Zonulin-Assessed Intestinal Permeability and Body Composition Changes in Systemic Sclerosis

Area of Science:

• Immunology
• Gastroenterology
• Rheumatology

Background:

• Systemic sclerosis (SSc) is a chronic autoimmune disease with significant gastrointestinal involvement impacting body composition.
• Intestinal permeability, potentially indicated by zonulin, is under investigation as a factor in SSc pathophysiology.
• Current markers for organ damage in SSc are limited, necessitating exploration of novel indicators like zonulin.

Purpose of the Study:

• To investigate the association between intestinal permeability, measured by serum zonulin levels, and body composition changes in patients with Systemic sclerosis.
• To explore zonulin as a potential biomarker for gut barrier dysfunction in SSc.

Main Methods:

• Forty patients meeting EULAR criteria for Systemic sclerosis were enrolled.
• Serum zonulin levels were measured biochemically.
• Body composition was analyzed using bioelectrical impedance analysis (BIA), assessing fat-free mass index (FFMI), body cellular mass index (BCMI), fat mass index (FMI), and visceral fat area (VFA).

Main Results:

• Reduced FFMI was observed in 35% of SSc patients and correlated with higher zonulin levels (p < 0.01).
• Serum zonulin levels showed negative correlations with BCMI (r = -0.332, p < 0.05), fat-free mass (FFM) (r = -0.302, p < 0.05), and muscle mass (r = -0.276, p < 0.05).

Conclusions:

• Elevated serum zonulin levels in SSc patients are associated with adverse body composition changes, including reduced muscle mass.
• Gut barrier dysfunction, indicated by increased intestinal permeability, may contribute to muscle loss in SSc.
• Zonulin warrants further investigation as a potential therapeutic target for managing body composition abnormalities in Systemic sclerosis.