SEARCHNARRATIVE_REVIEWrheumatology, gastroenterology

narrative_review·rheumatology, gastroenterology, immunology, microbiology·PMC10015446

Relationship between gut microbiota and rheumatoid arthritis: A bibliometric analysis

Frontiers in Immunology · 15 authors, 2 centres

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This bibliometric analysis of 459 publications (2004–2022) maps the research landscape on gut microbiota (GM) in rheumatoid arthritis (RA), showing rapid growth since 2013 with China and the United States as leading contributors. The study identifies that research has moved from establishing the association between GM and RA toward exploring mechanisms (e.g., Th17/Treg balance, short-chain fatty acids) and therapeutic applications (probiotics, diet, drug modulation). The clinical significance lies in providing a structured roadmap for future research directions, highlighting that while the GM-RA link is well-established, detailed mechanistic and translational work remains needed.

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**Background:** Rheumatoid arthritis (RA) is a chronic autoimmune disease with high disability, involving both genetic and environmental factors. Over 100 trillion microbes inhabit the human gut, and accumulating evidence suggests gut microbiota (GM) plays a notable role in RA pathogenesis. Despite growing research, no prior bibliometric study had systematically mapped this field. This study aimed to depict the knowledge framework of GM in RA from a holistic perspective using bibliometric analysis.

**Methods:** Literature was searched in the Web of Science Core Collection (WOSCC) on November 14, 2022, covering publications from 1985 to 2022. Search terms combined "rheumatoid arthritis" with multiple GM-related terms (e.g., "gut microbiota," "intestinal microbiota," "fecal microbiota"). Only English articles and reviews were included, with manual exclusion of irrelevant reports. A total of 459 publications (255 original research articles, 204 reviews) were analyzed. Bibliometric software VOSviewer v1.6.18.0 and Bibliometrix were used to analyze annual output, cooperation networks, author productivity, journal distribution, keyword co-occurrence, topic migration, and thematic maps.

**Key Results:** The earliest retrievable article was a 2004 review; the first original research article appeared in 2005. Annual publications remained low until 2013, which marked a growth explosion point, with sustained increases through 2022. Total citations reached 20,153 (10,659 for research articles, 9,494 for reviews), and the H-index reached 71 by 2022. Publications came from 64 countries/regions. China and the United States had the highest output and citations, though China's citations were less than half of the US's despite slightly more articles. Harvard University had the most publications (17 total: 10 research articles, 7 reviews), followed by New York University (16) and Mayo Clinic (15). Among 2,472 authors, Scher, Jose U. (New York University) and Taneja, Veena (Mayo Clinic) were the most productive and cited. Frontiers in Immunology published the most articles (32, IF=8.786) with the fastest growth rate, while eLife had the highest total citations (1,248 citations, IF=8.713) from just 2 articles. The most locally cited research articles were Zhang X, 2015 (Nat Med, LCS=107, GCS=847) and Scher JU, 2013 (eLife, LCS=102, GCS=1,090). Keyword co-occurrence analysis revealed four clusters: (1) association evidence between GM and RA (red cluster, 45 nodes); (2) therapeutic applications including probiotics, diet, and drug modulation (green cluster, 37 nodes); (3) experimental research focusing on metabolomics, short-chain fatty acids, and animal models (blue cluster, 37 nodes); (4) immune mechanisms involving T cells, Th17, Treg cells, and toll-like receptors (yellow cluster, 30 nodes). Recent hotspot keywords (circa 2020) included "metabolites," "metabolomics," "acid," "b cells," "balance," "treg cells," and "probiotic supplementation." The thematic map showed that association studies (Motor Themes quadrant) were well-developed, while mechanism and application research fell into Basic and Emerging quadrants, indicating they are important but still developing.

**Clinical Implications:** This study provides a data-driven, objective introduction to the GM-RA research field, offering researchers a valuable reference for understanding development trends and selecting future directions. The evidence base confirming a bidirectional relationship between GM and RA is solid—GM dysbiosis occurs in RA patients, can precede clinical symptoms, and can be partially restored with treatment. However, detailed mechanisms remain unclear, with only a few bacterial strains (e.g., Prevotella copi, Lactobacillus species) having specific RA reports. The field has moved from establishing association toward mechanistic exploration (Th17/Treg balance, short-chain fatty acids, molecular mimicry) and application development (probiotic supplementation, dietary intervention, drug-microbiome interactions). The authors note that most application studies remain at the surface level of efficacy plus microbiota identification without elucidating internal mechanisms. Future research should prioritize deeper mechanistic studies and translational work to develop new RA treatment strategies based on GM modulation.

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narrative_review

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rheumatology

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ORIGINAL PAPER

PMC10015446

Relationship between gut microbiota and rheumatoid arthritis: A bibliometric analysis

Frontiers in Immunology

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ABSTRACT

Introduction Rheumatoid arthritis (RA) is a multifactorial autoimmune disease. Recently, growing evidence demonstrates that gut microbiota (GM) plays an important role in RA. But so far, no bibliometric studies pertaining to GM in RA have ever been published. This study attempts to depict the knowledge framework in this field from a holistic and systematic perspective based on the bibliometric analysis. Methods Literature related to the involvement of GM in RA was searched and picked from the Web of Science Core Collection (WOSCC) database. The annual output, cooperation, hotspots, research status and development trend of this field were analyzed by bibliometric software (VOSviewer and Bibliometricx). Results 255 original research articles and 204 reviews were included in the analysis. The articles in this field that can be retrieved in WOSCC were first published in 2004 and increased year by year since then. 2013 is a growth explosion point. China and the United States are the countries with the most contributions, and Harvard University is the affiliation with the most output. Frontiers in Immunology (total citations = 603) is the journal with the most publications and the fastest growth rate. eLife is the journal with the most citations (total citations = 1248). Scher, Jose U. and Taneja, Veena are the most productive and cited authors. The research in this field is mainly distributed in the evidence, mechanism and practical application of GM participating in RA through the analysis of keywords and documents. There is sufficient evidence to prove the close relationship between GM and RA, which lays the foundation for this field. This extended two colorful and tender branches of mechanism research and application exploration, which have made some achievements but still have broad exploration space. Recently, the keywords ”metabolites“, ”metabolomics“, ”acid“, ”b cells“, ”balance“, ”treg cells“, ”probiotic supplementation“ appeared most frequently, which tells us that research on the mechanism of GM participating in RA and exploration of its application are the hotspots in recent years. Discussion Taken together, these results provide a data-based and objective introduction to the GM participating in RA, giving readers a valuable reference to help guide future research.

CITATION EXPORT

Ying Dong, Jianling Yao, Qingyue Deng et al.. Relationship between gut microbiota and rheumatoid arthritis: A bibliometric analysis. Frontiers in Immunology. (2023). https://doi.org/10.3389/fimmu.2023.1131933

AUTHORS

15 · 2 CENTRES

Ying Dong, Jianling Yao, Qingyue Deng, Xianxian Li, Yingyu He, Xueyang Ren, Yuan Zheng, Ruolan Song, Xiangjian Zhong, Jiamu Ma, Dongjie Shan, Fang Lv, Xiuhuan Wang, Ruijuan Yuan, Gaimei She

1 School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
2 Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China