Rheumatoid arthritis (RA) is a destructive chronic
autoimmune disease characterized by synovium
inflammation, cartilage destruction, bone erosion and the presence of
autoantibodies.
Hypoxia is a prominent micro-environmental feature in a range of disorders including RA. A combination of increased
oxygen consumptionby inflamed resident cells and infiltrating immune cells along with a disrupted blood supply due to vascular dysfunction contribute to tissue
hypoxia in RA.
Hypoxia in turn regulates a number of key signaling pathways that help adaptation. The primary signaling pathway activated by
hypoxia is the
hypoxia-inducible factor (HIF) pathway. It has been shown that HIFs are highly expressed in the synovium of RA. HIFs mediate the pathogenesis of RA through inducing
inflammation, angiogenesis, cell migration, and cartilage destruction, and inhibiting the apoptosis of synovial cells and inflammatory cells. HIF expressed in RA can be regulated in both
oxygen-dependent and independent fashions, like inflammatory
cytokines, leading to the aggravation of this disease. Considering the vital role of HIF in the pathogenesis of RA, we reviewed the new advances about
hypoxia and RA. In this review, we firstly discussed the
hypoxia-inducible factor and its regulation, and then, the pathologic role of
hypoxia in RA, mainly elucidating the role of
hypoxia in
synovitis and cartilage destruction and immune cells. Finally, we provided evidence about the potential therapeutic target for treating RA.