“…Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovitis, progressive articular cartilage erosion, and bone destruction, which is regulated by a complex pathological process involving multiple inflammatory cells. , Nowadays, pathological research has revealed that fibroblast-like synovial (FLS) cells are one of the critical effector cells in RA, and their hyperproliferation and infiltration play a key role in the pathogenesis of RA. , Once RA happens, the two- to three-layer synovial lining would be converted to rheumatoid and pannus-like, which is a hyperplastic structure with a greater amount of stimulated FLS cells and macrophages that stretches into the articular interior, connects to the cartilage surface, and infiltrates and decomposes the cartilage matrix leading to bone loss and joint dysfunction. − Recently, many research reports demonstrate that the activation of FLS cells and subsequent joint injury are closely related to the changes of intracellular energy metabolism. , In RA activated FLS (RA-FLS) cells, the balance of the glucose metabolism is disturbed, which is reflected as the proportion of the glycolysis pathway being obviously higher than that of the oxidative phosphorylation pathway. With the rise of glycolysis and acid resistance, RA-FLS cells are especially sensitive to glucose and highly dependent on glycolysis and have a tenacious vitality advantage, which is the main factor for the rapid proliferation and invasion of inflammatory synovium .…”