Journal
JOURNAL OF CLINICAL MEDICINE
Volume 8, Issue 5, Pages -Publisher
MDPI
DOI: 10.3390/jcm8050630
Keywords
rheumatoid arthritis; periodontitis; periodontal disease; anti-citrullinated protein autoantibodies; rheumatoid factor; smoking; medication; Porphyromonas gingivalis
Categories
Funding
- European Union's FP7 Research Project TRIGGER grant [FP7-Health-2013-306029]
- Stockholm County Council [20170285]
- Swedish Research Council [201702084]
- Karolinska Institutet [20161213]
- Swedish Dental Society [1382]
- Foundation for Research in Rheumatology
- European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program [CoG 2017 - 7722209_PREVENT RA, 777357_RTCure]
- FOREUM
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This study aimed to investigate the periodontal health of patients with established rheumatoid arthritis (RA) in relation to oral microbiota, systemic and oral inflammatory mediators, and RA disease activity. Forty patients underwent full-mouth dental/periodontal and rheumatological examination, including collection of blood, saliva, gingival crevicular fluid (GCF) and subgingival plaque. Composition of plaque and saliva microbiota were analysed using 16S rRNA sequencing and levels of inflammatory mediators by multiplex-immunoassay. The majority of the patients (75%) had moderate or severe periodontitis and the rest had no/mild periodontitis. Anti-citrullinated protein antibody (ACPA) positivity was significantly more frequent in the moderate/severe periodontitis (86%) compared to the no/mild group (50%). No significance between groups was observed for RA disease duration or activity, or type of medication. Levels of sCD30/TNFRSF8, IFN-2, IL-19, IL-26, MMP-1, gp130/sIL-6R ss, and sTNF-R1 were significantly higher in serum or GCF, and April/TNFSF13 was significantly higher in serum and saliva samples in moderate/severe periodontitis. The microbial composition in plaque also differed significantly between the two groups. In conclusion, the majority of RA patients had moderate/severe periodontitis and that this severe form of the disease was significantly associated with ACPA positivity, an altered subgingival microbial profile, and increased levels of systemic and oral inflammatory mediators.
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