Metabolic checkpoints in rheumatoid arthritis

Valentina Pucino, Michelangelo Certo, Gilda Varricchi, Giancarlo Marone, Francesco Ursini, Francesca Wanda Rossi, Amato de Paulis, Claudio Mauro, Karim Raza, Christopher Buckley

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)
184 Downloads (Pure)


Several studies have highlighted the interplay between metabolism, immunity and inflammation. Both tissue resident and infiltrating immune cells play a major role in the inflammatory process of rheumatoid arthritis (RA) via the production of cytokines, adipocytokines and metabolic intermediates. These functions are metabolically demanding and require the most efficient use of bioenergetic pathways. The synovial membrane is the primary site of inflammation in RA and exhibits distinctive histological patterns characterized by different metabolism, prognosis and response to treatment. In the RA synovium, the high energy demand by stromal and infiltrating immune cells, causes the accumulation of metabolites, and adipo-cytokines, which carry out signaling functions, as well as activating transcription factors which act as metabolic sensors.
These events drive immune and joint-resident cells to acquire pro-inflammatory effector functions which in turn perpetuate chronic inflammation. Whether metabolic changes are a consequence of the disease or one of the causes of RA pathogenesis is still under investigation. This review covers our current knowledge of cell metabolism in RA. Understanding the intricate interactions between metabolic pathways and the inflammatory and immune responses will provide more awareness of the mechanisms underlying RA pathogenesis and will identify novel therapeutic options to treat this disease.
Original languageEnglish
Article number347
JournalFrontiers in Physiology
Publication statusPublished - 17 Apr 2020


  • immunity
  • immunometabolism
  • mediators of inflammation
  • metabolism
  • rheumatoid arthritis


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