Rutter-Locher Zoe, Smith Toby O, Giles Ian, Sofat Nidhi
Musculoskeletal Research Group, Institute of Infection and Immunity, St George's University of London, London, United Kingdom.
Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom.
Front Immunol. 2017 Oct 17;8:1295. doi: 10.3389/fimmu.2017.01295. eCollection 2017.
Systemic lupus erythematosus (SLE) is a chronic systemic inflammatory autoimmune disease, the etiology of which remains only partially characterized. Strong evidence implicates chronic infections in the development and chronicity of autoimmune conditions. Recently, an association has been demonstrated between periodontitis and rheumatoid arthritis. Such observations have led to the investigation of the possible role of periodontitis and oral dysbiosis in other systemic inflammatory conditions, including SLE. The aim of this study was to examine whether there is an association between SLE and periodontitis.
MEDLINE OVID, EMBASE OVID, and PsycINFO OVID databases were searched to identify eligible studies, screened by two independent authors and verified by a third. Studies comparing presence of periodontitis in SLE cases to controls without SLE were included. Data were extracted using a predefined table and papers were appraised using Down's and Black tool. Mantel-Haenszel meta-analysis was performed using RevMan.
Eight case-control studies were included, with 487 SLE cases and a total of 1,383 participants. On meta-analysis of four studies, risk of periodontitis in SLE cases compared to controls was significantly greater with a risk ratio of 1.76 (95% CI 1.29-2.41, = 0.0004). No statistical difference was found in individual measures of periodontitis, such as probing depth or clinical attachment loss, between SLE cases and controls.
Our study found a statistically significant increased risk of periodontitis in patients with SLE compared to controls. This finding suggests a possible association between these two conditions. Larger longitudinal studies are needed to confirm this possible association.
系统性红斑狼疮（SLE）是一种慢性全身性炎症性自身免疫性疾病，其病因仅部分明确。有力证据表明慢性感染与自身免疫性疾病的发生和慢性化有关。最近，已证实牙周炎与类风湿性关节炎之间存在关联。这些观察结果促使人们研究牙周炎和口腔生态失调在包括SLE在内的其他全身性炎症性疾病中的可能作用。本研究的目的是检查SLE与牙周炎之间是否存在关联。
检索MEDLINE OVID、EMBASE OVID和PsycINFO OVID数据库以识别符合条件的研究，由两位独立作者进行筛选并由第三位作者进行核实。纳入比较SLE病例与无SLE对照者牙周炎存在情况的研究。使用预定义表格提取数据，并使用唐斯和布莱克工具对论文进行评估。使用RevMan进行Mantel-Haenszel荟萃分析。
纳入八项病例对照研究，共487例SLE病例和1383名参与者。对四项研究进行荟萃分析发现，与对照组相比，SLE病例患牙周炎的风险显著更高，风险比为1.76（95%CI 1.29 - 2.41，P = 0.0004）。在SLE病例与对照组之间，牙周炎的个体测量指标，如探诊深度或临床附着丧失，未发现统计学差异。
我们的研究发现，与对照组相比，SLE患者患牙周炎的风险在统计学上显著增加。这一发现表明这两种情况之间可能存在关联。需要更大规模的纵向研究来证实这种可能的关联。
