Potential role of bile acids as a microbiome-derived mechanism in synovitis of knee osteoarthritis synovitis
Authors' conclusion
Detection of BAs and their receptors in synovial tissue, together with their modulatory effects on synovial cells, supports a potential biological role for BAs in KOA.
Study context
- Population
- Radiographic knee OA patients with complete datasets; Bile acids (BAs) profiled in plasma or synovial fluid (SF)plasma N=28 · BAs profiled in plasma 28 · or SF 29
- Participants
- 16 vs 12
- Comparison
- High-grade vs low-grade synovitis in knee OA
- Low-grade synovitisn = 16reference
- High-grade synovitisn = 12
- Outcome
- Relationship between bile acids and synovitis in knee OA
Methodological detailsin vitro experiments
- In vitro experiments
Main finding
As reported in the abstract
Plasma bile acids by synovitis grade
Glycohyodeoxycholic acid (per-group values above)
0.76
95% CI 0.04–1.89
Lithocholic acid
0.63
95% CI 0.00–1.58
Low-grade synovitis
1.198
± 0.983
High-grade synovitis
1.954
± 0.686
Further findings
LPS-binding protein (LBP) correlation with synovitis, obese participants (BMI ≥ 30)
- Rho
- 0.58
- p
- P = 0.037
- 95% CI
- −0.807-0.46
- Only in obese participants
LBP, lithocholic acid and glycohyodeoxycholic acid predicting high synovitis
- Sensitivity
- 92%
- Specificity
- 75%
- AUC
- 0.875
- AUC 95% CI
- 0.99-1.05
- p
- P < 0.001
SF taurodeoxycholic and glycohyodeoxycholic acids vs WOMAC
- Correlated positively with WOMAC pain and stiffness subscores and total WOMAC
BA receptors in synovial tissue
- TGR5 and LXR present in synovial tissue
In vitro effect of BAs
- BAs reduced cytokine secretion in fibroblast-like synoviocytes (FLS) and bone marrow-derived macrophages (BMDM)
Original publication
Potential role of bile acids as a microbiome-derived mechanism in synovitis of knee osteoarthritis synovitis. Osteoarthritis Cartilage. Published 26 February 2026. doi:10.
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