Accumulating evidence indicates that the gut microbiome plays a critical role in the pathology of osteoarthritis (OA).45 Earlier studies have shown that spontaneous T cell-dependent Rheumatoid Arthritis (RA) cannot be induced in IL-1αR−/−mice under GF conditions.46 In toll-like receptor 4 (TLR4)-deficient mice, RA manifestations were also significantly inhibited, and the gut microbiota was thought to act as an antigen or adjuvant to induce or assist RA production.46,47 The gut microbiota also has an impact on the development of traumatic OA. This evidence concerns the gene TLR4 and rheumatoid arthritis.