A NEW observational study has revealed that oral microbiome dysbiosis and disrupted oral-gut microbial networks are associated with hand osteoarthritis, pointing to a potential oral-gut microbiome axis involved in disease pathogenesis in a condition affecting millions worldwide.
Hand osteoarthritis affects hundreds of millions of people worldwide and has remained a substantial source of disease burden, yet its pathogenesis has remained poorly understood. The oral microbiome has been recognised as a key modulator of systemic inflammation, partly through its interactions with the gut microbiome, which has previously been implicated in symptomatic hand osteoarthritis. However, the specific role of oral microbiome dysbiosis in this condition remained unclear.
Researchers recruited participants from the Xiangya Osteoarthritis (XO) Study, an ongoing community-based observational study, and analysed saliva samples using 16S ribosomal RNA gene sequencing. Oral microbial richness, composition, and relative abundance of specific taxa were compared between participants with symptomatic hand osteoarthritis (SHOA) and controls without the condition. Correlations within the oral-gut microbiome network were also assessed and compared between the two groups.
Compared with 712 controls, the 52 participants with SHOA showed significantly lower oral microbial richness (p=0.007) and altered composition (p=0.007). The relative abundance of the genus Trichococcus was significantly higher in SHOA participants (β=0.437, 95% CI 0.174 to 0.699, p=0.001, Q=0.073) and was positively associated with disease severity. The number of significant correlations within the oral-gut microbiome network was markedly reduced in SHOA participants compared with controls. Trichococcus abundance in the oral microbiome also correlated positively with the gut microbial KEGG pathway of tyrosine metabolism (r=0.137, p=0.001, Q=0.047), which was itself linked to SHOA.
These findings have suggested that oral microbiome dysbiosis and disruption of the oral-gut microbiome network are associated with prevalent hand osteoarthritis, supporting a potential role for the oral-gut microbiome axis in disease pathogenesis. As this was a cross-sectional observational study with a relatively small SHOA sample size, causality cannot be established. The authors have called for larger studies to confirm these associations.
Reference
Li J et al. Oral microbiome dysbiosis and oral-gut microbial network disruption in hand osteoarthritis: data from the Xiangya Osteoarthritis Study. RMD Open. 2026;12:e006962.
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