Advances in the Application of Single-Cell Transcriptomics to Studies of Arthritis Pathogenesis and Treatment with Traditional Chinese Medicine
Arthritis incidence has risen steadily, with complex and protracted pathological progression; it remains among the leading causes of disability worldwide. Existing therapeutic approaches, including traditional Chinese medicine (TCM) hot compress and acupuncture, provide symptomatic relief but rarely achieve disease modification, and some carry adverse effects. TCM's multi-component, multi-target, multi-pathway characteristics are mechanistically compatible with arthritis heterogeneity, yet its pharmacodynamic basis remains poorly resolved at the cellular level. Bulk RNA sequencing averages transcriptional signals across cell populations, obscuring rare pathogenic subpopulations and cell-state transitions. Single-cell RNA sequencing (scRNA-seq) resolves gene expression heterogeneity at single-cell resolution, enabling construction of joint tissue cellular atlases and identification of key subpopulations and molecular targets driving disease progression. This review systematically summarizes the technical advantages of scRNA-seq relative to bulk RNA-seq, including platforms such as 10× Genomics and BD, and examines its application to rheumatoid arthritis, osteoarthritis, and gouty arthritis. It further discusses prospects and challenges for integrating scRNA-seq into TCM-based arthritis research, including cell-cell communication inference, macrophage M1/M2 polarization analysis, and SPP1+ chondrocyte identification, providing a reference for mechanistic studies and development of novel Chinese herbal therapeutics.