Glucose metabolism not only provides energy for physical activity but also mediates a variety of physiological processes through the formation of complex signalling networks. Recent studies have indicated that glucose metabolism plays an important role in the pathogenesis of rheumatoid arthritis (RA), an autoimmune disease involving the inflammation of joints. Herein, we review recent progress in this area. Evidence indicates that RA synovial tissues have increased glycolytic activity, which leads to an acidic microenvironment that further induced the transformation of normal synovial cells. Enhanced glycolysis activity is related to hypoxia in RA synovial membranes. Glucose phosphate isomerase, enolase and aldolase and key enzymes of the glycolysis pathway promote RA autoimmunity by acting as autoantigens. Lactate and pyruvate, substrates of RA synovium metabolism, stimulate abnormal cell proliferation, angiogenesis and pannus formation.
© 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.