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Review Article

Immuno-metabolic reprogramming of T cell: a new frontier for pharmacotherapy of Rheumatoid arthritis

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Received 20 Feb 2023, Accepted 08 Mar 2024, Published online: 25 Mar 2024
 

Abstract

Rheumatoid arthritis (RA) is a persistent autoimmune condition characterized by ongoing inflammation primarily affecting the synovial joint. This inflammation typically arises from an increase in immune cells such as neutrophils, macrophages, and T cells (TC). TC is recognized as a major player in RA pathogenesis. The involvement of HLA-DRB1 and PTPN-2 among RA patients confirms the TC involvement in RA. Metabolism of TC is maintained by various other factors like cytokines, mitochondrial proteins & other metabolites. Different TC subtypes utilize different metabolic pathways like glycolysis, oxidative phosphorylation and fatty acid oxidation for their activation from naive TC (T0). Although all subsets of TC are not deleterious for synovium, some subsets of TC are involved in joint repair using their anti-inflammatory properties. Hence artificially reprogramming of TC subset by interfering with their metabolic status poised a hope in future to design new molecules against RA

Graphical Abstract

Naïve T cells (T0) primarily rely on oxidative phosphorylation (OXPHOS) within the mitochondria for their energy needs. Upon activation, they undergo a metabolic switch, favoring aerobic glycolysis for rapid ATP generation. This metabolic shift is crucial for their differentiation into effector T cells. The PI3K/AKT/mTOR pathway plays a key role in regulating T cell metabolism. Targeting this pathway can alter their metabolic status, impacting their differentiation and cytokine production. In Rheumatoid Arthritis (RA), aberrant T cell activation and cytokine release contribute to inflammation and disease progression. Modulating T cell bioenergetics through PI3K/AKT/mTOR inhibition offers a promising therapeutic strategy for controlling autoimmunity in RA

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

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