Maliha Mashkoor, Shihua Zhang, Allan Stensballe
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by complex immune cell associations and continuous joint damage. Personalized clinical assessment and treatment options for RA remain hindered by a precision gap due to an inability to precisely match current global treatment strategies to individual molecular and spatial disease profiles. Recent advances in spatial transcriptomics and proteomics offer unprecedented opportunities to map molecular heterogeneity and spatial heterogeneity within RA tissues by identifying immune microenvironments activated during the disease, thus enabling precise therapeutic targeting. These techniques address the precision gap in RA by identifying distinct pathogenic subpopulations and cellular niches, providing insights into the biomolecules that possess significant therapeutic responses and are involved in disease progression. This review synthesizes recent findings demonstrating how spatial omics technologies, including spatial transcriptomics and proteomics, together with artificial intelligence, are transforming precision rheumatology.