ArticleArthritis & rheumatology (Hoboken, N.J.)2020
Rheumatoid Arthritis Morning Stiffness Is Associated With Synovial Fibrin and Neutrophils.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- A Systemic Review on Nutraceutical Supplements used in the Management of Osteoarthritis.Recent advances in food, nutrition & agriculture · 2024Pooled it
- Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Rheumatoid Arthritis: A Network Meta-Analysis of Randomized Controlled Trials.Frontiers in immunology · 2022Pooled it
- Trial
- The Effects and Potential Mechanisms of Moxibustion for Rheumatoid Arthritis-Related Pain: A Randomized, Controlled Trial.Journal of pain research · 2023Trial
- Low Dose Radiation Therapy Induces Long-Lasting Reduction of Pain and Immune Modulations in the Peripheral Blood - Interim Analysis of the IMMO-LDRT01 Trial.Frontiers in immunology · 2021Trial
- Sources of Knowledge, Family and Peer Support, Disclosure, and Posting on Social Media Platforms Among Patients with Systemic Autoimmune Rheumatic Diseases (SARDs): A Survey-Based Cross-Sectional Study.Journal of patient experience · 2026Article
- Novel insights into the biology of childhood arthritis- lessons learned from the synovium.Arthritis research & therapy · 2025Review
- ALKBH5 Regulates Apoptosis of Rheumatoid Arthritis Fibroblast-like Synoviocytes by Modulating miR-181b-5p Maturation via m6A Demethylation.Journal of musculoskeletal & neuronal interactions · 2025Article
- Association between knee stiffness and MRI-detected lesions: data from the osteoarthritis initiative (OAI).BMC musculoskeletal disorders · 2025Article
- Pathogenic and Regulatory Roles of Fibrinolytic Factors in Autoimmune Diseases.Current issues in molecular biology · 2025Review
- Neutrophil extracellular traps in rheumatoid arthritis: pathogenic mechanisms and therapeutic potential.Frontiers in immunology · 2025Review
- Patient-Reported Fatigue Associated with Joint Histopathology in Rheumatoid Arthritis.ACR open rheumatology · 2025Article
- Juvenile Idiopathic Arthritis.Indian journal of pediatrics · 2024Review
- Molecular maps of synovial cells in inflammatory arthritis using an optimized synovial tissue dissociation protocol.iScience · 2024Article
- Explainable deep learning for disease activity prediction in chronic inflammatory joint diseases.PLOS digital health · 2024Article
- Vigeo attenuates cartilage and bone destruction in a collagen‑induced arthritis mouse model by reducing production of pro‑inflammatory cytokines.Experimental and therapeutic medicine · 2024Article
- Review
- Therapeutic Efficacy of Medicinal Plants with Allopathic Medicine in Musculoskeletal Diseases.International journal of plant, animal and environmental sciences · 2024Article
- Neutrophil-to-lymphocyte ratio combined with albumin to globulin ratio for predicting rheumatoid arthritis-associated pneumonia.American journal of translational research · 2024Article
- Knowledge of Common Symptoms of Rheumatic Diseases and Causes of Delayed Diagnosis in Saudi Arabia.Patient preference and adherence · 2024Article
Corrections and comments
Authors and funding
14 authors at 6 institutions in 2 countries.
Funding
Abstract
objectiveMorning stiffness is a hallmark symptom of rheumatoid arthritis (RA), but its etiology is poorly understood. This study was undertaken to determine whether any histologic features of synovium are associated with this symptom.
methodsData on patient-reported morning stiffness duration and severity, and Disease Activity Score in 28 joints (DAS28) were collected from 176 patients with RA undergoing arthroplasty. Synovium was scored for 10 histopathologic features: synovial lining hyperplasia, lymphocytes, plasma cells, Russell bodies, binucleate plasma cells, fibrin, synovial giant cells, detritus, neutrophils, and mucin. Fibrinolysis of clots seeded with various cell types was measured in turbidimetric lysis assays.
resultsStiffness severity and morning stiffness duration were both significantly associated with DAS28 (P = 0.0001 and P = 0.001, respectively). None of the synovial features examined were associated with patient-reported stiffness severity. The presence of neutrophils and fibrin in RA synovial tissue were significantly associated (P < 0.0001) with patient-reported morning stiffness of ≥1 hour, such that 73% of patients with both synovial fibrin and neutrophils reported morning stiffness of ≥1 hour. Further, neutrophils and fibrin deposits colocalized along the synovial lining. In in vitro analyses, fibrin clots seeded with necrotic neutrophils were more resistant to fibrinolysis than those seeded with living neutrophils or no cells (P = 0.008). DNase I treatment of necrotic neutrophils abrogated the delay in fibrinolysis.
conclusionIn RA, prolonged morning stiffness may be related to impaired fibrinolysis of neutrophil-enmeshed fibrin deposits along the synovial membrane. Our findings also suggest that morning stiffness severity and duration may reflect distinct pathophysiologic phenomena.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.