Dynamics of inflammation-associated plasma proteins following faecal microbiota transplantation in patients with psoriatic arthritis and healthy controls: exploratory findings from the FLORA trial

• DOI: 10.1136/rmdopen-2023-003750
• Publication Date: 2024-01-31T04:15:45Z
• Authors: Maja Skov Kragsnaes; Jennifer Rugaard ...; Anna Christine Ni...; Muhammad Irfan Malik; Heidi Lausten Munk; Jens Kristian Ped...; Hans Christian Horn; Mogens Kruhøffer; Karsten Kristiansen; Benjamin H Mullish; Julian R Marchesi; Jens Kjeldsen; Richard Röttger; Torkell Ellingsen
• Keywords: Lactobacillus casei

Objectives The gut microbiota can mediate both pro and anti-inflammatory responses. In patients with psoriatic arthritis (PsA), we investigated the impact of faecal transplantation (FMT), relative to sham transplantation, on 92 inflammation-associated plasma proteins. Methods This study relates FLORA trial cohort, where 31 moderate-to-high peripheral PsA disease activity, despite at least 3 months methotrexate treatment, were included in a 26-week, double-blind, randomised, sham-controlled trial. Participants allocated receive either one gastroscopic-guided healthy donor FMT (n=15) or (n=16). Patient samples collected baseline, week 4, 12 26 while from age-matched sex-matched controls (HC) baseline. Samples analysed using proximity extension assay technology (Olink Target-96 Inflammation panel). Results Levels proteins differed significantly between HC pre-FMT (adjusted p<0.05), which 10 elevated PsA: IL-6, CCL20, CCL19, CDCP1, FGF-21, HGF, interferon-γ (IFN-γ), IL-18R1, monocyte chemotactic protein 3, IL-2. group, levels changed across all timepoints (tumour necrosis factor (TNF), IFN-γ, TWEAK, signalling lymphocytic activation molecule (SLAMF1), CD8A, CD5, Flt3L, CCL25, FGF-23, CD6, caspase-8). Significant differences sham-treated observed for TNF (p=0.002), IFN-γ (p=0.011), stem cell (p=0.024), matrix metalloproteinase-1 (p=0.038), SLAMF1 (p=0.042). had largest positive effect Axin-1 CCL25 negative CCL19 IL-6. Conclusions Patients active have distinct immunological signature compared pre-FMT. affects several these markers, including sustained elevation IFN-γ. Trial registration number NCT03058900 .