Roles of autophagy in rheumatoid arthritis

Autophagy, a vital mechanism restrict-ed in tissues, exerts its cytoprotective role through the degradation mecha-nism of damaged or aging organelles, harmful protein aggregates and intra-cellular pathogens, followed by energy furnishment. However, dysfunctional autophagy is associated with the de-velopment of autoimmune diseases such as rheumatoid arthritis (RA). In pathological conditions, autophagy may be involved in the maturation, sur-vival and proliferation of various im-mune and non-immune cells and plays a key role in the pathogenesis of RA. Furthermore, autophagy appears to be involved in the citrullination of T lym-phocytes and the presentation of citrul-linated peptides, which are presented to T lymphocytes via the major histo-compatibility complex, causing immune responses and chronic inflammation, as well as bone and cartilage destruction associated with apoptosis resistance of RA fibroblast-like synoviocyte (RA-FLS) and osteoclastogenesis. In this review, we have summarised the roles of autophagy in the pathogenesis of RA including citrullination, immune toler-ance break, osteoclastogenesis, RA FLS cell dysplasia, apoptosis resistance, to-gether with the therapeutic potentials of autophagy regulators.