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Rheumatoid arthritis (RA) is an autoimmune disease responsible for significant human morbidity in modern life. However, oxidative stress is one of the key markers for determining pathophysiology of patients with RA. The interaction between cellular immune system and body's endogenous and/or exogenous antigens produce reactive oxygen species (ROS) and reactive nitrogen species (RNS) in autoimmune disease like RA. ROS and RNS include highly toxic superoxide (O) and peroxynitrite (ONOO) radicals, which activate the signaling cascades of inflammatory cells to synthesize pro-inflammatory cytokines and chemokines. Previous studies reported that Th1 cytokines could promote the development of autoimmune disorders like RA, whereas the Th2 cytokines may attenuate the same diseases. An increased awareness of the relationship between food and health led to a tremendous increase of antioxidant research in the last decade. Evaluation of the efficacy of dietary antioxidants is also becoming highly acceptable in RA research. A number of dietary phytomolecules are already established as having antioxidant activity in isolated synovial cellular infiltrate or peripheral blood neutrophils and lymphocytes. This review aims to highlight the oxidative stress in inflammatory cells of patients with RA and to summarize the clinical relevance of dietary antioxidants as a first step in assessing beneficial effect, safety and dose safety ratio in patients with RA.

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Curcuma caesia Roxb. (Zingiberaceae), known as black turmeric in English, is a perennial herb found throughout the Himalayan region, North-East and Central India. The plant has been traditionally used in India for several medicinal purposes. Present study was carried out to evaluate the methanol extract of C. caesia (MECC) rhizome for some in vitro antioxidant studies as because we know that many diseases are associated with reactive oxygen species (ROS) and reactive nitrogen species (RNS). Effect of MECC on ROS and RNS were evaluated in different in vitro methods like 1, 1-diphenyl-2-picrylhydrazil radical, hydroxyl radicals, superoxide anions, nitric oxide, hydrogen peroxide, peroxynitrite and hypochlorous acid. Lipid peroxidation, total phenolic content was also measured by standard assay method. The extract showed significant antioxidant activities in a dose dependent manner. The IC 50 values for scavenging of free radicals were 94.03±0.67 μg/ml, 155.59±3.03 μg/ml, 68.10±1.24 μg/ml, 21.07±1.78 μg/ml, 260.56±12.65 μg/ml and 33.33±0.52 μg/ml for DPPH, nitric oxide, superoxide, hydroxyl, peroxynitrite and hypochlorous acid respectively. Reductive ability of the extract was also tested where dose dependent reducing capability was observed. The rhizome extract contains 677.7 μg of phenolic compound in 10 mg of the extract which is accounted for its free radical as well as antioxidant activity. From the above study it is concluded that the methanol extract of C. caesia rhizome is a potential source of natural antioxidant.

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Free radicals are involved in the pathogenesis of Rheumatoid arthritis, a systemic autoimmune disorder characterized by unchecked synovial inflammation. Allylpyrocatechol, a phytoconstituent of Piper betle leaves, has potent anti-inflammatory activity and this study evaluated its anti-oxidant effect on the synovial infiltrate of patients with Rheumatoid arthritis. The ex vivo effect of allylpyrocatechol upon generation of reactive oxygen species in neutrophils, macrophages and lymphocytes was measured by flow cytometry using dichlorodihydrofluorescein diacetate, wherein it significantly decreased basal levels as also scavenged phorbol myristate acetate generated reactive oxygen species. Furthermore, its effect on generation of superoxide and hydroxyl radicals produced within infiltrated neutrophils was measured by cytochrome c and deoxyribose assay, respectively. Allylpyrocatechol significantly scavenged superoxide and hydroxyl radicals in infiltrated neutrophils. The effect of allylpyrocatechol on nitric oxide was measured in macrophages using 4,5-diaminofluorescein diacetate by flow cytometry wherein it decreased production of nitric oxide in infiltrated macrophages, which correlated with its in vitro nitric oxide scavenging activity. Taken together, this ex vivo study has established that allylpyrocatechol has potent scavenging activity and could be considered as an add-on therapy in the treatment of inflammation-associated disorders like Rheumatoid Arthritis.