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Rheumatoid arthritis
Stage-specific roles of microbial dysbiosis and metabolic disorders in rheumatoid arthritis
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  • Published on: 10 November 2022
    Correspondence on “Stage-specific roles of microbial dysbiosis and metabolic disorders in rheumatoid arthritis” by Cheng et al.
    • Yinlan Wu, Medicinae Doctor West China Hospital, Sichuan University
    • Other Contributors:
      • Yanhong Li, Medicinae Doctor
      • Tong Wu, Medicinae Doctor
      • Siyin Li, Rheumatologist and immunologist
      • Yubin Luo, Professor of medicine
      • Yi Liu, Professor of medicine

    Cheng et al. recently reported the changes in fecal microbiota and peripheral blood metabolites in patients with rheumatoid arthritis (RA) across four stages of the disease. In addition, they performed 16S rRNA sequencing and identified bacteria in synovial fluid of RA. and successfully isolated and identified many microbes in synovial fluid samples of RA patients at the stage 4 (RAS4). Moreover, substances shaped like bacteria in rod-like or spherical forms were also observed under scanning electron microscopy.1 This is the first time that bacteria were successfully isolated from the synovial fluid of RA and this finding deserves attention.
    First, it is always an interesting question whether bacteria are actually present in the synovial fluid of RA. Up to date, several studies have reported the presence of microbial DNA in joint effusion of RA by 16S rRNA gene sequencing technology (Table 1). However, there is no direct evidence on isolation of bacteria from RA synovial fluid. The synovial fluid is usually sterile, and RA is a kind of chronic non-infectious arthritis induced by autoimmune disorder.2 It was indeed reported that bacteria were found in the synovial fluid of RA, however, this was mainly because of multiple arthroscopic washouts and joint injections. Unfortunately, the history information of repeated arthroscopy or arthrocentesis was missing in RAS4 of which bacteria were isolated from synovial fluid in this article. Thus, it is uncertain if these isolat...

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    Conflict of Interest:
    None declared.