{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:46:47Z","timestamp":1793296007848,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 \u22642.6) were analyzed. Multivariate models explored links between intestinal, inflammatory, and treatment response biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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&amp;lt;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 (\u03b2=0.314) and IL-1\u03b2 (\u03b2=0.416); claudin-1 with male sex (\u03b2=\u20130.342); and zonulin with lower IL-1\u03b2 (\u03b2=\u20130.313) and higher resistin (\u03b2=0.294).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1756621","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T15:05:47Z","timestamp":1774623947000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Association between intestinal permeability, systemic inflammation, and response to anti-TNF therapy in patients with rheumatoid arthritis: a prospective controlled study"],"prefix":"10.3389","volume":"17","author":[{"given":"Aimara","family":"Garc\u00eda-Studer","sequence":"first","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina-Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA) Plataforma Centro Andaluz de Nanomedicina y Biotecnolog\u00eda (BIONAND)","place":["M\u00e1laga, Spain"]},{"name":"Unidad de Gesti\u00f3n Cl\u00ednica (UGC) de Reumatolog\u00eda, Hospital Regional Universitario de M\u00e1laga","place":["M\u00e1laga, Spain"]},{"name":"Departamento de Medicina. 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