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By activating HIFs and downstream signaling pathways, promoting angiogenesis factors, and increasing the recruitment of immune cells, the hypoxic microenvironment itself aggravates the pathological processes of synovitis, angiogenesis, cartilage destruction, mitochondrial damage, cell migration, and invasion of RA

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Subsequently, several studies also revealed other effects, such as intensifying cell motility, angiogenesis, immune response, cell differentiation, and anti-apoptosis (Xie et al., 2001)