Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
Department of Periodontics, and the Department of Oral Medicine, University of Washington, Seattle, WA, USA.
J Periodontal Res. 2021 Oct;56(5):907-916. doi: 10.1111/jre.12887. Epub 2021 May 5.
We studied cytokines in gingival crevicular fluid (GCF) in a cross-sectional population-based cohort of rheumatoid arthritis (RA) patients ≥61 years of age with and without a diagnosis of periodontitis.
Earlier studies on cytokines in GCF in RA patients have not given clear results.
In a population-based cross-sectional study of patients ≥61 years of age, 233 RA patients were identified. 132 (57%) dentate RA patients participated. All participants received rheumatological and dental examinations, and had a panoramic radiograph taken. GCF was sampled on each patient. Interleukins 1-β (IL-1β), IL-4, IL-6, IL-10, IL-17A, tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), and chemokines RANTES/CCL5, eotaxin and monocyte chemoattractant protein (MCP-1) were analyzed in GCF. These cytokines were stratified for periodontitis, age, gender, body mass index (BMI), smoking, and anti-cyclic citrullinated protein (anti-CCP) status. Binary logistic regression analyses with periodontitis as outcome were performed adjusting for the above mentioned confounding factors including anti-rheumatic medication, disease duration and the cytokine in question.
Periodontitis was diagnosed in 80/132 (61%) of study participants. The 110 RA patients not participating were older, had a higher mean erythrocyte sedimentation rate (ESR), had a higher mean DAS28ESR (Disease Activity Score 28 using ESR) and were less often on biologic treatment. Only RANTES was associated with periodontitis (p = .049, OR 1.001, 95% CI 1.000-1.002) in the binary logistic regression analyses.
In this population-based elderly RA cohort, neither pro-inflammatory nor anti-inflammatory cytokines in GCF were clearly associated with a diagnosis of periodontitis.
我们研究了伴或不伴牙周炎的老年类风湿关节炎(RA)患者龈沟液(GCF)中的细胞因子。
早期关于 RA 患者 GCF 中细胞因子的研究结果并不明确。
在一项基于人群的老年 RA 患者横断面研究中,我们确定了 233 名 RA 患者,其中 132 名(57%)为有牙 RA 患者参与了研究。所有参与者均接受了风湿病学和牙科检查,并拍摄了全景片。对每位患者进行 GCF 取样。在 GCF 中分析白细胞介素 1-β(IL-1β)、IL-4、IL-6、IL-10、IL-17A、肿瘤坏死因子-α(TNF-α)、干扰素 γ(IFN-γ)以及趋化因子 RANTES/CCL5、嗜酸性粒细胞趋化因子和单核细胞趋化蛋白-1(MCP-1)。根据牙周炎、年龄、性别、体重指数(BMI)、吸烟和抗环瓜氨酸肽(anti-CCP)状况对这些细胞因子进行分层。采用二元逻辑回归分析,以牙周炎为结局,调整上述混杂因素,包括抗风湿药物、病程和所研究的细胞因子。
80/132(61%)名研究参与者被诊断为牙周炎。未参与研究的 110 名 RA 患者年龄更大,红细胞沉降率(ESR)平均值更高,DAS28ESR(基于 ESR 的疾病活动评分 28)平均值更高,接受生物治疗的比例更低。只有 RANTES 与牙周炎相关(p=0.049,OR 1.001,95%CI 1.000-1.002)。
在这项基于人群的老年 RA 队列中,GCF 中的促炎或抗炎细胞因子均与牙周炎的诊断无明显相关性。