Postprandial Inflammation in Rheumatoid Arthritis

Conditions

Arthritis, Rheumatoid, Dietary Exposure, Diet, Healthy, Inflammatory Response

Keywords

postprandial, inflammation, rheumatoid arthritis, RA, diet, PIRA

Brief summary

Patients with RA will be studied to see whether meals of different content will affect inflammation and metabolic variables in the postprandial state. Healthy controls will also be invited to examine potentially different responses to patients with RA.

Detailed description

The PIRA study aims to evaluate the metabolic and inflammatory effects after a vegan meal or a meal containing red meat or fish in patients with RA and matched controls. The study have a cross-over design and each participant will have one of three meals every week and then be compared to themselves. In addition healthy individuals will be included for the red meat meal so that the response from this meal could be compared between patients with RA and their matched controls. Blood samples will be collected before the meal (fasting) and every hour until 5h. Primary outcome will be high sensitive IL-6. Secondary outcomes will be additional inflammation markers such as area under curve for hs-CRP and gene expression in PBMC:s regarding genes related to inflammation and, glucose, blood lipids and metabolomics-profile in serum and urine.

Lindqvist HM, Hulander E, Bärebring L, Gjertsson I, Winkvist A.

2025-05-26

10.1007/s00394-025-03710-0

Inflammatory and lipemic response to red meat intake in women with and without Rheumatoid Arthritis: a single meal study within a randomized controlled trial

Torsten Sällström, Linnea Bärebring, Erik Hulander, Inger Gjertsson, Anna Winkvist et al. (6 authors)

BMC Nutrition2025-04-111 citations

10.1186/s40795-025-01055-9

Exploring the differences in serum metabolite profiles after intake of red meat in women with rheumatoid arthritis and a matched control group

Helen M. Lindqvist, Inger Gjertsson, Erik Hulander, Linnea Bärebring, Anna Winkvist

European Journal of Nutrition2023-10-097 citations

10.1007/s00394-023-03257-y

Validity of bioimpedance for assessment of fat-free mass in women with Rheumatoid Arthritis compared to non-rheumatic controls

Helen M. Lindqvist, Ola Wallengren, Anders Eriksson, Erik Hulander, Anna Winkvist et al. (6 authors)

Clinical Nutrition ESPEN2021-11-142 citations

10.1016/j.clnesp.2021.11.016

Interventions

OTHERMeal based on red meat, fish products or vegan products

Three meals will be served

OTHERMeal based on red meat

Matched Controls will be served only one meal of meat to compare response between (non-RA) matched controls and patients with RA

Study design

Allocation

RANDOMIZED

Intervention model

CROSSOVER

Primary purpose

BASIC_SCIENCE

Masking

SINGLE (Outcomes Assessor)

Masking description

All data will be given a new code Before statistical analysis to mask treatment (study meal or Control) to the outcome assessor

Eligibility

Sex/Gender

FEMALE

Age

20 Years to 70 Years

Healthy volunteers

Yes

Inclusion criteria

for patients with RA: * Diagnosed with rheumatoid arthritis * BMI 18.5-30.0 kg/m2 * 2 years or more since diagnosis * No DMARD changes during the last 3 months Inclusion Criteria for healthy controls: * Absence of diagnosis of RA * BMI 18.5-30.0 kg/m2 * Self-assessed as healthy

Exclusion criteria

* Diagnosis of cancer, inflammatory bowel disease, celiac disease, diabetes * Allergy or intolerance to any of the foods in the study * Pregnancy or breastfeeding * Use of any blood lipid lowering medication, glucocorticoids or IL-6-inhibitor during the last 4 weeks prior to enrolment * Smoking * Hemoglobin \< 100 g/L

Design outcomes

Primary

Measure	Time frame	Description
Circulating interleukin 6	From baseline up to 5 hours postprandial	Changes from fasting to postprandial
Circulating high sensitive C-reactive protein (CRP)	From baseline up to 5 hours postprandial	Changes from fasting to 5 hours postprandial, area under curve
Circulating triacylglycerides	From baseline up to 5 hours postprandial	Blood lipid levels, Area Under curve from fasting to 5 hours postprandial
Gene expression analysis	From baseline up to 5 hours postprandial	Changes in gene expressions related to inflammation and disease activity in peripheral blood mononuclear cells
Serum metabolomics	From baseline up to 5 hours postprandial	Patterns of nuclear magnetic resonance (NMR) analysis of metabolites, analysis of several timepoints separately
Urine metabolomics	From baseline up to 5 hours postprandial	Patterns of nuclear magnetic resonance (NMR) analysis of metabolites,analysis of several timepoints separately

Secondary

Measure	Time frame	Description
Patient-reported dietary intake	Through study completion, expected to be complete within 1 year	measured by food frequency questionnaire and 4-day food diary
Body composition	Measured at inclusion of trial, expected to be complete within 6 months	Measured by dual energy X-ray technology
Patient-reported disability	During trial, expected to be complete within 1 year	Health Assessment Questionnaire, disability index (HAQ)
Patient-reported background and dietary habits	During trial, expected to be complete within 1 year	Measured by questionnaire about socioeconomic status and changes in dietary habits related to perceived health
Resting metabolic rate	through study completion, expected within 1 year	measured by indirect calorimetry
Glucose	From baseline up to 5 hours postprandial	blood glucose levels measured by NMR-analysis
Insulin	From baseline up to 5 hours postprandial	blood insulin levels measured by NMR-analysis
Patient-reported quality of life	through study completion, expected to be complete within 1 year	Measured by EQ5D-5L questionnaire
Patient-reported health	through study completion, expected to be complete within 1 year	Measured by the Short Form (SF36) questionnaire

Countries

Sweden

Outcome results

None listed