{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:20:48Z","timestamp":1785903648979,"version":"3.56.0"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T00:00:00Z","timestamp":1695340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012041","name":"Versus Arthritis","doi-asserted-by":"publisher","award":["21228"],"award-info":[{"award-number":["21228"]}],"id":[{"id":"10.13039\/501100012041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We investigated intestinal permeability and fecal, plasma, and urine metabolomic profiles in methotrexate\u2010treated active psoriatic arthritis (PsA) and how this related to clinical response following one sham or fecal microbiota transplantation (FMT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This exploratory study is based on the FLORA trial cohort, in which 31 patients with moderate\u2010to\u2010high peripheral PsA disease activity, despite at least 3 months of methotrexate\u2010treatment, were included in a 26\u2010week, double\u2010blind, 1:1 randomized, sham\u2010controlled trial. Participants were randomly allocated to receive either one healthy donor FMT (n\u00a0=\u00a015) or sham (n\u00a0=\u00a016) via gastroscopy. The primary trial end point was the proportion of treatment failures through 26\u2009weeks. We performed a lactulose\u2010to\u2010mannitol ratio (LMR) test at baseline (n\u00a0=\u00a031) and at week 26 (n\u00a0=\u00a026) to assess small intestinal permeability. Metabolomic profiles in fecal, plasma, and urine samples collected at baseline, weeks 4, 12, and 26 were measured using <jats:sup>1<\/jats:sup>H Nuclear Magnetic Resonance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Trial failures (n\u00a0=\u00a07) had significantly higher LMR compared with responders (n\u00a0=\u00a019) at week 26 (0.027 [0.017\u20100.33]) vs. 0.012 [0\u20100.064], <jats:italic>P<\/jats:italic> =\u20090.013), indicating increased intestinal permeability. Multivariate analysis revealed a significant model for responders (n\u00a0=\u00a019) versus failures (n\u00a0=\u00a012) at all time points based on their fecal (<jats:italic>P<\/jats:italic> &lt;\u20090.0001) and plasma (<jats:italic>P<\/jats:italic> =\u20090.005) metabolomic profiles, whereas urine metabolomic profiles did not differ between groups (<jats:italic>P<\/jats:italic> =\u20091). Fecal N\u2010acetyl glycoprotein GlycA correlated with Health Assessment Questionnaire Disability Index (coefficient\u00a0=\u00a00.50; <jats:italic>P<\/jats:italic> =\u20090.03) and fecal propionate correlated with American College of Rheumatology 20 response at week 26 (coefficient\u00a0=\u00a027, <jats:italic>P<\/jats:italic> =\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intestinal permeability and fecal and plasma metabolomic profiles of patients with PsA were associated with the primary clinical trial end point, failure versus responder.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11604","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T04:02:33Z","timestamp":1695355353000},"page":"583-593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Small Intestinal Permeability and Metabolomic Profiles in Feces and Plasma Associate With Clinical Response in Patients With Active Psoriatic Arthritis Participating in a Fecal Microbiota Transplantation Trial: Exploratory Findings From the <scp>FLORA<\/scp> Trial"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9641-9065","authenticated-orcid":false,"given":"Maja Skov","family":"Kragsnaes","sequence":"first","affiliation":[{"name":"Odense University Hospital and University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Miguens Blanco","sequence":"additional","affiliation":[{"name":"Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6300-3100","authenticated-orcid":false,"given":"Benjamin H.","family":"Mullish","sequence":"additional","affiliation":[{"name":"Imperial College London and St. Mary's Hospital, Imperial College Healthcare National Health Service Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Ivan","family":"Serrano\u2010Contreras","sequence":"additional","affiliation":[{"name":"Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Kjeldsen","sequence":"additional","affiliation":[{"name":"Odense University Hospital and University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Christian","family":"Horn","sequence":"additional","affiliation":[{"name":"Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Kristian","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Odense University Hospital and University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi Lausten","family":"Munk","sequence":"additional","affiliation":[{"name":"Odense University Hospital  Odense, and Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Christine","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ash","family":"Salam","sequence":"additional","affiliation":[{"name":"Imperial College London, Hammersmith Hospital Campus  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Imperial College London, Hammersmith Hospital Campus  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Chekmeneva","sequence":"additional","affiliation":[{"name":"Imperial College London, Hammersmith Hospital Campus  London 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