Full Papers
Identification of intestinal biomarkers for evaluating disease activity in rheumatoid arthritis
N. Wang1, R. Wang2, Y. Peng3, T. Kang4, Y. Zhufeng5, X. Hou6, X. Li7, J. He8
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, People’s Republic of China.
- Department of Rheumatology, Beijing University of Chinese Medicine Dongfang Hospital, Beijing, People’s Republic of China.
- Department of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China.
- Department of Rheumatology, Beijing University of Chinese Medicine Dongfang Hospital, Beijing, People’s Republic of China.
- Department of Rheumatology and Immunology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China.
- Department of Rheumatology, Beijing University of Chinese Medicine Dongfang Hospital, Beijing, People’s Republic of China.
- Department of Dermatology, Beijing Hospital of Traditional Chinese Medicine Huairou District Hospital, Beijing, People’s Republic of China.
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, People’s Republic of China. hejing1105@126.com
CER19731
Full Papers
PMID: 42446642 [PubMed]
Received: 25/01/2026
Accepted : 29/05/2026
In Press: 09/07/2026
Abstract
OBJECTIVES:
To clarify the crucial prediction role of intestinal barrier markers – lipopolysaccharide binding protein (LBP), soluble cluster of differentiation 14 (sCD14), and intestinal fatty acid binding protein (I-FABP) – through combined diagnostics in rheumatoid arthritis (RA) patients.
METHODS:
A retrospective multi-centre study was conducted involving 139 RA patients from three hospitals, alongside 52 healthy controls (HCs). Serum levels of LBP, sCD14, and I-FABP were quantified by enzyme-linked immunosorbent assay (ELISA). Clinical records were systematically collected, and receiver operating characteristic (ROC) analysis was performed to assess the predictive performance of the biomarkers.
RESULTS:
Compared to HCs, serum levels of sCD14, LBP and I-FABP were significantly higher in RA patients (p<0.05). Among those, sCD14 levels demonstrated a significant positive correlation with disease activity score for 28 joints based on C-reactive protein (DAS28-CRP) (p=0.002), DAS28 based on erythrocyte sedimentation rate (DAS28-ESR) (p=0.048) and inflammatory index. I-FABP also exhibited a positive association with DAS28-ESR (p=0.027). The triad of biomarkers demonstrated a superior diagnostic capability for distinguishing RA from HCs (area under the curve [AUC]=0.936; p<0.001) and contributed to the reliability of disease activity prediction, yielding an AUC of 0.804. Notably, sCD14 levels emerged as an independent predictor of synovitis (odds ratio: 1.834, 95% confidence interval: [1.160–2.901], p=0.009).
CONCLUSIONS:
Intestinal barrier-related biomarkers are associated with disease activity in RA. The combined assessment of LBP, sCD14, and I-FABP demonstrates good performance in differentiating RA from HCs and in evaluating disease activity. Furthermore, sCD14 may serve as a potential indicator of active synovitis, highlighting the clinical value of these biomarkers as complementary tools for disease assessment.
