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Main related signaling pathways and transcription factors of RA The activation of synovial cell TLR leads to exacerbation of arthritis (208), in which the expression of TLR2, TLR3, TLR4 and TLR5 in RA synovial cells is increased and they are involved in the regulation of inflammatory factor production in RA synovial cells

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In addition, this uncontrolled immune response could be potentiated by impaired pituitary function due to autoimmune damage, which manifests in symptoms varying in severity, such as fatigue, orthostatic hypotension and sleep disturbances, depending on the degree of pituitary damage (42, 59)

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doi: 10.1155/2016/8160393