Evidence mapPaperPMID 42548760Full record

ReviewFrontiers in immunology2026

Immunological heterogeneity in rheumatoid arthritis: challenges in early-stage stratification, non-response to targeted therapy, and the restoration of immune tolerance.

Yanmei Li, Kairui Zhu, Yushan Ding, Dongyang Wu, Yulong Mu, Xiaoke Liu, Xuelin Liu, Xinran Yu, Yuhan Yan, Yunxiao Sun and 1 more

Abstract readReview
In one paragraph

Review in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yanmei Li *Department of Rheumatology and Immunology, Yantaishan Hospital Affiliated to Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Kairui Zhu *Department of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Yushan DingDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Dongyang WuDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Yulong MuDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Xiaoke LiuDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Xuelin LiuDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Xinran YuDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Yuhan YanDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Yunxiao SunDepartment of Pediatrics, Yantaishan Hospital Affiliated to Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.
Youjie LiDepartment of Biochemistry and Molecular Biology, Shandong Medical and Pharmaceutical University, Yantai, Shandong, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic erosive synovitis, progressive bone destruction, and marked inter-patient heterogeneity in disease course and treatment response. This review critically examines the mechanisms underlying RA immunological heterogeneity, including genetic susceptibility, epigenetic regulation, autoantibody diversification, synovial pathotypes, and gut-joint axis-related immune-metabolic interactions. We further discuss how peripheral blood multi-omics, synovial molecular pathology, and biopsy-driven clinical trial evidence may inform early stratification and prediction of primary non-response. Rather than proposing a deterministic precision-medicine model, this review emphasizes an evidence-weighted framework in which molecular and tissue-level biomarkers are integrated with clinical phenotype and longitudinal treatment response. Emerging approaches, including pharmacomicrobiomics, local drug delivery, nanomedicine, and cell-based therapies, are evaluated as investigational strategies that require further validation. Overall, this review highlights how a more critical understanding of RA heterogeneity may improve patient stratification and support more rational therapeutic selection.

Indexed as

Arthritis, RheumatoidImmune ToleranceAnimalsAutoantibodiesBiomarkersGenetic Predisposition to DiseaseHumansMolecular Targeted TherapyAutoantibodiesBiomarkersautoantibody diversificationgut-joint axisimmunological heterogeneitymolecular subtypingprecision stratificationrheumatoid arthritissynovial pathotypetreatment non-response

Identifiers

PMID42548760
PMCPMC13429679

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.