Red wine antioxidant properties implications in rheumatic diseases: exploring clonal variations in resveratrol and other bioactive compounds

Resveratrol (RS), a non-flavonoid polyphenol, is a well-recognised anti-inflammatory compound of red wine. This narrative review aims to explore the mechanisms underlying its potential antioxidant properties in osteoarthritis (OA), rheumatoid arthritis (RA), spondyloarthritis (SpA), and osteoporosis (OP), as well as its clonal variation in red wine and future perspectives for clinical applications.Although human data remain limited and sometimes controversial, recent studies in animal models have demonstrated that RS can reduce inflammation by interacting with various cellular pathways, including the activation of sirtuins, which regulate oxidative stress and bone density in OA and OP, and modulating gut microbiota, as central inflammatory trigger for SpA and RA.While RS effects and toxicity are dosedependent, its concentration in red wine may vary depending on grape clone selection and maceration time, potentially increasing its levels and associated health benefits. Additionally, pterostilbene, a compound structurally related to RS, has shown greater bioavailability and promising antioxidant effects. The rapid metabolism of RS in the human body remains a limitation for its therapeutic use, which might be improved through combination with other antioxidants such as vitamins C and E, curcumin, and quercetin, offering synergistic anti-inflammatory effects.Moreover, advanced delivery systems, including nanotechnology, have been developed to enhance RS absorption and stability. Continued research is essential to better understand the role of RS and other antioxidants, and to optimise their therapeutic potential in the near future.