REVIEW article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Immunometabolism in Rheumatoid Arthritis: Mechanisms, Biomarkers, and the Path to Precision Medicine
Provisionally accepted
- Changchun University of Chinese Medicine, Changchun, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Synovitis and gradual joint degeneration are hallmarks of rheumatoid arthritis (RA), a chronic inflammatory illness. To sustain inflammation and tissue damage, pathogenic immune and stromal cells undergo specific metabolic reprogramming that alters glycolysis, oxidative phosphorylation, and lipid metabolism. This pathology is driven by immunometabolic dysregulation, according to new research. This review summarizes the current understanding of cell-type-specific immunometabolic dysregulation in RA, with particular attention to T cells, macrophages, B cells, and fibroblast-like synoviocytes. We assess how high-dimensional biomarkers, such as blood-based metabolomic, transcriptomic, and proteomic signatures, and synovial molecular pathotypes can be used to stratify patients and predict how well biologic and targeted treatments will work. We also reviewed treatment approaches targeting immunometabolic pathways, including new metabolic inhibitors and drug repurposing, such as metformin. To facilitate more individualized and efficient RA treatment, we conclude by offering a clinically applicable paradigm for integrating immunometabolic profiling into precision medicine.
Keywords: clinical applications, Immunometabolism, personalized medicine, Rheumatoid arthritis, Rheumatoid arthritis (RA)
Received: 24 Aug 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Liu, Wang, Lou, Tang, Fang, Zhang and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yinghua Hu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.