GUDUCHI RASAYANA IN INTEGRATIVE RHEUMATOLOGY: EVIDENCE, INFLAMMAGING, AND FUTURE DIRECTIONS

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent synovial inflammation, progressive cartilage destruction, bone erosion, and functional disability. Increasing evidence indicates that immune dysregulation begins during the preclinical phase, preceding the onset of clinically apparent arthritis.[1] The emerging concept of inflammaging(definition), characterized by chronic low-grade sterile inflammation associated with biological ageing, links immune senescence(definition), oxidative stress, mitochondrial dysfunction(definition), and persistent inflammatory signalling with RA progression. [2] Guḍūcī Rasāyana (Tinospora cordifolia), one of the most important Rasāyana drugs in Āyurveda, has traditionally been used to promote longevity, enhance Vyādhikṣamatva (immune competence), maintain physiological homeostasis, and delay age-related degeneration.[3] Contemporary studies have demonstrated its immunomodulatory,anti-inflammatory, antioxidant, adaptogenic, and cytoprotective activities. These effects are attributed to a wide range of bioactive phytoconstituents, including alkaloids, diterpenoid lactones, glycosides, polysaccharides, flavonoids and phenolic compounds. Experimental and emerging clinical evidence suggests that Guḍūcī exerts multitarget actions by regulating key molecular pathways involved in rheumatoid arthritis and inflammaging, including TNF-α, IL-1β, IL-6, NF-κB, JAK–STAT, Nrf2, reactive oxygen species (ROS), and endogenous antioxidant defence systems. These mechanisms contribute to immune homeostasis,attenuation of chronic inflammation, reduction of oxidative stress, and preservation of cellular and mitochondrial function, supporting its role in integrative rheumatology.[4] This chapter critically reviews the classical Āyurvedic concepts, phytochemistry, molecular mechanisms, experimental findings, and available clinical evidence on Guḍūcī Rasāyana in rheumatic diseases. Particular emphasis is placed on its potential role in modulating inflammaging and its translational relevance in evidence-based integrative rheumatology.The chapter also discusses current limitations, standardization challenges and future research priorities for its wider clinical application.