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RPMTG (Total saponins from Rhizoma Panacis Majoris) is a botanical extract derived from the rhizome of *Panax japonicus* var. *major*, a traditional Chinese medicinal herb known as Zhu zi shen. It is primarily composed of saponins and is being investigated for its therapeutic potential in autoimmune diseases and oncology. In rheumatoid arthritis (RA) models, RPMTG has been shown to ameliorate joint inflammation and synovial hyperplasia by restoring the balance between autophagy and apoptosis. Its mechanism involves the downregulation of High Mobility Group Box 1 (HMGB1) expression, which facilitates the formation of the Beclin 1-Bcl-2 complex, thereby suppressing excessive autophagy and promoting apoptosis in fibroblast-like synoviocytes (FLSs). Additionally, RPMTG modulates the PI3K/Akt/mTOR and MAPK signaling pathways to inhibit synovial overproliferation.
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