While this study was the first to explore the differential expressions and significance of intracellular and extracellular GRP78/Bip in relation to disease activity and progression of RA, and points to the significance of subject-specific changes in GRP78/Bip in serum, SF, and synovium, additional molecular cell research, animal or in vitro experiments, and clinical studies are necessary to evaluate the effects of GRP78/Bip so as to provide further comprehensive evidence and guidance for its diagnostic value and clinical application in RA. This evidence concerns the gene HSPA5 and rheumatoid arthritis.