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Dietary antioxidants in inflammatory arthritis: do they have any role in etiology or therapy?


Rheumatoid arthritis is an autoimmune-mediated inflammatory disease of unknown etiology, and is characterized by joint pain and soft-tissue swelling. The role of dietary antioxidants in the prevention and amelioration of symptoms in inflammatory joint disease has been of interest for many years. Epidemiological studies provide evidence of a link between dietary antioxidant intake and the likelihood of developing inflammatory arthritis. Interventional studies of antioxidant supplementation in established disease have been inconclusive overall; however, the quality of such studies has often been poor. The pathways by which antioxidant compounds might act are now better understood. In this Review, we explore not only some of the accepted mechanisms of antioxidant function but also outline some concepts that could aid further investigation of the potential therapeutic role of dietary antioxidants in inflammatory arthritis.

Key Points

  • Oxidative stress is frequently related to diseases that have an inflammatory component, such as inflammatory arthritis

  • Epidemiological evidence suggests that dietary antioxidants can diminish the oxidative stress associated with inflammatory arthritis

  • Dietary antioxidants might confer protective properties through mechanisms unrelated to conventional antioxidant properties

  • Future research is needed to clarify the mechanisms of action of dietary antioxidants, their bioavailability in humans and the quantities required to promote health

  • Current evidence does not support the use of antioxidant nutraceuticals in the management of inflammatory arthritis

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Figure 1: The course of inflammatory polyarthritis.
Figure 2: Schematic diagram showing the inflamed rheumatoid joint and the activation of neutrophils therein.
Figure 3: Chemical structures of three dietary antioxidants.
Figure 4: A mechanism by which antioxidant micronutrients might exert anti-inflammatory activity—modulation of the activity of the redox-regulated transcription factor NFκB.

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The authors thank Joanna Tarr for her help with preparing Figure 2.

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Correspondence to Dorothy J Pattison.

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Pattison, D., Winyard, P. Dietary antioxidants in inflammatory arthritis: do they have any role in etiology or therapy?. Nat Rev Rheumatol 4, 590–596 (2008).

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