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The mechanisms underlying these effects include modulation of the skin immune response by suppressing the production of inflammatory cytokines, such as interleukin (IL)-1 and tumor necrosis factor-alpha (TNF), and increasing the production of anti-inflammatory cytokines, such as IL-4 and IL-10, therefore promoting a favorable environment for tissue healing and reducing inflammation (Routley and Ashcroft, 2009

Good nutrition and lifestyle modulation support collagen synthesis, mitochondrial function, and tissue remodeling

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Small molecular metabolites, including prostaglandins (PGs), lipoxins (LXs), platelet-activating factor (PAF) and leukotrienes (LTs), nitric oxide (NO), and reactive oxygen species (ROS), are also vital participants and mediators in the physiopathology of RA (20)