Evidence map›Paper›PMID 40527852›Full record

ArticleMedicine2025

Unraveling the causal nexus of cathepsins and rheumatoid arthritis: Insights from a two-sample Mendelian randomization framework.

Han Zhang, Jian Zhang, Xiao Ma, Xiaohong Huang, Dongxu Zhu, Tianrui Wang, Wanlu Liu, Guanhong Chen, Yingze Zhang, Tengbo Yu

Abstract read
In one paragraph

Article in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Han ZhangDepartment of Orthopedics, Affiliated Hospital of Qingdao University, Qingdao, China.
Jian ZhangDepartment of Traumatology, Fushan People's Hospital, Yantai, China.
Xiao MaDepartment of Orthopedics, Affiliated Hospital of Qingdao University, Qingdao, China.
Xiaohong HuangMedical Research Center, Shandong Institute of Traumatic Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China.
Dongxu ZhuDepartment of Orthopedics, Affiliated Hospital of Qingdao University, Qingdao, China.
Tianrui WangDepartment of Orthopedics, Affiliated Hospital of Qingdao University, Qingdao, China.
Wanlu LiuDepartment of Paediatrics, Shanxian Central Hospital, Heze, China.
Guanhong ChenDepartment of Orthopaedics, Shanxian Central Hospital, Heze, China.
Yingze ZhangDepartment of Orthopedics, Affiliated Hospital of Qingdao University, Qingdao, China.
Tengbo YuDepartment of Orthopedics, Qingdao Municipal Hospital, Qingdao, China.ORCID 0009-0003-6597-1342

Funding

Qingdao Science and Technology Benefit People Demonstration Guide Special Project 22-3-7-smjk-5-nshShandong Province Major Scientific and Technical Innovation Project 2021SFGC0502Shandong Provincial Natural Science Foundation Project ZR2023MH205
6 · The paper itself

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease attacking joints throughout the body. Cathepsins (CTSs) are essential intracellular proteases participating in immune regulation, bone remodeling, and cartilage degradation. Though the observational and experimental studies have linked the biological functions of CTSs to the pathogenesis of RA, the cause-and-effect relationship between CTSs and RA remains unclear. Mendelian randomization (MR) recruited the single nucleotide polymorphism (SNP) associations of CTSs, including CTSB, CTSE, CTSF, CTSG, CTSH, CTSO, CTSS, CTSL2, and CTSZ, from 3301 individuals in the genome-wide association studies datasets to link the causal relationships between CTSs and RA (8255 RA cases and 409,001 controls). Inverse-variance weighted (IVW), MR-Egger, and weighted median (WM) methods were employed to reinforce the casual relationship. Robust sensitivity analyses, including the Cochran Q test, MR-Egger intercept test, and leave-one-out method, were conducted to validate the reliability. A significant causal correlation between CTSS and RA was identified post Bonferroni correction indicated by IVW (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.02-1.07, P = 5.15 × 10-4), MR-Egger test (OR: 1.06, 95% CI: 1.02-1.10, P = 4.71 × 10-3), and WM (OR: 1.04, 95% CI: 1.01-1.07, P = .018). The reliability and consistency of our findings were confirmed. Specifically, no statistical heterogeneity among SNPs was identified (IVW, Q = 35.001, P = .832; MR-Egger, Q = 33.860, P = .839), nor did the evidence for horizontal pleiotropy (MR-Egger intercept test, P = .291). No SNP exerted a substantial impact on the outcome (leave-one-out method). Moreover, the remaining 8 CTSs did not exhibit causal relationship with RA (IVW, MR-Egger test, and WM, P > .05). And, the MR Steiger test confirmed the correctness of directionality. Elevated CTSS levels increased RA risk, which suggests a great potential of CTSS to serve a promising biomarker in RA prediction and prognosis and shows light on developing a CTSS-based therapeutic strategy in RA treatment.

Indexed as

Arthritis, RheumatoidCathepsinsGenetic Predisposition to DiseaseGenome-Wide Association StudyHumansMendelian Randomization AnalysisPolymorphism, Single NucleotideCathepsinscathepsinscausal relationshipCTSSMendelian randomizationrheumatoid arthritis

Identifiers

PMID40527852
PMCPMC12173251

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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.