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In RA, the synovial microvasculature is highly dysregulated, resulting in inefficient oxygen perfusion to the synovium, which, along with the high metabolic demands of activated immune and stromal cells, leads to a profoundly hypoxic microenvironment
Scar tissue, while structurally filling the wound, lacks the functional properties of the original tissue scar tissue in tendons is weaker and less elastic, scar tissue in skin lacks normal sensation and flexibility, and scar tissue in the gut lacks normal mucosal barrier function
Hyperthyroidism is also common, but has the opposite effect, making more than enough thyroid hormone and disrupting thyroid function