Multifactorial pathogenesis of rheumatoid arthritis: interaction between inflammation, metabolic dysregulation, and tissue mechanics

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent synovitis, progressive joint destruction, and diverse extra-articular complications. Increasing evidence indicates that RA pathogenesis is not driven by isolated inflammatory events, but by a tightly interconnected network involving immune dysregulation, metabolic reprogramming, and aberrant mechanotransduction. This review synthesizes recent advances in these three pathogenic dimensions and proposes a