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Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis

  • Authors:
    • Dengfeng Wu
    • Yihan Deng
    • Yiping Huang
    • Jun Zhao
    • Wei Long
    • Yilin Peng
    • Zhenfang Xiong
    • Rui Wu
  • View Affiliations / Copyright

    Affiliations: Department of Rheumatology and Immunology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, P.R. China, First Clinical Medical School, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China, Department of Pathology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
    Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 58
    |
    Published online on: January 24, 2025
       https://doi.org/10.3892/etm.2025.12808
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Abstract

The General Synovitis Score (GSS) is a well‑established method for scoring synovial inflammation. Despite its widespread use, the GSS does not fully capture the inflammatory manifestations characteristic of the synovium in rheumatoid arthritis (RA). To address this limitation, the modified GSS (mGSS) was developed. The present study compared the correlation of the mGSS and the GSS with clinical disease activity. The aim was to provide a more precise histopathological scoring system based on hematoxylin and eosin (H&E) staining for assessing synovial inflammation in patients with active RA. In this cross‑sectional study, synovial tissues were obtained from 60 patients with RA using a novel synovial biopsy device. Sections from synovial tissues were stained with H&E, and were assessed using the GSS and the mGSS. Neovascularization was observed in 56 patients (93.3%) and was significantly correlated with disease activity score in 28 joints‑C‑reactive protein (DAS28‑CRP) (ρ=0.49; P<0.001), erythrocyte sedimentation rate (ESR) (ρ=0.44; P<0.001) and CRP (ρ=0.51; P<0.001). In addition, patients with severe neovascularization had significantly higher DAS28‑CRP, ESR and CRP levels than those with mild‑to‑moderate neovascularization (P<0.05). Synoviocyte detachment, which occurred in nine patients (15.0%), was associated with higher DAS28‑CRP, ESR and CRP levels than in the patients with synoviocyte proliferation (P<0.05). Furthermore, the mGSS was more strongly correlated with DAS28‑CRP (ρ=0.62; P<0.001) than the GSS (ρ=0.37; P=0.003). These findings indicated that neovascularization and synoviocyte detachment, which are critical yet often overlooked aspects in the traditional GSS, are important in RA. Incorporating these elements into the mGSS may enhance the assessment of disease activity, providing a more precise and accurate evaluation of the synovial histopathology in patients with RA.
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Copy and paste a formatted citation
Spandidos Publications style
Wu D, Deng Y, Huang Y, Zhao J, Long W, Peng Y, Xiong Z and Wu R: Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis. Exp Ther Med 29: 58, 2025.
APA
Wu, D., Deng, Y., Huang, Y., Zhao, J., Long, W., Peng, Y. ... Wu, R. (2025). Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis. Experimental and Therapeutic Medicine, 29, 58. https://doi.org/10.3892/etm.2025.12808
MLA
Wu, D., Deng, Y., Huang, Y., Zhao, J., Long, W., Peng, Y., Xiong, Z., Wu, R."Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis". Experimental and Therapeutic Medicine 29.3 (2025): 58.
Chicago
Wu, D., Deng, Y., Huang, Y., Zhao, J., Long, W., Peng, Y., Xiong, Z., Wu, R."Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis". Experimental and Therapeutic Medicine 29, no. 3 (2025): 58. https://doi.org/10.3892/etm.2025.12808
Copy and paste a formatted citation
x
Spandidos Publications style
Wu D, Deng Y, Huang Y, Zhao J, Long W, Peng Y, Xiong Z and Wu R: Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis. Exp Ther Med 29: 58, 2025.
APA
Wu, D., Deng, Y., Huang, Y., Zhao, J., Long, W., Peng, Y. ... Wu, R. (2025). Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis. Experimental and Therapeutic Medicine, 29, 58. https://doi.org/10.3892/etm.2025.12808
MLA
Wu, D., Deng, Y., Huang, Y., Zhao, J., Long, W., Peng, Y., Xiong, Z., Wu, R."Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis". Experimental and Therapeutic Medicine 29.3 (2025): 58.
Chicago
Wu, D., Deng, Y., Huang, Y., Zhao, J., Long, W., Peng, Y., Xiong, Z., Wu, R."Refining synovial inflammation assessment: A modified General Synovitis Score for active rheumatoid arthritis". Experimental and Therapeutic Medicine 29, no. 3 (2025): 58. https://doi.org/10.3892/etm.2025.12808
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