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Western diets high in sugar, fat, and n-6 PUFA disrupt the gut barrier by increasing pro-inflammatory mediators, whereas Mediterranean diets rich in dietary fiber, plant polyphenols, and n-3 PUFA enhance microbiota diversity and promote the production of anti-inflammatory metabolites, such as SCFAs, thereby alleviating intestinal inflammation [247,248,249]

Lots of drugs or strategies have been developed and applied on clinical trial ( Table 3 ), such as DMARDs, biologic agents, TCM, cell transfer, gene therapy, vaccine and nano drug delivery system, to treat RA with both advantages and shortcomings