Synovial Organoids and Cell Culture Models: An Ideal Platform for Exploring Traditional Chinese Medicine in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial hyperplasia, inflammation, and pannus formation. Although conventional therapies are effective, they are often associated with significant side effects. Traditional Chinese medicine (TCM), known for its high safety profile and multitarget therapeutic effects, has shown unique potential in the treatment of RA. In vitro models, including synovial organoids and cell culture systems, serve as crucial platforms for replicating the structure and function of human synovial tissue. Synovial organoids closely mimic the pathological microenvironment of RA, providing an ideal tool for drug screening and efficacy evaluation. In contrast, cell culture models, which offer greater experimental flexibility, allow precise control of conditions to facilitate an in-depth investigation of the roles and mechanisms of individual or interacting cell types in RA pathogenesis. This review first covers the fundamental structure and pathophysiology of the synovium, followed by a detailed discussion of the development and construction techniques of synovial organoids. Building on this foundation, it explores the therapeutic potential of TCM using synovial organoids and cell culture models, highlighting how TCM exerts therapeutic effects by inhibiting synovial hyperplasia and modulating immune responses through its multitarget and multipathway mechanisms. Finally, the review envisions the broad application prospects of integrating synovial organoids and cell culture models with TCM in RA treatment, underscoring the importance of interdisciplinary collaboration and innovation. This study aims to provide a novel perspective on the integration of TCM with modern biotechnological approaches and promote innovative advances in RA therapy.