Regulation of Sirt1 on energy metabolism and immune response in rheumatoid arthritis

Int Immunopharmacol. 2021 Dec;101(Pt A):108175. doi: 10.1016/j.intimp.2021.108175. Epub 2021 Oct 29.


Rheumatoid arthritis (RA) is a systemic autoimmune disease. Synovial hyperplasia and persistent inflammation serve as its typical pathological manifestations, which ultimately lead to joint destruction and function loss. Both clinical observations and metabolomics studies have revealed the prevalence of metabolic disorders in RA. In inflammatory immune microenvironments, energy metabolism is profoundly changed. Increasingly evidences suggest that this abnormality is involved in the occurrence and development of RA-related inflammation. Unsurprisingly, many energy metabolism sensors have been confirmed with immunoregulatory properties. As a representative, silent information regulator type 1 (Sirt1) controls many aspects of immune cells, such as cell lifespan, polarization, and secretion by functioning as a transcriptional regulator. Because of the profound clinical implication, researches on Sirt1 in the regulation of energy metabolism and immune functions under RA conditions have gradually gained momentum. This signaling balances glycolysis, lipid metabolism and insulin secretion orchestrating with other metabolism sensors, and consequently affects immune milieu through a so-called metabolism-immune feedback mechanism. This article reviews the involvement of Sirt1 in RA by discussing its impacts on energy metabolism and immune functions, and specially highlights the potential of Sirt1-targeting anti-rheumatic regimens. It also provides a theoretical basis for clarifying the mystery about the high incidence of metabolic complications in RA patients and identifying new anti-rheumatic reagents.

Keywords: Energy metabolism; Immune cells; NF-κB; Rheumatoid arthritis; Sirt1.

Publication types

  • Review

MeSH terms

  • Animals
  • Antirheumatic Agents / pharmacology
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / immunology*
  • Arthritis, Rheumatoid / pathology
  • Disease Models, Animal
  • Energy Metabolism / drug effects
  • Energy Metabolism / immunology*
  • Gene Expression Regulation / drug effects
  • Gene Expression Regulation / immunology
  • Glycolysis / drug effects
  • Glycolysis / immunology
  • Humans
  • Lipid Metabolism / drug effects
  • Lipid Metabolism / immunology
  • Signal Transduction / drug effects
  • Signal Transduction / immunology
  • Sirtuin 1 / antagonists & inhibitors
  • Sirtuin 1 / metabolism*
  • Synovial Membrane / drug effects
  • Synovial Membrane / immunology
  • Synovial Membrane / pathology


  • Antirheumatic Agents
  • SIRT1 protein, human
  • Sirt1 protein, mouse
  • Sirtuin 1