Marine-Derived Biologically Active Compounds for the Potential Treatment of Rheumatoid Arthritis
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marine drugs Review Marine-Derived Biologically Active Compounds for the Potential Treatment of Rheumatoid Arthritis Muhammad Bilal 1,* , Maimoona Qindeel 2, Leonardo Vieira Nunes 3 , Marco Thúlio Saviatto Duarte 4 , Luiz Fernando Romanholo Ferreira 5,6 , Renato Nery Soriano 7 and Hafiz M. N. Iqbal 8,* 1 School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huaian 223003, China 2 Department of Pharmacy, Quaid-i-Azam University, Islamabad 45320, Pakistan; [email protected] 3 Department of Medicine, Federal University of Juiz de Fora, Juiz de Fora-MG 36036-900, Brazil; [email protected] 4 Department of Medicine, Federal University of Juiz de Fora, Governador Valadares-MG 35010-180, Brazil; [email protected] 5 Graduate Program in Process Engineering, Tiradentes University (UNIT), Av. Murilo Dantas, 300, Farolândia, Aracaju-Sergipe 49032-490, Brazil; [email protected] 6 Institute of Technology and Research (ITP), Tiradentes University (UNIT), Av. Murilo Dantas, 300, Farolândia, Aracaju-Sergipe 49032-490, Brazil 7 Division of Physiology and Biophysics, Department of Basic Life Sciences, Federal University of Juiz de Fora, Governador Valadares-MG 35010-180, Brazil; [email protected] 8 School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey 64849, Mexico * Correspondence: [email protected] or [email protected] (M.B.); hafi[email protected] (H.M.N.I.) Abstract: Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease with a prevalence rate of up to 1% and is significantly considered a common worldwide public health concern. Com- mercially, several traditional formulations are available to treat RA to some extent. However, these synthetic compounds exert toxicity and considerable side effects even at lower therapeutic concentra- tions. Considering the above-mentioned critiques, research is underway around the world in finding and exploiting potential alternatives. For instance, marine-derived biologically active compounds Citation: Bilal, M.; Qindeel, M.; have gained much interest and are thus being extensively utilized to confront the confines of in Nunes, L.V.; Duarte, M.T.S.; Ferreira, practice counterparts, which have become ineffective for 21st-century medical settings. The utiliza- L.F.R.; Soriano, R.N.; Iqbal, H.M.N. tion of naturally available bioactive compounds and their derivatives can minimize these synthetic Marine-Derived Biologically Active compounds’ problems to treat RA. Several marine-derived compounds exhibit anti-inflammatory Compounds for the Potential and antioxidant properties and can be effectively used for therapeutic purposes against RA. The Treatment of Rheumatoid Arthritis. results of several studies ensured that the extraction of biologically active compounds from marine Mar. Drugs 2021, 19, 10. https://doi. sources could provide a new and safe source for drug development against RA. Finally, current org/10.3390/md19010010 challenges, gaps, and future perspectives have been included in this review. Received: 19 November 2020 Keywords: rheumatoid arthritis; marine-derived compounds; anti-inflammatory; drug development; Accepted: 10 December 2020 biomedical applications Published: 29 December 2020 Publisher’s Note: MDPI stays neu- tral with regard to jurisdictional claims in published maps and institutional 1. Introduction affiliations. Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects the synovial joints lining and is allied with progressive disability, mortality, and socioeconomic burdens. The disease is more common in women than men, with a prevalence rate of 1%. The clinical sign and symptoms of RA include swelling, arthralgia, the loss of mobility, and Copyright: © 2020 by the authors. Li- redness of the joints [1,2]. The early diagnosis of RA is considered as the critical parameter censee MDPI, Basel, Switzerland. This to prevent disease progression. In the past 20 years, a significant advancement in the article is an open access article distributed diagnosis and management of the disease has occurred. However, the early diagnosis under the terms and conditions of the remains challenging because it depends on the clinical information collected from the Creative Commons Attribution (CC BY) license (https://creativecommons.org/ patient’s clinical and physical examination, including blood test and imaging results [3,4]. licenses/by/4.0/). The pathogenesis of RA is allied with genetic factors and stimulated by environmental Mar. Drugs 2021, 19, 10. https://doi.org/10.3390/md19010010 https://www.mdpi.com/journal/marinedrugs Mar. Drugs 2021Mar., Drugs19, 10 2020 , 18, x 2 of 23 2 of 21 However, the early diagnosis remains challenging because it depends on the clinical information collected from the patient’s clinical and physical examination, including blood test and imaging factors. It is proposed that almost 60–65% of RA cases are due to genetic factors. There results [3,4]. The pathogenesis of RA is allied with genetic factors and stimulated by environmental are nearly 100 loci that are responsible for the progression of RA [5,6]. Among the several factors. It is proposed that almost 60–65% of RA cases are due to genetic factors. There are nearly 100 loci, the most common loci associated with RA contains information for the expression of loci that are responsiblemajor for histocompatibility the progression of complex RA [5,6]. (MHC Among class-II), the several especially loci, the HLADRO1/O4. most common Addition- loci associated with RAally, contains the loci thatinformation express thefor th post-translationale expression of major modified histocompatibility enzyme, intercellular complex regulatory (MHC class-II), especiallypathways, HLADRO1/O4. and costimulatory Additionally pathways, the alsoloci that contribute express towards the post-translational disease progression [7]. modified enzyme, intercellularThe environmental regulatory factors pathways, like exposure and costimulatory to Epstein-barr pathways virus, also silica contribute particles, alcohol, towards disease progressionand obesity [7]. The also environmental possesses the capabilityfactors like to exposure stimulate to suchEpstein-barr genetic loci.virus, The silica interaction particles, alcohol, andamong obesity these also genetic possesses and environmental the capability triggersto stimulate leads tosuch the genetic onset of loci. self-citrullinated The interaction among theseproteins, genetic which and form environmental autoantibodies triggers against leads citrullinated to the onset peptides. of self-citrullinated The exposure of the proteins, which formlungs autoantibodies to several exogenous against citrull compoundsinated peptides. like silica The particles, exposure Epstein-barr of the lungs virus, toAggregati- several exogenous bactercompounds actinomycetemcomitans like silica , andparticles,Porphyromonas Epstein-barr gingivalis virus,can triggerAggregatibacter the maturation of actinomycetemcomitansanti-citrullinated, and Porphyromonas protein-antibody gingivalis can (ACPA)trigger the and maturation citrullination of anti-citrullinated of self-proteins [8]. This protein-antibody (ACPA)citrullination and citrullination is catalyzed of self- via theproteins calcium-dependent [8]. This citrullination enzyme, is i.e.,catalyzed peptidylamine via the deami- nase (PAD4), which converts the cationic arginine into neutral but polar citrulline. In RA calcium-dependent enzyme, i.e., peptidylamine deaminase (PAD4), which converts the cationic patients, the PAD4 is secreted from the activated macrophages and granulocytes [9]. On the arginine into neutral but polar citrulline. In RA patients, the PAD4 is secreted from the activated other hand, the level of ACPA is increased in RA patients due to an abnormal response of macrophages and granulocytesthe immune [9]. system On the against other varioushand, the citrullinated level of ACPA proteins, is increased including in RA fibronectin, patients histones, due to an abnormal responsetype-II collagen, of the immune vimentin, system and ag fibrin.ainst Thesevarious compounds citrullinated also proteins, activate including the MHC-class II, fibronectin, histones,which type-II subsequently collagen, vimentin, stimulates and fibrin. the B-cells These to compounds produce further also activate ACPA. the This MHC- phase is also class II, which subsequentlyconsidered stimulates as the loss the of tolerance.B-cells to Anproduce interesting further thing ACPA. about This the ACPA phase is is that also the level of considered as the lossthese of tolerance. antibodies An is detected interesting years thing before about the the onset ACPA of RA is symptoms, that the level hence of earlythese detection antibodies is detectedand years prophylactic before the treatmentonset of RA of symptoms, these antibodies hence can early reduce detection the severity and prophylactic and progression of treatment of these antibodiesthe disease. can reduce the severity and progression of the disease. The visual illustrationThe of visualthe several illustration stages ofinvol theved several in the stages development involved of in RA the is development depicted in of RA is Figure 1 [10]. depicted in Figure1[10]. Figure 1. TheFigure visual 1. illustrationThe visual ofillustration the impact of of the several impact genetic of several and environmental genetic and factorsenvironmental in the pathogenesis factors in ofthe rheumatoid arthritis (RA).pathogenesis RF - rheumatoid of rheumatoid factor.