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Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation and hyperplasia, which is predominantly driven by abnormal activation of fibroblast-like synoviocytes (RA-FLS). Current therapeutic strategies are frequently plagued by major limitations such as suboptimal efficacy and adverse effects. In the present study, a novel nanotherapeutic system (TSN-FLP) was developed by encapsulating Toosendanin (TSN) into liposomes capable of recognizing fibroblast activation protein-α (FAPα), enabling targeted delivery to RA-FLS. The therapeutic potential and its underlying mechanism of TSN-FLP was systematically investigated. The findings indicated that TSN-FLP notably inhibited the proliferation of RA-FLS by inducing cell cycle arrest at the G2/M phase. This was accompanied by downregulating cyclin-dependent kinase 1 (CDK1), which is involved in the crucial regulatory pathway of cell cycle progression. Furthermore, in vivo studies revealed that TSN-FLP administration effectively alleviated joint swelling, attenuated cartilage and bone erosion, and reduced the secretion of pro-inflammatory cytokines, as evidenced by histopathological analysis, micro-computed tomography (CT) imaging, and enzyme-linked immunosorbent assay (ELISA). Collectively, these preclinical findings provide compelling evidence that TSN-FLP exerts a potent therapeutic effect on RA while maintaining a favorable safety profile. Thus, TSN-FLP represents a promising candidate for the development of novel therapeutic interventions against rheumatoid arthritis.

This is an open access article under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0, https://creativecommons.org/licenses/by/4.0/).
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