CD8A and rheumatoid arthritis: This metabolic profile under conditions of hypoxia promotes the proliferation of CD8+ T-lymphocytes and their production of pro-inflammatory cytokines, as well as an increase in the expression of granzyme B. In addition, it has been described that cytotoxic T-lymphocytes are able to activate B-lymphocytes in the synovial membrane in patients with RA [53].