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[类风湿关节炎患者基质金属蛋白酶-3的表达及其与慢性牙周炎和类风湿关节炎的相关性]

[Expression of matrix metalloproteinase-3 in patients with reheumatoid arthritis and its correlation with chronic periodontitis and rheumatoid arthritis].

作者信息

Zhao Y, Jin Y, Ren Y S, Song L M, Li J, Lin X P

机构信息

Department of Stomatology, Shengjing Hospital, China Medical University, Shenyang 110004, China.

Department of Cadres Clinic, School of Stomatology, China Medical University & Liaoning Institute of Dental Research, Shenyang 110002, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2019 Mar 9;54(3):164-169. doi: 10.3760/cma.j.issn.1002-0098.2019.03.004.

Abstract

To detect the expression of matrix metalloproteinase-3 (MMP-3) in serum and gingival crevicular fluid in patients with rheumatoid arthritis (RA) and its correlation with chronic periodontitis (CP). From March 2017 to July 2018, 26 patients with RA and CP [CP+RA group, (54.9±6.5) years old, 4 males and 22 females], 22 patients with RA only [RA group, (49.6±11.7) years old,5 males and 17 females] in the Department of Rheumatology and Immunology, Shengjing Hospital Affiliated to China Medical University, 22 patients with simple CP in the Department of Stomatology, Shengjing Hospital Affiliated to China Medical University [CP group, (51.4±12.5) years old, 8 males and 14 females] and 18 generally healthy controls in Physical Examination Center of Shengjing Hospital Affiliated to China Medical University [group H, (49.4±9.1) years old, 8 males and 10 females] were recruited. There were no significant differences in age and sex ratio amongst 4 groups. Patient's general status, probing depth (PD) , clinical attachment loss (CAL), sulcus bleeding index (SBI), simplified calculus index (CI-S) and simplified debris index (DI-S) were recorded in 4 groups. Samples of serum and gingival crevicular fluid were collected from patients of each group, and the expression levels of MMP-3 in serum and gingival crevicular fluid samples were detected by using enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate, rheumatoid factor, anti-cyclic citrulline peptide antibody and C-reactive protein were detected in the serum of subjects in RA group and CP+RA group. Correlation analysis was conducted between MMP-3 expression level and periodontal indices amongst 4 groups. The results were statistically analyzed using the SPSS 20.0 software package. The indices of CAL [(4.12±1.13) mm], SBI (2.58±0.64) and DI-S (2.65±0.69) in CP+RA group were significantly higher than indices of CAL [(3.00±0.00) mm], SBI (2.59±1.05) and DI-S, (2.36±0.49) in CP group (0.05); The expression levels of MMP-3 in serum samples of CP+RA group [(1 1645.6±6 903.4) μg/L] and CP group [(9 337.0±6 719.0) μg/L] were significantly higher than that of RA group [(2 389.9±1 320.3) μg/L] and H group [(1 493.5±292.1) μg/L] (0.05). The expression level of MMP-3 in gingival crevicular fluid samples of CP+RA group [(164.4±45.3) μg/L] was significantly higher than that of CP group [(84.6±92.5) μg/L], RA group [(49.0±18.1) μg/L] and H group [(20.4±6.3) μg/L] (0.05), respectively. The erythrocyte sedimentation rate, rheumatoid factor and anti-cyclic cirullinated peptide antibodies levels in the CP+RA group were significantly higher than those in the RA group (0.05). The expression level of MMP-3 in serum is positively correlated with PD (0.45, 0.04) and the expression level of MMP-3 in gingival crevicular fluid is positively correlated with CAL (0.58, <0.01). The levels of MMP-3 in serum and gingival crevicular fluid of patients with RA and CP were significantly increased. MMP-3 may be associated with the development of CP and RA.

摘要

检测类风湿关节炎(RA)患者血清和龈沟液中基质金属蛋白酶-3(MMP-3)的表达及其与慢性牙周炎(CP)的相关性。选取2017年3月至2018年7月在中国医科大学附属盛京医院风湿免疫科就诊的26例RA合并CP患者[CP+RA组,年龄(54.9±6.5)岁,男4例,女22例]、22例单纯RA患者[RA组,年龄(49.6±11.7)岁,男5例,女17例],在中国医科大学附属盛京医院口腔科就诊的22例单纯CP患者[CP组,年龄(51.4±12.5)岁,男8例,女14例]以及在中国医科大学附属盛京医院体检中心的18例健康对照者[H组,年龄(49.4±9.1)岁,男8例,女10例]。4组患者的年龄和性别比差异无统计学意义。记录4组患者的一般情况、探诊深度(PD)、临床附着丧失(CAL)、龈沟出血指数(SBI)、简化牙石指数(CI-S)和简化软垢指数(DI-S)。采集每组患者的血清和龈沟液样本,采用酶联免疫吸附测定法检测血清和龈沟液样本中MMP-3的表达水平。检测RA组和CP+RA组患者血清中的红细胞沉降率、类风湿因子、抗环瓜氨酸肽抗体和C反应蛋白。对4组患者MMP-3表达水平与牙周指标进行相关性分析。采用SPSS 20.0软件包进行统计学分析。CP+RA组的CAL[(4.12±1.13)mm]、SBI(2.58±0.64)和DI-S(2.65±0.69)指标显著高于CP组的CAL[(3.00±0.00)mm]、SBI(2.59±I.05)和DI-S(2.36±0.49)(P<0.05);CP+RA组[(11 645.6±6 903.4)μg/L]和CP组[(9 337.0±6 719.0)μg/L]血清样本中MMP-3的表达水平显著高于RA组[(2 389.9±1 320.3)μg/L]和H组[(1 493.5±292.1)μg/L](P<0.05)。CP+RA组龈沟液样本中MMP-3的表达水平[(164.4±45.3)μg/L]显著高于CP组[(84.6±92.5)μg/L]、RA组[(49.0±18.1)μg/L]和H组[(20.4±6.3)μg/L](P<0.05)。CP+RA组的红细胞沉降率、类风湿因子和抗环瓜氨酸肽抗体水平显著高于RA组(P<0.05)。血清中MMP-3的表达水平与PD呈正相关(r=0.45,P=0.0),龈沟液中MMP-3的表达水平与CAL呈正相关(r=0.58,P<0.01)。RA合并CP患者血清和龈沟液中MMP-3水平显著升高,MMP-3可能与CP和RA的发生发展有关。

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