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Inappropriate osteoclast activity instigates pathological bone loss in rheumatoid arthritis. We have investigated how osteoclasts generate sufficient ATP for the energy-intensive process of bone resorption in the hypoxic microenvironment associated with this rheumatic condition. We show that in human osteoclasts differentiated from CD14(+) monocytes, hypoxia (24 h, 2% O2 ): (a) increases ATP production and mitochondrial electron transport chain activity (Alamar blue, O2 consumption); (b) increases glycolytic flux (glucose consumption, lactate production); and (c) increases glutamine consumption. We demonstrate that glucose, rather than glutamine, is necessary for the hypoxic increase in ATP production and also for cell survival in hypoxia. Using siRNA targeting specific isoforms of the hypoxia-inducible transcription factor HIF (HIF-1α, HIF-2α), we show that employment of selected components of the HIF-1α-mediated metabolic switch to anaerobic respiration enables osteoclasts to rapidly increase ATP production in hypoxia, while at the same time compromising long-term survival. We propose this atypical HIF-driven metabolic pathway to be an adaptive mechanism to permit rapid bone resorption in the short term while ensuring curtailment of the process in the absence of re-oxygenation.

Original publication




Journal article


J pathol

Publication Date





755 - 764


Adaptation, Physiological, Adenosine Triphosphate, Basic Helix-Loop-Helix Transcription Factors, Bone Resorption, Cell Hypoxia, Cell Survival, Cells, Cultured, Electron Transport Chain Complex Proteins, Energy Metabolism, Glucose, Glutamine, Glycolysis, Humans, Hypoxia-Inducible Factor 1, alpha Subunit, Lactic Acid, Mitochondria, Osteoclasts, Oxygen Consumption, Pyruvate Dehydrogenase Complex, RNA Interference, Time Factors, Transfection, Up-Regulation