Tachibana Masahiro, Yonemoto Yukio, Okamura Koichi, Suto Takahito, Sakane Hideo, Kaneko Tetsuya, Dam Trang Thuy, Okura Chisa, Tajika Tsuyoshi, Tsushima Yoshito, Chikuda Hirotaka
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Showa-machi 3-39-15, Maebashi, Gunma, 371-8511, Japan.
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Showa-machi 3-39-15, Maebashi, Gunma, 371-8511, Japan.
Arthritis Res Ther. 2020 Jul 25;22(1):178. doi: 10.1186/s13075-020-02269-x.
Rheumatoid arthritis (RA) and periodontitis (PD) have been suggested to share many clinical and pathological features. However, few reports have investigated the relationship between the degree of PD and the treatment response to RA. This study aimed to examine the relationship between the extent of PD and the treatment response to biologics in RA patients using FDG-PET/CT.
Sixty RA patients (male, n = 14; female, n = 46; average age, 58.3 years) treated with biologic agents were included in this study. FDG-PET/CT was performed at baseline and 6 months after the initiation of biological therapy. The maximum standardized uptake value (SUVmax) was used as a representative value for the assessment of the FDG uptake in periodontal tissue and joints including the bilateral shoulders, elbows, wrists, hip, knees, and ankle joints. The Disease Activity Score (DAS) 28-CRP and the following clinical parameters were assessed: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated peptide antibody (ACPA), rheumatoid factor (RF), and matrix metalloproteinase 3 (MMP-3). The relationship between the treatment response of RA and the baseline SUVmax of the periodontal tissue was evaluated.
The baseline periodontal SUVmax was related to patient age (r = 0.302, p = 0.009) and the ACPA level (r = 0.265, p = 0.025). The DAS28-CRP, CRP, ESR, MMP-3, and joint SUVmax values were significantly decreased after 6 months of biological therapy. However, the mean periodontal SUVmax, ACPA, and RF showed no significant changes after treatment. There was a significantly negative correlation between the baseline periodontal SUVmax and the treatment response of DAS28-CRP (r = - 0.369, p = 0.004).
There was a negative correlation between the extent of PD at baseline and the treatment response of RA patients who received biological therapy. The evaluation of the periodontal condition is considered to be an essential part for the management of RA.
类风湿关节炎（RA）和牙周炎（PD）被认为具有许多临床和病理特征。然而，很少有报告研究PD的严重程度与RA治疗反应之间的关系。本研究旨在使用FDG-PET/CT检查RA患者中PD的程度与生物制剂治疗反应之间的关系。
本研究纳入了60例接受生物制剂治疗的RA患者（男性14例，女性46例；平均年龄58.3岁）。在基线期和生物治疗开始6个月后进行FDG-PET/CT检查。最大标准化摄取值（SUVmax）用作评估牙周组织以及包括双侧肩部、肘部、腕部、髋部、膝部和踝关节在内的关节中FDG摄取的代表值。评估疾病活动评分（DAS）28-CRP以及以下临床参数：C反应蛋白（CRP）、红细胞沉降率（ESR）、抗环瓜氨酸肽抗体（ACPA）、类风湿因子（RF）和基质金属蛋白酶3（MMP-3）。评估RA的治疗反应与牙周组织基线SUVmax之间的关系。
牙周组织基线SUVmax与患者年龄（r = 0.302，p = 0.009）和ACPA水平（r = 0.265，p = 0.025）相关。生物治疗6个月后，DAS28-CRP、CRP、ESR、MMP-3和关节SUVmax值显著降低。然而，治疗后牙周组织平均SUVmax、ACPA和RF无显著变化。牙周组织基线SUVmax与DAS28-CRP的治疗反应之间存在显著负相关（r = -0.369，p = 0.004）。
基线时PD的程度与接受生物治疗的RA患者的治疗反应之间存在负相关。牙周状况的评估被认为是RA管理的重要组成部分。
