AUTHOR=Wen Jianting , Liu Jian , Wan Lei , Wang Fanfan , Li Yang 
  
TITLE=Immunometabolic dysregulation in autoimmune rheumatic diseases: the central role of glycolytic reprogramming in pathogenesis and traditional Chinese medicine therapy
  
JOURNAL=Frontiers in Immunology
  
VOLUME=Volume 17 - 2026
  
YEAR=2026
  
URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1754832
  
DOI=10.3389/fimmu.2026.1754832
  
ISSN=1664-3224
  
ABSTRACT=Immunometabolic dysregulation has emerged as a key driver in the pathogenesis of autoimmune rheumatic diseases (ARDs), including rheumatoid arthritis (RA), osteoarthritis (OA), and systemic lupus erythematosus (SLE). This review highlighted the central role of glycolytic reprogramming in driving immune cell dysfunction and disease progression. In RA, enhanced glycolysis promoted T cell dysregulation, synovial fibroblast activation, and macrophage polarization. In OA, glycolytic alterations in chondrocytes and synovial tissues were central to disease pathology, while SLE was characterized by metabolic shifts in podocytes, T cells, and NETosis processes. Traditional Chinese medicine (TCM) may be a promising therapeutic strategy by targeting glycolytic pathways to modulate immune responses and restore metabolic balance. Despite existing challenges, the integration of multi-omics and artificial intelligence (AI) may facilitate the development of personalized immunometabolic therapies. This review underscored glycolysis as a pivotal therapeutic target and advocated for interdisciplinary approaches in future ARD research.