Objective. Hyperplasia and phenotypic changes in fibroblasts are often observed in chronic inflammatory lesions, and yet the autonomous pathogenic contribution of these changes is uncertain. The purpose of this study was to analyze the intrinsic ability of fibroblasts from chronically inflamed synovial tissue to drive cell recruitment and angiogenesis.Methods. Fibroblasts from patients with rheumatoid arthritis (RA) or osteoarthritis (OA), as well as fibroblasts from healthy synovial tissue and healthy skin, were cultured and subcutaneously engrafted into immunodeficient mice. Cell infiltration and angiogenesis were analyzed in the grafts by immunohistochemical studies. The role of vascular endothelial growth factor (VEGF), CXCL12, and hypoxia-inducible transcription factor 1␣ (HIF-1␣) in these processes was investigated using specific antagonists or small interfering RNA (siRNA)-mediated down-regulation of HIF-1␣ in fibroblasts.Results. Inflammatory (OA and RA) synovial fibroblasts, compared with healthy dermal or synovial tissue fibroblasts, induced a significant enhancement in myeloid cell infiltration and angiogenesis in immunodeficient mice. These activities were associated with increased constitutive and hypoxia-induced expression of VEGF, but not CXCL12, in inflammatory fibroblasts compared with healthy fibroblasts. VEGF and CXCL12 antagonists significantly reduced myeloid cell infiltration and angiogenesis. Furthermore, targeting of HIF-1␣ expression by siRNA or of HIF-1␣ transcriptional activity by the small molecule chetomin in RA fibroblasts significantly reduced both responses.Conclusion. These results demonstrate that chronic synovial inflammation is associated with stable fibroblast changes that, under hypoxic conditions, are sufficient to induce inflammatory cell recruitment and angiogenesis, both of which are processes relevant to the perpetuation of chronic inflammation.Fibroblasts are ubiquitous mesenchymal cells with vital functions during development and adulthood. They synthesize the extracellular matrix components of connective tissues needed for homeostasis and reparative responses. During development, interactions between mesenchymal and other cell lineages are necessary for the formation of many organs, and fibroblasts are sufficient to provide the positional cues required for the induction and development of the different tissues (1,2). In the adult, multiple evidence points to specialized fibroblasts as a major force in the regulation of cell homing, migration, and differentiation of highly dynamic cell populations, such as cells of the immune system or the bone marrow (3,4). With regard to the pathologic