{
  "abstract": "Introduction Systemic sclerosis (SSc) is a rare connective tissue disease characterized by vasculopathy, immune dysregulation, and progressive fibrosis of the skin and internal organs. Increasing evidence suggests that disruption of the intestinal barrier may contribute to systemic inflammation and nutritional decline. The primary objective of this study was to evaluate the correlations between intestinal permeability markers, nutritional status, clinical manifestations, and serological profiles in patients with SSc.Material and Methods We conducted a cross-sectional study including 46 patients fulfilling the ACR/EULAR 2013 classification criteria for SSc. Clinical data, laboratory parameters, and body composition (bioelectrical impedance analysis) were recorded. Intestinal permeability was assessed using serum markers: Claudin-3 (CLDN3) and intestinal fatty acid-binding protein (FABP2). Nutritional status was evaluated with the Malnutrition Universal Screening Tool (MUST). Associations between permeability markers, disease subtype (limited vs diffuse), clinical features, and body composition were analyzed using appropriate statistical tests.Results The cohort had a mean age of 56.7 years, with an average disease duration of 5.1 years. According to MUST, 28% of participants were at risk of malnutrition. No significant differences in CLDN3 or FABP2 were observed between limited and diffuse SSc subtypes. Mean serum concentrations of CLDN3 (0.51 ng/mL) and FABP2 (254.6 pg/mL) exceeded values typically reported in healthy controls, indicating increased intestinal permeability in SSc. FABP2 showed wide inter-patient variability, with markedly elevated levels in a subset of patients, suggesting heterogeneity in intestinal involvement. CLDN3 correlated positively with body weight (r=0.50, p=0.018), skeletal muscle mass (r=0.49, p=0.004), lean body mass (r=0.61, p<0.001), and basal metabolic rate (r=0.61, p<0.001). CLDN3 showed a negative correlation with impedance (r= -0.40, p=0.023). FABP2 did not show consistent correlations with nutritional screening or systemic severity indices, but its variability indicates distinct pathophysiological subgroups. No significant associations were found between intestinal permeability markers and autoantibody profiles, although serological differences were evident between SSc subtypes.Conclusions Intestinal barrier dysfunction is detectable in systemic sclerosis. While permeability markers did not differ significantly between limited and diffuse subtypes, CLDN3 showed consistent associations with body composition, linking nutritional and metabolic status to gut barrier integrity. FABP2 variability points to heterogeneity in intestinal injury across patients. The frequency of malnutrition identified by MUST underscores the clinical relevance of systematic nutritional assessment in SSc. These findings support further investigation into the gut–muscle–nutrition axis and may suggest intestinal permeability as a potential therapeutic target in connective tissue diseases.",
  "authors": [
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Bartosz Stepien"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Olga Brzezinska"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Aleksandra Opinc-Rosiak"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Jakub Gajdecki"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Kinga Gajdecka"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Aleksandra Nadel"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Joanna Sarnik"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University of Lodz, Lodz, POLAND"
      ],
      "name": "Joanna Makowska"
    }
  ],
  "title": "P.167 Breaking the barrier: intestinal permeability, malnutrition, and serological profiles in systemic sclerosis",
  "uid": "0897e0ba-f2e0-50cc-bbc4-9dff3a38a9f0"
}