Hypoxia, oxidative stress and rheumatoid arthritis

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Abstract
The synovial cavity has a negative pressure in health. When the joint is exercised, vascular patency is maintained, allowing for nutrition of the avascular cartilage. In rheumatoid synovitis, the situation is altered. The cavity pressure is raised and upon movement this pressure exceeds the capillary perfusion pressure, causing collapse of the blood vessels. This leads to the production of multiple episodes of ‘hypoxic-reperfusion injury’ generating reactive oxygen species (ROS). Such ROS oxidise: Progressive hypoxia alters immune function, predominantly by calcium mediated pathways.

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