and IL-18.	[45]

NO.	Chinese herbal formulas	Model	Treatment	Mechanism	References
1	Baihu-Guizhi decoction	AIA-M rats, RAW264.7 cells, MH7A cells	Animal assay: 21.4 g·kg^?1·d^?1, i.g. Cell assay: 28.54 mg/mL for 24 h	Inhibit NF-kB via TLR4/PI3K/AKT signaling to suppress the activation of the NLRP3 inflammasome, leading to the downregulation of downstream Caspase-1, the reduced release of IL-1β and IL-18.	[40]
2	Duanteng Yimu decoction	RA mice chondrocyte	6, 12 and 24 μg/mL for 24 h	Decrease the expression of HMGB1 and NLRP3 in RA chondrocytes, and decrease mRNA expressions of Caspase-1, IL-1β and IL-18.	[46]
3	Gancao-Fuzi decoction	CIA rats	4, 8 and 16 g·kg^?1·d^?1, i.g.	Inhibit the protein expression of TLR4, cleaved Caspase-1, NLRP3, GSDMD-N, IL-1β, IL-6 in CIA rats, and increase the expression of IL-10.	[47]
4	Qingre Huoxue formula	CIA rats	8.5, 17 and 34 g·kg^?1·d^?1, i.g.	Down-regulate the expression of NLRP3/Caspase-1/GSDMD mRNA in the cell pyroptosis pathway and reduce the release of IL-1β and IL-18 inflammatory factors.	[49]
5	Sidaxue	MH7A cells	5, 10, 20 and 40 mg/L for 24 h	Down-regulate the expressions of TNF-α, IL-1β and IL-18, up-regulate the expressions of Bax, Fas, and FasL, and inhibit Bcl-2 and caspase-1 protein expressions.	[52]
6	Duhuo Jisheng decoction	AIA rats chondrocyte	Drug serum	Down-regulate the mRNA and protein level of NLRP3, Caspase-1, ASC, IL-1β and IL-18 in RA model chondrocyte cells via NLRP3/Caspase-1 signaling.	[51]
7	Bitongqing decoction	CIA rats, RAW264.7 cells	Animal assay: 9.68, 19.35 and 38.7 g·kg^?1·d^?1, i.g. Cell assay: 5, 10 and 15% drug serum	Suppress the expression of proteins in the NLRP3/Caspase-1/GSDMD pathway, and reduce the levels of IL-1β and IL-18.	[48]
8	Sishen decoction	AIA rats	4.5, 9 and 18 g·kg^?1·d^?1, i.g.	Inhibit ASIC1a/NLRP3 pathway activation, and decrease the expression of NLRP3, ASC and Caspase-1.	[50]
9	Xinfeng capsule	RA-FLS	20% drug serum	Alleviate inflammatory response of joints in RA by inhibiting pyroptosis of the FLS through inhibition of the NLRP3/GSDMD pathway.	[53]
10	Wanbiqing pills	RA patients with damp-heat obstruction syndrome	12 g/d for 4 weeks, p.o.	Inhibit the expression of NLRP3, Caspase-1, IL-1β and IL-18 mRNA, and reduce the inflammatory response.	[54]
11	Jinwujiangu capsule	New Zealand White rabbits; RA-FLS cells	Animal assay: 7.29 g^?1·kg·d^?1, i.g. Cell assay：5%, 15% and 20% drug serum	Down-regulate the expression of Caspase-1, 3, 4, 5, GSDMD, NLRP3, ASC, IL-1β, IL-18, and downregulate the number of double-positive FITC anti-caspase-1 and PI.	[37]

NO.	Chinese herbal formulas	Model	Treatment	Mechanism	References
1	Baihu-Guizhi decoction	AIA-M rats, RAW264.7 cells, MH7A cells	Animal assay: 21.4 g·kg^?1·d^?1, i.g. Cell assay: 28.54 mg/mL for 24 h	Inhibit NF-kB via TLR4/PI3K/AKT signaling to suppress the activation of the NLRP3 inflammasome, leading to the downregulation of downstream Caspase-1, the reduced release of IL-1β and IL-18.	[40]
2	Duanteng Yimu decoction	RA mice chondrocyte	6, 12 and 24 μg/mL for 24 h	Decrease the expression of HMGB1 and NLRP3 in RA chondrocytes, and decrease mRNA expressions of Caspase-1, IL-1β and IL-18.	[46]
3	Gancao-Fuzi decoction	CIA rats	4, 8 and 16 g·kg^?1·d^?1, i.g.	Inhibit the protein expression of TLR4, cleaved Caspase-1, NLRP3, GSDMD-N, IL-1β, IL-6 in CIA rats, and increase the expression of IL-10.	[47]
4	Qingre Huoxue formula	CIA rats	8.5, 17 and 34 g·kg^?1·d^?1, i.g.	Down-regulate the expression of NLRP3/Caspase-1/GSDMD mRNA in the cell pyroptosis pathway and reduce the release of IL-1β and IL-18 inflammatory factors.	[49]
5	Sidaxue	MH7A cells	5, 10, 20 and 40 mg/L for 24 h	Down-regulate the expressions of TNF-α, IL-1β and IL-18, up-regulate the expressions of Bax, Fas, and FasL, and inhibit Bcl-2 and caspase-1 protein expressions.	[52]
6	Duhuo Jisheng decoction	AIA rats chondrocyte	Drug serum	Down-regulate the mRNA and protein level of NLRP3, Caspase-1, ASC, IL-1β and IL-18 in RA model chondrocyte cells via NLRP3/Caspase-1 signaling.	[51]
7	Bitongqing decoction	CIA rats, RAW264.7 cells	Animal assay: 9.68, 19.35 and 38.7 g·kg^?1·d^?1, i.g. Cell assay: 5, 10 and 15% drug serum	Suppress the expression of proteins in the NLRP3/Caspase-1/GSDMD pathway, and reduce the levels of IL-1β and IL-18.	[48]
8	Sishen decoction	AIA rats	4.5, 9 and 18 g·kg^?1·d^?1, i.g.	Inhibit ASIC1a/NLRP3 pathway activation, and decrease the expression of NLRP3, ASC and Caspase-1.	[50]
9	Xinfeng capsule	RA-FLS	20% drug serum	Alleviate inflammatory response of joints in RA by inhibiting pyroptosis of the FLS through inhibition of the NLRP3/GSDMD pathway.	[53]
10	Wanbiqing pills	RA patients with damp-heat obstruction syndrome	12 g/d for 4 weeks, p.o.	Inhibit the expression of NLRP3, Caspase-1, IL-1β and IL-18 mRNA, and reduce the inflammatory response.	[54]
11	Jinwujiangu capsule	New Zealand White rabbits; RA-FLS cells	Animal assay: 7.29 g^?1·kg·d^?1, i.g. Cell assay：5%, 15% and 20% drug serum	Down-regulate the expression of Caspase-1, 3, 4, 5, GSDMD, NLRP3, ASC, IL-1β, IL-18, and downregulate the number of double-positive FITC anti-caspase-1 and PI.	[37]

[1]	Xiao XU, Shuailin WANG, Xin QIAN, Yi YAO, Zhangyu WANG, Xiaoyi ZHU, Qing MAO, Qi GUO. Research progress on the treatment of diabetic cardiomyopathy with traditional Chinese medicine [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(6): 764-773.
[2]	Ailin LU, Mengrui YUAN, Yongqing WU, Hongyi LIU. Progress of Chinese medicine intervention in HMGB1 pathway to improve type 2 diabetes mellitus and its complications [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(6): 827-835.
[3]	Hao ZHANG, Haolin LI, Ping CHEN, Aihua WANG, Weigang CHENG, Qian BAI, Juanjuan YANG, Yuping YANG, Zhimin ZHANG, Haidong WANG. Effect of Yiqi Huoluo Formula on Th17/Treg balance in rheumatoid arthritis model rats via regulating the JAK2/STAT3 pathway [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(5): 577-584.
[4]	Qun LI, Xinyue ZHANG, Shuo QI, Jin TAN. Research progress on the mechanism of TGF-β1/Smads signaling pathway in oral submucous fibrosis and regulation of traditional Chinese medicine [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(5): 666-674.
[5]	Mina GAO, Liya YANG, Shangying DUAN, Xinlu CHEN, Xiaoya LI, Bo QIAO, Yueying WU. Research progress on the prevention and treatment of high-altitude diseases by traditional Chinese medicine based on the "lung-brain axis" [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(5): 675-682.
[6]	Mengqin CHEN, Xi LING, Qiangqiang CHU, Danyan LIU, Yueye WANG, Tiantian WU, Manling DONG, Wei WEI, Yujing WU. Effects of IgD on polarization and phagocytosis of peripheral blood induced monocyte-macrophage in patients with rheumatoid arthritis [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(4): 443-450.
[7]	Ying ZHOU, Juntong LIU, Qingfeng WANG, Yufeng YANG, Yan SHI. Research progress on pharmacological mechanism of traditional Chinese medicine targeting type 2 diabetes related pathways [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(4): 500-508.
[8]	Liya SUN, Jiaxin LI, Guiyan SUN, Zhichao CHEN, Qingfeng WANG, Yufeng YANG, Yan SHI. Research progress of traditional Chinese medicine in the prevention and treatment of diabetic nephropathy based on intestinal flora and branched-chain amino acids [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(4): 527-535.
[9]	Yuanyuan HUANG, Lingzhun WANG. Research progress in the intervention of myocardial fibrosis by regulating signal pathways with traditional Chinese medicine [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(3): 372-381.
[10]	Pengfei WANG, Yuwei WANG, Fangmei JIN, Ping CHEN, Weiqing LI, Xuemei TIAN, Aihua WANG, Haidong WANG. The mechanism of action of Yiqi Huoluo formula in regulating the PI3K/Akt/mTOR pathway to suppress synovial inflammation in collagen-induced arthritis rats [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(2): 213-222.
[11]	XU Yuxiang, TIAN Ying, XU Qian, GE Zijing, YAO Lusha. Effects of sinomenine hydrochloride on adjuvant arthritis rats based on NLRP3/Gasdermin D/Caspase-1/Interleukin-1β pyroptosis pathway [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2025, 30(9): 1174-1181.
[12]	GAO Zitian, CHEN Yu, HE Haidong, TANG Yuyan. Short-chain fatty acids modulate the role of NLRP3 inflammatory vesicle pathway in CKD and the progress of traditional Chinese medicine intervention [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2025, 30(6): 812-819.
[13]	ZHANG Yidan, SUN Xinghua, QU Yang, HU Xiaoyang, ZHANG Miao. Research progress on the regulation of PI3K/Akt signaling pathway by active ingredients of traditional Chinese medicine in the treatment of cerebral ischemia-reperfusion injury [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2025, 30(6): 820-827.
[14]	DU Lijuan, LIN Jianhua, YE Jinghuan, SONG Lu, PENG Yanfen, LIU Yuping. Effect and mechanism of Yiqi tongfu xiere prescription on lipopolysaccharide-induced acute lung injury in mice [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2025, 30(5): 599-607.
[15]	JIA Dongye, PAN Zhi. Role of mitochondrial homeostasis in the pathogenesis of rheumatoid arthritis [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2025, 30(4): 541-547.