Background/Purpose: The intestine is no longer considered as an organ targeted by spondyloarthritis (SpA) but also an actor of the disease alongside environmental and immunological phenomena. In patients with SpA, increased intestinal permeability (IP) and bacterial translocation (BT) has been described. Whereas anti-inflammatory drugs (non- steroidal anti-inflammatory drugs, NSAIDs, or glucocorticoids, GCs) are known to induce deleterious intestinal changes in the general population, their effects in case of arthritis have been poorly studied. This aim of this study was to determine the effect of NSAIDs and GC on bacterial translocation and intestinal integrity in rats with adjuvant-induced arthritis (AIA).

Methods: AIA was induced in 6-week-old male Lewis rats by injection at the base of the tail of Mycobacterium butyricum in incomplete Freund’s adjuvant. At first signs of arthritis, rats were treated daily with naproxen (10 mg/kg/day, i.p.), diclofenac (5mg/kg twice daily, i.p.), celecoxib (3 mg/kg/day, i.p.), prednisolone (10 mg/kg/day, i.p.) or vehicle (saline). After 21 days of treatment, intestinal damage was assessed by measure of plasma levels of intestinal Fatty Acid Binding Protein (iFABP, ELISA) and bacterial translocation by measure of serum levels of soluble CD14 (sCD14, ELISA). Joint damage was assessed by the determination of an arthritis score (Sa).

Results: Compared to vehicle, all treatments reduced arthritis score in AIA rats (p< 0.05). Compared to AIA-vehicle, treatment with prednisolone and naproxen significantly decreased both circulating iFABP and sCD14 levels. Celecoxib decreased sCD14 but had no effect on iFABP levels. Diclofenac changed neither sCD14 nor iFABP levels.

Conclusion: This study demonstrated that NSAIDs and GC induced changes in intestinal damage and bacterial translocation in arthritis. Contrary to what is observed in healthy population, none anti-inflammatory drug enhanced intestinal damage or bacterial translocation but on the contrary, prednisolone and naproxen decreased these two parameters. Of interest, our data showed that the effect of NSAIDs is not a class-effect but depends on the balance of cyclooxygenase 1/2 inhibition.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/effect-of-anti-inflammatory-drugs-on-intestinal-epithelial-damage-and-bacterial-translocation-in-the-adjuvant-induced-arthritis-model/