Intestinal Permeability and Antigen Absorption in Rheumatoid Arthritis

Fagiolo, U; Paganelli, Roberto; Ossi, Elena; Quinti, Isabella; Cancian, Mauro; D’Offizi, Gianpiero; Fiocco, Ugo

doi:10.1159/000234930

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…This is seen more frequently in adults than in children due to the age‐related differences in medication use . The most commonly implicated medicines are nonsteroidal, anti‐inflammatory drugs (NSAIDs), which are thought to enhance the absorption of food allergens , as well as acting directly on effector cells . In NORA, NSAIDs were a suspected cofactor in 243 of 4917 (4.9%) reactions, almost all in adults (data to March 2014).…”

Section: Can We Predict Those At Risk Of Life‐threatening Reactions?mentioning

confidence: 99%

Can we identify patients at risk of life‐threatening allergic reactions to food?

Turner

Baumert

Beyer

et al. 2016

Allergy

200

207

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Anaphylaxis has been defined as a 'severe, life-threatening generalized or systemic hypersensitivity reaction'. However, data indicate that the vast majority of foodtriggered anaphylactic reactions are not life-threatening. Nonetheless, severe lifethreatening reactions do occur and are unpredictable. We discuss the concepts surrounding perceptions of severe, life-threatening allergic reactions to food by different stakeholders, with particular reference to the inclusion of clinical severity as a factor in allergy and allergen risk management. We review the evidence regarding factors that might be used to identify those at most risk of severe allergic reactions to food, and the consequences of misinformation in this regard. For example, a significant proportion of food-allergic children also have asthma, yet almost none will experience a fatal food-allergic reaction; asthma is not, in itself, a strong predictor for fatal anaphylaxis. The relationship between dose of allergen exposure and symptom severity is unclear. While dose appears to be a risk factor in at least a subgroup of patients, studies report that individuals with prior anaphylaxis do not have a lower eliciting dose than those reporting previous mild reactions. It is therefore important to consider severity and sensitivity as separate factors, as a highly sensitive individual will not necessarily experience severe symptoms during an allergic reaction. We identify the knowledge gaps that need to be addressed to improve our ability to better identify those most at risk of severe food-induced allergic reactions.

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Section: Can We Predict Those At Risk Of Life‐threatening Reactions?mentioning

confidence: 99%

Can we identify patients at risk of life‐threatening allergic reactions to food?

Turner

Baumert

Beyer

et al. 2016

Allergy

200

207

View full text Add to dashboard Cite

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“…In the 90’, several authors have evidenced that established RA patients have an increased intestinal absorption of orally administered probes, such as polyethylene glycol, or milk beta-lactoglobulin ( 7 , 25 , 26 ). However, if compromised intestinal mucosal integrity plays a role in the human RA pathogenesis, one would expect mucosal permeability to be altered prior to disease onset, during pre-clinical or early stages of RA ( 27 ).…”

Section: Introductionmentioning

confidence: 99%

Brief report: Assessment of mucosal barrier integrity using serological biomarkers in preclinical stages of rheumatoid arthritis

et al. 2023

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BackgroundThe pathogenesis of rheumatoid arthritis (RA) is believed to initiate at mucosal sites. The so-called ‘mucosal origin hypothesis of RA’ postulates an increased intestinal permeability before disease onset. Several biomarkers, including lipopolysaccharide binding protein (LBP) and intestinal fatty acid binding protein (I-FABP), have been proposed to reflect gut mucosa permeability and integrity, while serum calprotectin is a new inflammation marker proposed in RA.MethodsWe analyzed serum samples of individuals genetically at increased risk of RA in a nested-case-control study. Participants from a longitudinal cohort of first-degree relatives of RA patients (SCREEN-RA cohort) were divided into three pre-clinical stages of RA, based on the presence of risk factors for subsequent RA onset: 1) low-risk healthy asymptomatic controls; 2) intermediate-risk individuals without symptoms, but with RA-associated auto-immunity; 3) high-risk individuals with clinically suspect arthralgias. Five patients with newly diagnosed RA were also sampled. Serum LBP, I-FABP and calprotectin were measured using commercially available ELISA kits.ResultsWe included 180 individuals genetically at increased risk for RA: 84 asymptomatic controls, 53 individuals with RA-associated autoimmunity and 38 high risk individuals. Serum LBP, I-FAPB or calprotectin concentrations did not differ between individuals in different pre-clinical stages of RA.ConclusionBased on the serum biomarkers LBP, I-FABP and calprotectin, we could not detect any evidence for intestinal injury in pre-clinical stages of RA.

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“…They allowed linking impaired intestinal barrier function to diseases, such as celiac disease [62] or depression [63]. Evidence for increased gut permeability in established RA is weak [30,64,65], and mostly biased because of non-steroidal anti-inflammatory drugs (NSAIDs) use. Indeed, NSAIDs are known to induce small bowel lesions, referred to as NSAID-induced enteropathy.…”

Section: Hypothesis Linking Gut Microbiota To Ramentioning

confidence: 99%

“…NSAID (human data) [65]. Hyperglycemia (mice data) [85] Gliadin (mice data), increases intestinal permeability and exacerbates NSAID-induced small-intestinal damage.…”

Section: Impairing the Intestinal Barrier (Increased Permeability)mentioning

confidence: 99%

The Role of Nutritional Factors and Intestinal Microbiota in Rheumatoid Arthritis Development

2020

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Evidence about the role of nutritional factors and microbiota in autoimmune diseases, and in rheumatoid arthritis (RA) in particular, has grown in recent years, however many controversies remain. The aim of this review is to summarize the role of nutrition and of the intestinal microbiota in the development of RA. We will focus on selected dietary patterns, individual foods and beverages that have been most consistently associated with RA or with the occurrence of systemic autoimmunity associated with RA. We will also review the evidence for a role of the intestinal microbiota in RA development. We propose that diet and digestive microbiota should be considered together in research, as they interact and may both be the target for future preventive interventions in RA.

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Intestinal Permeability and Antigen Absorption in Rheumatoid Arthritis

Cited by 6 publications

References 16 publications

Can we identify patients at risk of life‐threatening allergic reactions to food?

Can we identify patients at risk of life‐threatening allergic reactions to food?

Brief report: Assessment of mucosal barrier integrity using serological biomarkers in preclinical stages of rheumatoid arthritis

The Role of Nutritional Factors and Intestinal Microbiota in Rheumatoid Arthritis Development

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