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Kombucha also activates SIRT-1 and AMPK, suppressing chronic inflammation via NF-B inhibition, boosting mitochondrial biogenesis and ATP catabolism, while reducing lipogenesis and hepatic cholesterol synthesismechanisms associated with improved energy expenditure and anti-obesity effects

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Figure 1 A critical pathological feature of RA is the hypoxic microenvironment of the synovial tissues ( via glycolysis enables cells to produce ATP when oxygen levels are low to generate the energy required by RA cells ( Pyruvate dehydrogenase complex and pyruvate carboxylase decarboxylate pyruvate to form acetyl-coenzyme A and oxaloacetate, respectively, which enter the TCA cycle in the mitochondria