HMGB1 induces angiogenesis in rheumatoid arthritis via HIF-1α activation

Eur J Immunol. 2015 Apr;45(4):1216-27. doi: 10.1002/eji.201444908. Epub 2015 Jan 15.


High-mobility group box protein 1 (HMGB1), a nonhistone nuclear protein and a cytokine mediator, is implicated in the pathogenesis of rheumatoid arthritis (RA). Extracellular HMGB1 binds to its receptors and triggers downstream signal cascade leading to the perpetuation of synovitis and local tissue invasion. Here, we investigated a novel role of HMGB1 in regulating hypoxia-inducible factor (HIF)-1α to mediate angiogenesis in RA synovium. HIF-1α mRNA levels and activities in synovial fibroblasts from RA patients were enhanced by HMGB1. Pharmacological inhibition of TLR4 and NF-kappaB activation blocked the HMGB1-dependent upregulation of HIF-1α mRNA expression and its activity, suggesting the involvement of transcriptional regulation. HMGB1 stimulated expression of vascular endothelial growth factor (VEGF), and inhibition of HIF-1α attenuated HMGB1-induced VEGF. Conditioned media derived from HMGB1-stimulated synovial fibroblasts enhanced tube formation in human microvascular endothelial cells by upregulating HIF-1α. In the joint tissues of mice with collagen-induced arthritis, treatment with anti-HMGB1 neutralizing antibody prevented blood vessel formation in association with decreased expression of HIF-1α. These observations support the idea that increased HMGB1 induces an extension of inflamed synovium by accelerating angiogenesis in RA through enhancement of HIF-1α activation. Therefore, inhibition of HMGB1 could prove beneficial for the treatment of angiogenesis in RA.

Keywords: Fibroblast; HIF-1α; HMGB1; Rheumatoid arthritis; angiogenesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies, Neutralizing / pharmacology
  • Arthritis, Experimental
  • Arthritis, Rheumatoid / pathology*
  • Endothelial Cells / metabolism
  • Enzyme Activation
  • Female
  • HMGB1 Protein / antagonists & inhibitors
  • HMGB1 Protein / metabolism*
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / antagonists & inhibitors
  • Hypoxia-Inducible Factor 1, alpha Subunit / genetics
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism*
  • Male
  • Mice
  • Mice, Inbred DBA
  • Middle Aged
  • NF-kappa B / antagonists & inhibitors
  • Neovascularization, Pathologic / pathology*
  • RNA Interference
  • RNA, Messenger / genetics
  • RNA, Small Interfering
  • Synovial Membrane / blood supply*
  • Toll-Like Receptor 4 / antagonists & inhibitors
  • Transcription, Genetic
  • Transcriptional Activation
  • Vascular Endothelial Growth Factor A / biosynthesis


  • Antibodies, Neutralizing
  • HIF1A protein, human
  • HMGB1 Protein
  • HMGB1 protein, human
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • NF-kappa B
  • RNA, Messenger
  • RNA, Small Interfering
  • TLR4 protein, human
  • Toll-Like Receptor 4
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A