Altamash Institute of Dental Medicine, Department of Periodontology, Karachi, Pakistan; Karolinska Institutet, Department of Dental Medicine, Division of Oral Diseases, Section of Periodontology, Huddinge, Sweden; Balochistan University of Information Technology, Engineering and Management Sciences, Department of Microbiology, Faculty of Life Sciences and Informatics, Quetta, Pakistan.
Habib Medical Centre, Rheumatology Clinic, Karachi, Pakistan, Karachi, Pakistan.
Cytokine. 2020 Jul;131:155117. doi: 10.1016/j.cyto.2020.155117. Epub 2020 May 8.
Periodontal disease (PD) and rheumatoid arthritis (RA) are chronic immuno-inflammatory conditions with osteolysis being a hallmark feature. The influence of PD on RA's systemic inflammatory status and disease activity remains unclear. The objective of this study was to assess the systemic inflammation and disease activity of RA under the influence of PD.
In this case-control study, 38 RA patients (19 with PD and 19 without PD) were compared to 38 non-RA patients and 12 healthy controls. Periodontal parameters (bleeding on probing (BOP), probing pocket depth (PPD), PPD Total, PPD Disease and marginal bone loss (MBL) were determined. Serological analyses included quantification of 92 inflammatory biomarkers using a multiplex proximity extension assay, anti-citrullinated protein antibodies (ACPA), rheumatoid factor (IgM-RF) and erythrocyte sedimentation rate (ESR). RA disease activity was determined using Disease Activity Score for 28 joints (DAS28). All RA patients were on medication.
IgM-RF was higher in RA patients with PD. PD conditions were more severe in the non-RA group. Inflammatory biomarkers (IL-10RB, IL-18, CSF-1, NT-3, TRAIL, PD-L1, LIF-R, SLAMF1, FGF-19, TRANCE, CST5, STAMPB, SIRT2, TWEAK, CX3CL1, CXCL5, MCP-1) were significantly higher in RA patients with PD than RA without PD. DAS28 associated with twice as many inflammatory biomarkers in RA patients with PD whereas IgM-RF and ACPA associated more frequently with biomarkers in the RA without PD group. IgM-RF correlated inversely with BOP.
Periodontal disease augments systemic inflammation in RA. A profound influence exists independent of autoimmune status.
牙周病（PD）和类风湿关节炎（RA）是慢性免疫炎症性疾病，骨质溶解是其标志特征。PD 对 RA 全身炎症状态和疾病活动的影响尚不清楚。本研究旨在评估 PD 对 RA 全身炎症和疾病活动的影响。
在这项病例对照研究中，比较了 38 名 RA 患者（19 名患有 PD，19 名没有 PD）、38 名非 RA 患者和 12 名健康对照者。测定牙周参数（探诊出血（BOP）、探诊牙周袋深度（PPD）、PPD 总深度、PPD 疾病程度和边缘骨丧失（MBL）。血清学分析包括使用多重邻近延伸分析测定 92 种炎症生物标志物的定量，包括抗瓜氨酸蛋白抗体（ACPA）、类风湿因子（IgM-RF）和红细胞沉降率（ESR）。使用 28 个关节疾病活动评分（DAS28）确定 RA 疾病活动。所有 RA 患者均接受药物治疗。
PD 组 RA 患者 IgM-RF 升高。非 RA 组 PD 程度更严重。炎症生物标志物（IL-10RB、IL-18、CSF-1、NT-3、TRAIL、PD-L1、LIF-R、SLAMF1、FGF-19、TRANCE、CST5、STAMPB、SIRT2、TWEAK、CX3CL1、CXCL5、MCP-1）在 PD 组 RA 患者中显著高于无 PD 组 RA 患者。DAS28 在 PD 组 RA 患者中与两倍的炎症生物标志物相关，而 IgM-RF 和 ACPA 在无 PD 组 RA 患者中与更多的生物标志物相关。IgM-RF 与 BOP 呈负相关。
牙周病加重 RA 全身炎症。存在与自身免疫状态无关的深远影响。
