Specifics of barrier function impairment of the large intestine in patients with ulcerative collitis and joint damage.

Abstract

Objective: Aim: To study the characteristics of barrier function impairments of the large intestine in patients with UC and concomitant joint damage.

Patients and methods: Materials and Methods: At the clinical base of the Department of Therapy and Family Medicine, 80 patients with inflammatory bowel disease (IBD) were examined. Patients with IBD were divided into two groups. Group 1 (n=78) included patients with IBD and diagnosed with joint damage, namely spondylarthritis (SPA), and group 2 (n=40) included patients with IBD without joint damage. Patients were tested to determine the level of fecal calprotectin (FC), a1-antirpsin (a1-AT) and zonulin. Changes in the quantitative and qualitative composition of the colon microflora were assessed.

Results: Results: Patients with UC have been diagnosed with large intestine dysbiosis (LID), which is more pronounced in patients of the 1st group. Stage 3 dysbiosis was 17,3 % (p<0.01) more likely to be found in patient of the 1st group, and stage 4 dysbiosis - 12,9 % (p<0.05) more likely. The level of zonulin, both in blood serum and in feces, was significantly higher in patients with UC compared to controls. In group I patients we found a significant increase in zonulin compared to group II patients (by 1.5 times in blood serum and by 1.4 times in feces, p<0.01). Identical results were observed when analyzing the levels of α1-AT in blood, feces, as well as its clearance (1.6 times (p<0.01), 1.3 times (p<0.05) and 1.4 times (p<0.01) accordingly).

Conclusion: Conclusions: Increased levels of zonulin and a1-AT in blood serum and feces was found in patients with UC, which indicates an increased permeability of the intestinal wall in these patients. At the same time, more pronounced changes indicating intestinal barrier function impairment were found in patients with UC and SPA. In patients with UC and SPA, a direct correlation between the change in intestinal permeability and LID severity was established (fecal zonulin levels correlate with LID stages ІІІ and IV- r=0.94; р<0.01 та r=0.88; р<0.01 accordingly).