TLR4 and rheumatoid arthritis: Ephedra sinica polysaccharide (ESP) exhibits a good therapeutic effect on RA (Zheng et al., 2023) by reducing the lipopolysaccharide stimulated nuclear translocation of the NF-κB p65 subunit, improving the levels of RA inflammatory markers, and reducing the release of inflammatory factors (TNF-α, IL-1β, and IL-6) and NO by inhibiting the TLR4 signaling pathway (Li et al., 2023).