Evidence mapPaperPMID 41972162Full record

ArticleFrontiers in immunology2026

Association between intestinal permeability, systemic inflammation, and response to anti-TNF therapy in patients with rheumatoid arthritis: a prospective controlled study.

Aimara García-Studer, Arkaitz Mucientes, Jose Manuel Lisbona-Montañez, Patricia Ruiz-Limón, Sara Manrique-Arija, Fernando Ortiz-Márquez, Christopher Hinestroza-Echavarría, Laura Cano-García, Natalia Mena-Vázquez, Antonio Fernández-Nebro

Abstract read
In one paragraph

Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Aimara García-StuderInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Arkaitz MucientesInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Jose Manuel Lisbona-MontañezInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Patricia Ruiz-LimónInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Sara Manrique-ArijaInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Fernando Ortiz-MárquezInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Christopher Hinestroza-EchavarríaInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Laura Cano-GarcíaInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Natalia Mena-VázquezInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.
Antonio Fernández-NebroInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnología (BIONAND), Málaga, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: To evaluate the association between biomarkers related to intestinal epithelial barrier integrity, systemic inflammation, and clinical response to anti-TNF therapy in patients with rheumatoid arthritis (RA). Methods: A prospective controlled 24-week study of patients with active RA receiving anti-TNF therapy was performed. Findings were compared with those of age- and sex-matched healthy controls. Values of tight junction proteins (occludin, claudin-1), zonulin, lipopolysaccharide (LPS), and LPS-binding protein (LBP) were determined in serum and feces at baseline and at 6 months. The associations with clinical, inflammatory, and remission parameters (DAS28-CRP ≤2.6) were analyzed. Multivariate models explored links between intestinal, inflammatory, and treatment response biomarkers. Results: The study population comprised 70 patients with RA and 70 controls. Baseline serum levels of occludin and claudin-1 were lower in patients than in controls (p<0.001). After 6 months, systemic inflammation had improved significantly, and values of several biomarkers had returned to normal in patients who achieved clinical remission. In multivariate analysis, higher baseline occludin and claudin-1 levels were associated with a greater probability of achieving remission (OR = 1.04, and 1.02, respectively). Average HAQ was inversely associated with remission (OR = 0.26). Increased occludin after anti-TNF was associated with baseline DAS28-CRP (β=0.314) and IL-1β (β=0.416); claudin-1 with male sex (β=-0.342); and zonulin with lower IL-1β (β=-0.313) and higher resistin (β=0.294). Conclusions: Biomarkers of intestinal integrity, especially serum occludin, are altered in patients with RA and were associated with response to anti-TNF. Disruption of the intestinal barrier, as reflected by these indirect markers, is associated with systemic inflammation, thus reinforcing the gut-joint axis as a potential therapeutic target.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidIntestinal MucosaTumor Necrosis Factor-alphaAdultAgedBiomarkersClaudin-1FemaleHaptoglobinsHumansInflammationIntestinal Barrier FunctionLipopolysaccharide-Binding ProteinMaleMiddle AgedAntirheumatic AgentsBiomarkersClaudin-1HaptoglobinsLipopolysaccharide-Binding ProteinOccludinProtein PrecursorsTumor Necrosis Factor-alphazonulinanti-TNFinflammationintestinal permeabilityrheumatoid arthritistight junction proteins

Identifiers

PMID41972162
PMCPMC13067904

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.