Bello-Gualtero Juan M, Lafaurie Gloria I, Hoyos Lida X, Castillo Diana M, De-Avila Juliette, Munevar Juan C, Unriza Sonia, Londoño John, Valle-Oñate Rafael, Romero-Sánchez Consuelo
Biomab Research Institute, Bogotá, Colombia.
Faculty of Medicine, Universidad Militar Nueva Granada, Bogotá, Colombia.
J Periodontol. 2016 Apr;87(4):346-56. doi: 10.1902/jop.2015.150455. Epub 2015 Nov 26.
Recent consensus emphasizes the importance of studying individuals at risk for rheumatoid arthritis (pre-RA) and those with early RA (eRA). Periodontal tissues have been recently evaluated, but these studies are limited. To evaluate the periodontal condition, immunoglobulin (Ig)G subclasses against Porphyromonas gingivalis in individuals with pre-RA and eRA were compared with controls to establish an association between periodontal infection markers and rheumatic activity.
Rheumatologic and periodontal condition was evaluated in 119 individuals with pre-RA, 48 patients with eRA, and matched controls. P. gingivalis IgG1 and IgG2 were analyzed. C-reactive protein, erythrocyte sedimentation rate (ESR), rheumatoid factor, anticitrullinated protein antibodies (ACPAs), and RA activity were measured. The groups were compared with McNemar test and paired t-test. Conditional logistic regression was performed for pre-RA confounders, and χ(2) test was used to evaluate periodontal variables and RA activity indices.
Pre-RA individuals showed significantly higher levels of plaque index (P = 0.01) and bleeding on probing (P = 0.03) and higher severity of periodontal disease (P = 0.02). Periodontitis was associated with pre-RA (odds ratio, 3.39; 95% confidence interval, 1.64 to 7.01) but not with eRA. In pre-RA, P. gingivalis-specific IgG2 was associated with ACPAs (P = 0.049) and disease severity visual analog scale (P = 0.03). In eRA, IgG2 against P. gingivalis was associated with ESR (P = 0.046) and ACPAs (P = 0.04). P. gingivalis was associated with ACPAs (P = 0.04).
This study shows that individuals with pre-RA have significant inflammatory periodontal involvement. There was a significant association between IgG against P. gingivalis and ACPAs in pre-RA and markers of RA activity in individuals with eRA.
最近的共识强调了研究类风湿关节炎风险个体（类风湿关节炎前期）和早期类风湿关节炎（eRA）患者的重要性。牙周组织最近已得到评估，但这些研究有限。为了评估牙周状况，将类风湿关节炎前期和早期类风湿关节炎患者中针对牙龈卟啉单胞菌的免疫球蛋白（Ig）G亚类与对照组进行比较，以确定牙周感染标志物与风湿活动之间的关联。
对119例类风湿关节炎前期个体、48例早期类风湿关节炎患者和匹配的对照组进行了风湿病学和牙周状况评估。分析了牙龈卟啉单胞菌IgG1和IgG2。测量了C反应蛋白、红细胞沉降率（ESR）、类风湿因子、抗瓜氨酸化蛋白抗体（ACPA）和类风湿关节炎活动度。采用McNemar检验和配对t检验对各组进行比较。对类风湿关节炎前期的混杂因素进行条件逻辑回归分析，并使用χ²检验评估牙周变量和类风湿关节炎活动指数。
类风湿关节炎前期个体的菌斑指数（P = 0.01）和探诊出血（P = 0.03）水平显著更高，牙周疾病严重程度更高（P = 0.02）。牙周炎与类风湿关节炎前期相关（比值比，3.39；95%置信区间，1.64至7.01），但与早期类风湿关节炎无关。在类风湿关节炎前期，牙龈卟啉单胞菌特异性IgG2与ACPA（P = 0.049）和疾病严重程度视觉模拟量表（P = 0.03）相关。在早期类风湿关节炎中，针对牙龈卟啉单胞菌的IgG2与ESR（P = 0.046）和ACPA（P = 0.04）相关。牙龈卟啉单胞菌与ACPA相关（P = 0.04）。
本研究表明，类风湿关节炎前期个体存在明显的炎症性牙周受累。在类风湿关节炎前期，针对牙龈卟啉单胞菌的IgG与ACPA之间存在显著关联，在早期类风湿关节炎个体中与类风湿关节炎活动标志物也存在显著关联。
