{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T08:55:33Z","timestamp":1765184133705,"version":"3.46.0"},"reference-count":54,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objectives: To assess gastrointestinal permeability (GP) in children with Juvenile Idiopathic Arthritis (JIA) using a segment-specific sugar probe approach to assess gastric, small intestinal, and colonic permeability, and to determine whether GP alterations are associated with disease activity. Methods: This prospective study included 30 children with JIA and 22 healthy controls who underwent a validated multi-sugar absorption test. Urinary excretion of sucrose, lactulose, mannitol, and sucralose was measured to evaluate gastric, small intestinal, and colonic permeability. All JIA patients had discontinued immunosuppressive therapy for at least three months before testing. None had a relapse of the disease. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score (JADAS10). Comparisons were conducted between patients and controls and between remission and active disease groups. Results: None of the participants reported gastrointestinal manifestations. The lactulose\/mannitol (LA\/MA) ratio, a global index of small intestinal permeability, showed no significant difference between JIA patients and controls, suggesting preserved overall barrier function. However, urinary excretion of lactulose, mannitol, and sucralose was significantly higher in JIA patients, while sucrose excretion was significantly lower, indicating segment-specific alterations in small intestinal, colonic, and gastric permeability. These abnormalities were consistently present, even in patients in clinical remission. No statistically significant differences were observed between remission and active disease groups, though a trend toward increased permeability was noted in the latter. Conclusions: Children with JIA exhibit segmental GP alterations that persist independently of clinical disease activity. Despite the relatively small population, this exploratory study suggests subclinical mucosal dysfunction and the need for further investigation into how the gut\u2013joint axis may be playing a role in JIA pathogenesis, including via intestinal microbiota.<\/jats:p>","DOI":"10.3390\/children12121663","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T08:21:43Z","timestamp":1765182103000},"page":"1663","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Regional Gastrointestinal Permeability Patterns in Juvenile Idiopathic Arthritis: A Window into Subclinical Inflammation and Microbiota-Driven Disease Mechanisms"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5235-2900","authenticated-orcid":false,"given":"Francesco","family":"La Torre","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Pediatric Rheumatology Center, Giovanni XXIII Paediatric Hospital, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Marasciulo","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"La Grasta","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa Nadia","family":"Dargenio","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania Paola","family":"Castellaneta","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Amati","sequence":"additional","affiliation":[{"name":"Paediatric and Neonatology Unit, Department of Developmental Medicine, San Paolo Hospital, Local Health Authority of Bari, 70123 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violetta","family":"Mastrorilli","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Pediatric Rheumatology Center, Giovanni XXIII Paediatric Hospital, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Sisto","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Pediatric Rheumatology Center, Giovanni XXIII Paediatric Hospital, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Pediatric Rheumatology Center, Giovanni XXIII Paediatric Hospital, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4603-974X","authenticated-orcid":false,"given":"Ruggiero","family":"Francavilla","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Cristofori","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, University of Bari Aldo Moro, 70126 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e15122","DOI":"10.1111\/1756-185X.15122","article-title":"The role of microbiota on rheumatoid arthritis onset","volume":"27","year":"2024","journal-title":"Int. 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