The Danger Model Approach to the Pathogenesis of the Rheumatic Diseases

Figure 3

The hypoxic impaired fibroblast in RA. The hypoxia in the rheumatoid synovium induces several phenotypic changes in the fibroblasts; it not only enhances the synthesis of proinflammatory cytokines and metalloproteases, but also induces the glycolysis pathways upregulating the enzymes, which become antigenic because they are abundant in a stressed scenario and eventually are presented by the local APC.