Abstract
Rheumatoid arthritis (RA) is an autoimmune disorder characterized by persistent synovial inflammation and progressive joint destruction, with a rising global prevalence. By 2050, the age-standardized incidence rate is projected to reach 16.78 per 1,00,000 women and 7.85 per 1,00,000 men. In recent years, exosomes (EXOs) - membrane-bound vesicles (30-150 nm in diameter) that mediate intercellular communication by shuttling proteins, nucleic acids, and lipids - have emerged as promising targets for unraveling RA pathogenesis and developing novel therapies. As key carriers of biological signals, EXOs regulate synovial microenvironment dynamics, including fibroblast-like synoviocyte activation, macrophage polarization, and inflammatory cytokine secretion, thereby playing dual roles in promoting or alleviating RA progression. However, research at this interdisciplinary nexus remains fragmented, lacking systematic synthesis. To address this gap, we employed CiteSpace software to generate a knowledge map from 244 Web of Science Core Collection documents (2000-2025), analyzing global research trends, thematic evolution, and collaborative networks. Key findings include: Growth in academic output: the number of publications continues to rise year by year, with the total number of citations exceeding 9723, significantly enhancing academic influence. Geographical distribution: China leads with 145 publications (centrality = 0.57), followed by the United States. Notably, emerging research hubs in Iran and Germany have recently intensified activity. Thematic priorities: research hotspots cluster around 3 domains: anti-inflammatory activity of EXOs (e.g., M2 macrophage-derived EXOs modulating immune balance), metabolic reprogramming of fibroblast-like synoviocytes regulated by EXO-carried molecules (e.g., circRNAs, miRNAs), and cell-free DNA (cfDNA)-driven immune dysregulation and EXOs-mediated cfDNA clearance. Frontier areas include engineered EXOs delivery systems (e.g., targeted modification for joint enrichment) and cfDNA-mediated immunomodulatory mechanisms. Collaborative landscape: while international partnerships have formed, interdisciplinary integration remains biased toward biomedical sciences. Contributions from materials science and artificial intelligence remain nascent, underscoring opportunities for cross-sector innovation. This analysis provides the first comprehensive knowledge framework for the RA-EXOs interface, offering researchers a roadmap for strategic topic selection, collaboration, and translational innovation toward next generation RA therapies.