Luo Ting-Ting, Wu Yi-Jin, Yin Qin, Chen Wen-Gang, Zuo Jian
Department of Pharmacy, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, People's Republic of China.
Xin'an Medical Research Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241000, People's Republic of China.
J Inflamm Res. 2023 Apr 26;16:1837-1852. doi: 10.2147/JIR.S398291. eCollection 2023.
Obviously, immune cells like T cells and macrophages play a major role in rheumatoid arthritis (RA). On one hand, the breakdown of immune homeostasis directly induces systemic inflammation; on the other hand, these cells initiate and perpetuate synovitis and tissue damages through the interaction with fibroblast-like synoviocytes (FLS). In recent years, the pathological link between metabolic disorders and immune imbalance has received increasing attention. High energy demand of immune cells leads to the accumulation of metabolic byproducts and inflammatory mediators. They act on various metabolism-sensitive signal pathways as well as relevant transcription factors, such as HIF-1α, and STATs. These molecular events will impact RA-related effectors like circulating immune cells and joint-resident cells in return, allowing the continuous progression of systemic inflammation, arthritic manifestations, and life-threatening complications. In other words, metabolic complications are secondary pathological factors for the progression of RA. Therefore, the status of energy metabolism may be an important indicator to evaluate RA severity, and in-depth explorations of the mechanisms underlying the mystery of how RA-related metabolic disorders develop will provide useful clues to further clarify the etiology of RA, and inspire the discovery of new anti-rheumatic targets. This article reviews the latest research progress on the interactions between immune and metabolism systems in the context of RA. Great importance is attached to the changes in certain pathways controlling both immune and metabolism functions during RA progression.
显然,T细胞和巨噬细胞等免疫细胞在类风湿性关节炎(RA)中起主要作用。一方面,免疫稳态的破坏直接引发全身炎症;另一方面,这些细胞通过与成纤维样滑膜细胞(FLS)相互作用引发并持续滑膜炎和组织损伤。近年来,代谢紊乱与免疫失衡之间的病理联系受到越来越多的关注。免疫细胞对能量的高需求导致代谢副产物和炎症介质的积累。它们作用于各种对代谢敏感的信号通路以及相关转录因子,如低氧诱导因子-1α(HIF-1α)和信号转导子与转录激活子(STATs)。这些分子事件反过来又会影响与RA相关的效应细胞,如循环免疫细胞和关节驻留细胞,使全身炎症、关节炎表现和危及生命的并发症持续进展。换句话说,代谢并发症是RA进展的继发病理因素。因此,能量代谢状态可能是评估RA严重程度的重要指标,深入探究RA相关代谢紊乱发生机制背后的奥秘将为进一步阐明RA的病因提供有用线索,并激发新的抗风湿靶点的发现。本文综述了在RA背景下免疫和代谢系统相互作用的最新研究进展。文中高度重视RA进展过程中某些控制免疫和代谢功能的途径的变化。