Rheumatoid arthritis synovium contains phenotypically and functionally heterogeneous fibroblast-like synoviocytes. Cutting-edge analyses have now defined at least four distinct states of these cells related to their location in the synovium, epigenetic imprinting and the influence of microenvironment mediators.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout

References
Zhang, F. et al. Defining inflammatory cell states in rheumatoid arthritis joint synovial tissues by integrating single-cell transcriptomics and mass cytometry. Nat. Immunol. 20, 928–942 (2019).
Smith, M. H. et al. Drivers of heterogeneity in synovial fibroblasts in rheumatoid arthritis. Nat. Immunol. https://doi.org/10.1038/s41590-023-01527-9 (2023).
Nygaard, G. & Firestein, G. S. Restoring synovial homeostasis in rheumatoid arthritis by targeting fibroblast-like synoviocytes. Nat. Rev. Rheumatol. 16, 316–333 (2020).
Müller-Ladner, U. et al. Synovial fibroblasts of patients with rheumatoid arthritis attach to and invade normal human cartilage when engrafted into SCID mice. Am. J. Pathol. 149, 1607–1615 (1996).
Ainsworth, R. I. et al. Systems-biology analysis of rheumatoid arthritis fibroblast-like synoviocytes implicates cell line-specific transcription factor function. Nat. Commun. 13, 6221 (2022).
Yan, M. et al. ETS1 governs pathological tissue-remodeling programs in disease-associated fibroblasts. Nat. Immunol. 23, 1330–1341 (2022).
Wei, K. et al. Notch signalling drives synovial fibroblast identity and arthritis pathology. Nature 582, 259–264 (2020).
Boyle, D. L. et al. Improving transcriptome fidelity following synovial tissue disaggregation. Front. Med. 9, 919748 (2022).
Firestein, G. S. Invasive fibroblast-like synoviocytes in rheumatoid arthritis. Passive responders or transformed aggressors? Arthritis Rheum. 39, 1781–1790 (1996).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
G.S.F. declares that he has received a research grant from Eli Lilly. C.R.L.M. declares no competing interests.
Supplementary information
Rights and permissions
About this article
Cite this article
Machado, C.R.L., Firestein, G.S. Fibroblast multiplicity in RA: a synovial state of affairs. Nat Rev Rheumatol 19, 609–610 (2023). https://doi.org/10.1038/s41584-023-01015-2
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41584-023-01015-2