{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:27:49Z","timestamp":1786343269651,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Demand for arthroplasty due to osteoarthritis (OA) is rising with population aging and need for revision surgeries. Efforts to slow OA progression and prevent post-operative complications have been ineffective, likely due to inadequate identification of the primary disease-driving mechanisms underlying cartilage destruction. The aim of this study was to identify the primary disease-driving mechanisms underlying OA cartilage destruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patient stratification was performed using a Gaussian mixture model according to the expression profiles of 14 OA indicators in the cartilage collected from total or unicompartmental knee arthroplasty and verified by cartilage microbiome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six endotypes were identified from 122 OA cartilage samples. Regarding extracellular matrix remodeling, Cluster 1 had high COL1A1 and was dominated by the Pseudomonadaceae family, potentially associated with fibrosis. Cluster 2 showed high COMP transcription and low MMP13, with a high level of species\n                      <jats:italic>Acinetobacter johnsonii<\/jats:italic>\n                      , which may affect matrix regeneration. Cluster 5 had high ADAMTS4 and abundant Streptococcus agalactiae, highlighting cartilage degradation in OA progression and infection risk in arthroplasty. Inflammation-driven destruction, as indicated by high MCP1 and CCR2 levels, was pronounced in Cluster 4 patients, with nine key taxa correlated with NTRK1, suggesting their role in pain sensitization. Regarding mechanosensitivity, Cluster 3 featured high TRPV4 expression and a predominance of the Mycobacteriales order, suggesting a link between mechanosensitivity and aging. Cluster 6 had secondary high levels of CCR2 and PIEZO1, indicating mechanoflammation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study unveiled OA cartilage heterogeneity and highlighted the potential of using replaced cartilage, which may offer valuable clues for joint health assessment and future research into arthroplasty prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1852881","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:30:13Z","timestamp":1786339813000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Deciphering osteoarthritis cartilage heterogeneity: gene expression-guided patient stratification and microbiome correlations"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaohong","family":"Huang","sequence":"first","affiliation":[{"name":"Shandong Institute of Traumatic Orthopedics, Medical Research Center, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxu","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Medicine, Nankai University","place":["Tianjin, China"]},{"name":"Knee Preservation Center, Department of Orthopedics, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianrui","family":"Wang","sequence":"additional","affiliation":[{"name":"Knee Preservation Center, Department of Orthopedics, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Third Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengbo","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingze","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shandong Institute of Traumatic Orthopedics, Medical Research Center, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]},{"name":"School of Medicine, Nankai University","place":["Tianjin, China"]},{"name":"Knee Preservation Center, Department of Orthopedics, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]},{"name":"Department of Orthopedics, The Third Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1387651","DOI":"10.3389\/fimmu.2024.1387651","article-title":"Harmonizing hope: Navigating the osteoarthritis melody through the CCL2\/CCR2 axis for innovative therapeutic avenues.","volume":"15","author":"Abbasifard","year":"2024","journal-title":"Front. 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