{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:07:04Z","timestamp":1784678824227,"version":"3.55.0"},"reference-count":33,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81930071"],"award-info":[{"award-number":["81930071"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82372474"],"award-info":[{"award-number":["82372474"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82472524"],"award-info":[{"award-number":["82472524"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2024JJ3047"],"award-info":[{"award-number":["2024JJ3047"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Research Program of FuRong Laboratory","award":["2023SK2100"],"award-info":[{"award-number":["2023SK2100"]}]},{"name":"Scientific Research Program of FuRong Laboratory","award":["2024PT5108"],"award-info":[{"award-number":["2024PT5108"]}]},{"name":"Postdoctoral Fellowship Program (Grade C) of China Postdoctoral Science Foundation","award":["GZC20251392"],"award-info":[{"award-number":["GZC20251392"]}]},{"name":"Health Research Project of Hunan Provincial Health Commission","award":["W20241003"],"award-info":[{"award-number":["W20241003"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,5,14]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The oral microbiome plays a critical role in modulating systemic inflammation, partly through its interactions with the gut microbiome. Although gut microbiome dysbiosis has been implicated in symptomatic hand osteoarthritis (SHOA), the role of oral microbiome dysbiosis in SHOA and its relationship with gut microbiome dysbiosis remain unclear. Elucidating these associations could provide novel insights into SHOA pathogenesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were recruited from the Xiangya Osteoarthritis (XO) Study, an ongoing community-based observational study. Saliva samples were analysed using 16S ribosomal RNA gene sequencing. Oral microbial richness, composition and relative abundance of specific taxa were compared between SHOA participants and controls without SHOA. Correlations within the oral-gut microbiome network were also assessed and compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with controls (n=712), participants with SHOA (n=52) exhibited significantly lower oral microbial richness (p=0.007) and altered composition (p=0.007). The relative abundance of the genus\n                      <jats:italic>Trichococcus<\/jats:italic>\n                      was significantly higher in SHOA participants (\u03b2=0.437 (95% CI 0.174 to 0.699), p=0.001, Q=0.073) and positively associated with SHOA severity. Furthermore, the number of significant correlations within the oral-gut microbiome network was markedly reduced in SHOA participants compared with controls. Notably,\n                      <jats:italic>Trichococcus<\/jats:italic>\n                      abundance in the oral microbiome correlated positively with the gut microbial KEGG pathway of tyrosine metabolism (r=0.137, p=0.001, Q=0.047), both linked to SHOA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Oral microbiome dysbiosis and disruption of the oral-gut microbiome network are associated with prevalent SHOA. These findings suggest a potential role of the oral-gut microbiome axis in SHOA pathogenesis. Larger studies are needed to confirm these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04033757\">NCT04033757<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2026-006962","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:13Z","timestamp":1784678413000},"page":"e006962","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Oral microbiome dysbiosis and oral-gut microbial network disruption in hand osteoarthritis: data from the Xiangya Osteoarthritis Study"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04033757","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04033757","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1519-0615","authenticated-orcid":false,"given":"Jiatian","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9521-0809","authenticated-orcid":false,"given":"Yadan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0738-4812","authenticated-orcid":false,"given":"Tuo","family":"Yang","sequence":"additional","affiliation":[{"name":"Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3197-752X","authenticated-orcid":false,"given":"David J","family":"Hunter","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiya","family":"Zhang","sequence":"additional","affiliation":[{"name":"Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Doherty","sequence":"additional","affiliation":[{"name":"Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zidan","family":"Yang","sequence":"additional","affiliation":[{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment of Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9468-4110","authenticated-orcid":false,"given":"Yilun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment of Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxing","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment of Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjun","family":"Li","sequence":"additional","affiliation":[{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment of Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Diseases (Xiangya Hospital of Central South University), Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hematology and Critical Care Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Sepsis Translational Medicine of Hunan, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8891-9067","authenticated-orcid":false,"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeqin","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment of Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Diseases (Xiangya Hospital of Central South University), Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2987-138X","authenticated-orcid":false,"given":"Guanghua","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment of Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Diseases (Xiangya Hospital of Central South University), Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"FuRong Laboratory, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-8241","authenticated-orcid":false,"given":"Jie","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment of Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"FuRong Laboratory, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026072117000463000_12.3.e006962.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"2026072117000463000_12.3.e006962.2","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1038\/s41584-018-0095-4","article-title":"Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management","volume":"14","author":"Marshall","year":"2018","journal-title":"Nat Rev Rheumatol"},{"key":"2026072117000463000_12.3.e006962.3","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.170"},{"key":"2026072117000463000_12.3.e006962.4","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf141"},{"key":"2026072117000463000_12.3.e006962.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.131151"},{"key":"2026072117000463000_12.3.e006962.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.ebiom.2023.104892","article-title":"Association between gut microbiome-related metabolites and symptomatic hand osteoarthritis in two independent cohorts","volume":"98","author":"Wei","year":"2023","journal-title":"EBioMedicine"},{"key":"2026072117000463000_12.3.e006962.7","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1002\/art.41729","article-title":"Association Between Gut Microbiota and Symptomatic Hand Osteoarthritis: Data From the Xiangya Osteoarthritis Study","volume":"73","author":"Wei","year":"2021","journal-title":"Arthritis Rheumatol"},{"key":"2026072117000463000_12.3.e006962.8","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrev.2c00431"},{"key":"2026072117000463000_12.3.e006962.9","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-023-00963-6"},{"key":"2026072117000463000_12.3.e006962.10","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-024-01075-5"},{"key":"2026072117000463000_12.3.e006962.11","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.tim.2020.11.004","article-title":"The Oral Host-Microbial Interactome: An Ecological Chronometer of Health?","volume":"29","author":"Freire","year":"2021","journal-title":"Trends Microbiol"},{"key":"2026072117000463000_12.3.e006962.12","doi-asserted-by":"crossref","DOI":"10.1038\/s41392-022-00974-4","article-title":"Microbiota in health and diseases","volume":"7","author":"Hou","year":"2022","journal-title":"Signal Transduct Target Ther"},{"key":"2026072117000463000_12.3.e006962.13","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1038\/s41564-024-01680-3","article-title":"Oral bacteria relative abundance in faeces increases due to gut microbiota depletion and is linked with patient outcomes","volume":"9","author":"Liao","year":"2024","journal-title":"Nat Microbiol"},{"key":"2026072117000463000_12.3.e006962.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2024.02.012"},{"key":"2026072117000463000_12.3.e006962.15","doi-asserted-by":"crossref","DOI":"10.1093\/ije\/dyae156","article-title":"Cohort Profile: The Xiangya Osteoarthritis (XO) Study","volume":"53","author":"Li","year":"2024","journal-title":"Int J Epidemiol"},{"key":"2026072117000463000_12.3.e006962.16","doi-asserted-by":"crossref","unstructured":"Yang Y , Hao C , Jiao T , et al . Osteoarthritis treatment via the GLP-1\u2013mediated gut-joint axis targets intestinal FXR signaling. Science 2025;388. doi:10.1126\/science.adt0548","DOI":"10.1126\/science.adt0548"},{"key":"2026072117000463000_12.3.e006962.17","doi-asserted-by":"publisher","DOI":"10.1136\/ard.16.4.494"},{"key":"2026072117000463000_12.3.e006962.18","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.joca.2020.02.028","article-title":"Incidence and progression of hand osteoarthritis in a large community-based cohort: the Johnston County Osteoarthritis Project","volume":"28","author":"Snyder","year":"2020","journal-title":"Osteoarthr Cartil"},{"key":"2026072117000463000_12.3.e006962.19","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-28034-z"},{"key":"2026072117000463000_12.3.e006962.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pcbi.1009442","article-title":"Multivariable association discovery in population-scale meta-omics studies","volume":"17","author":"Mallick","year":"2021","journal-title":"PLoS Comput Biol"},{"key":"2026072117000463000_12.3.e006962.21","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.03.054"},{"key":"2026072117000463000_12.3.e006962.22","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1164\/rccm.202308-1357OC","article-title":"Commensal Oral Microbiota, Disease Severity, and Mortality in Fibrotic Lung Disease","volume":"209","author":"O\u2019Dwyer","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"key":"2026072117000463000_12.3.e006962.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.tree.2008.10.008"},{"key":"2026072117000463000_12.3.e006962.24","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-317791"},{"key":"2026072117000463000_12.3.e006962.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"2026072117000463000_12.3.e006962.26","doi-asserted-by":"crossref","first-page":"17126","DOI":"10.1038\/s41598-018-35473-6","article-title":"Variations in oral microbiome profiles in rheumatoid arthritis and osteoarthritis with potential biomarkers for arthritis screening","volume":"8","author":"Chen","year":"2018","journal-title":"Sci Rep"},{"key":"2026072117000463000_12.3.e006962.27","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-205003"},{"key":"2026072117000463000_12.3.e006962.28","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/6711160","article-title":"Metformin Alleviates Autistic-Like Behaviors Elicited by High-Fat Diet Consumption and Modulates the Crosstalk Between Serotonin and Gut Microbiota in Mice","volume":"2022","author":"Deng","year":"2022","journal-title":"Behav Neurol"},{"key":"2026072117000463000_12.3.e006962.29","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.3233\/JAD-220692","article-title":"Structural Alteration of Gut Microbiota During the Amelioration of Chronic Psychological Stress-Aggravated Diabetes-Associated Cognitive Decline by a Traditional Chinese Herbal Formula, ZiBu PiYin Recipe","volume":"90","author":"Zhou","year":"2022","journal-title":"J Alzheimers Dis"},{"key":"2026072117000463000_12.3.e006962.30","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jchromb.2018.03.047","article-title":"Perturbations in amino acids and metabolic pathways in osteoarthritis patients determined by targeted metabolomics analysis","volume":"1085","author":"Chen","year":"2018","journal-title":"J Chromatogr B Analyt Technol Biomed Life Sci"},{"key":"2026072117000463000_12.3.e006962.31","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.joca.2023.04.005","article-title":"Causal associations between serum amino acid levels and osteoarthritis: a Mendelian randomization study","volume":"31","author":"Cui","year":"2023","journal-title":"Osteoarthr Cartil"},{"key":"2026072117000463000_12.3.e006962.32","doi-asserted-by":"publisher","DOI":"10.1017\/S000711450769936X"},{"key":"2026072117000463000_12.3.e006962.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2015.11.009"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2026-006962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:16Z","timestamp":1784678416000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2026-006962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,7,21]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/rmdopen-2026-006962"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2026-006962","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}