scholarly journals Correlation between chronic periodontitis and rheumatoid arthritis: A periodontist perspective

2021 ◽  
Vol 9 (2) ◽  
pp. 67-71
Author(s):  
Shilpi Gangwar ◽  
Patel Umesh Bhai Becharbhai ◽  
Vaibhav Sheel ◽  
Umesh Chandra Chaudhary
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Periodontitis ◽  
Inflammatory Diseases ◽  
Pcr Amplification ◽  
Current Evidence ◽  
Oligonucleotide Primer ◽  
Serum Samples ◽  
Tannerella Forsythia ◽  
Bacterial Dna ◽  
The Relationship

In this study, we evaluate the relationship between rheumatoid arthritis (RA) and chronic periodontitis on the basis of clinical attachment present and severity of attachment loss in both the cases. First of all Diagnosis of rheumatoid arthritis and chronic periodontitis was performed, thereafter bacterial DNA extraction from blood serum sample and subgingival dental plaque of each group through PCR and later DNA purification through Spin protocol was performed, oligonucleotide primer was used to detect t.forcythia and PCR amplification was done to detect T. Denticola for both the groups .PBDNA was detected in both SGP and serum samples of both the groups. In SGP samples, Tannerella forsythia was more frequently detected as compared to serum samples of both the groups. In result theclinical attachment Level (CAL) was observed to be higher in RA group as compared to CP group. Comparison of CAL according to severity was also observed in both the groups which suggested that RA group has mild periodontitis as compared to CP group in which moderate to severe periodontitis was seen, Detection of periodontal bacterial DNA by PCR assay PBDNA was detected in both SGP and serum samples. In SGP samples, Tannerella forsythia was more frequently detected as compared to serum samples of both the groups. So these are two common chronic inflammatory diseases with a similar host-mediated pathogenesis. Current evidence suggests that an association exists between periodontitis and RA. Well-designed multicenter longitudinal clinical trials and studies with sufficient sample sizes are needed to ascertain the relationship between these two diseases and whether periodontal treatment can reduce the severity of RA or prevent its onset.

Study on the Prevalence of Periodontopathogenic Bacteria in Serum and Subgingival Bacterial Plaque in Patients with Rheumatoid Arthritis

2017 ◽  
Vol 68 (8) ◽  
pp. 1946-1950 ◽  
Author(s):  
Maria Alexandra Martu ◽  
Sorina Mihaela Solomon ◽  
Irina Georgeta Sufaru ◽  
Igor Jelihovschi ◽  
Silvia Martu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Dental Plaque ◽  
Study Group ◽  
Prevotella Intermedia ◽  
Serum Samples ◽  
Bacterial Dna ◽  
Refractory Rheumatoid Arthritis ◽  
Periodontopathogenic Bacteria ◽  
Oral Pathogens ◽  
Bacterial Plaque

The purpose of this study was to detect bacterial periodontal DNA from subgingival dental plaque and serum in patients affected by rheumatoid arthritis and periodontitis. The study group included 19 patients with periodontitis and refractory rheumatoid arthritis. The patients were clinically examined and diagnosed and the bacterial DNA was detected in the subgingival bacterial plate and serum by PCR. Severe chronic periodontitis was the most commonly diagnosed (42.2%). The DNA of periodontopathogenic bacteria was detected 100% in subgingival plate samples, and in serum samples it was identified in 84.2% of cases. The most commonly found species in subgingival plate samples were P. intermedia (100%), T. denticola (84.2%) and P. gingivalis (78.9%). In serum samples, the most frequently detected species were P. intermedia (89.4% and 73.6% respectively) and P. gingivalis (57.8% and 42.1%, respectively). A. actinomycetemcomitans and P. gingivalis did not show statistically significant differences between samples. This finding suggests that it could be an association because the same bacteria species detected in the serum were present in bacterial plaque samples. Patients with rheumatoid arthritis contain levels of oral pathogens in the serum and subgingival plaque that are common to red complex organisms, namely Porphyromonas gingivalis, Tannerella forsythia and Prevotella intermedia.

Multiple antibody reactivities to citrullinated antigens in sera from patients with rheumatoid arthritis: association with HLA-DRB1 alleles

2008 ◽  
Vol 68 (5) ◽  
pp. 736-743 ◽  
Author(s):  
O Snir ◽  
M Widhe ◽  
C von Spee ◽  
J Lindberg ◽  
L Padyukov ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Shared Epitope ◽  
Type Ii Collagen ◽  
Cross Reactivity ◽  
Igg Antibodies ◽  
Serum Samples ◽  
Hla Dr ◽  
Citrullinated Proteins ◽  
The Relationship ◽  
Citrullinated Protein

Background:Autoantibodies to cyclic citrullinated peptides (anti-CCP) are present in most patients with rheumatoid arthritis (RA), and associate with HLA-DRB1 shared epitope (SE) alleles.Objective:To investigate reactivities of anti-CCP to various citrullinated proteins/peptides, which represent potential autoantigens in RA, and to examine the relationship between such antibodies, and their association with genetic variants within HLA-DRB1 SE alleles.Methods:Serum samples from 291 patients with established RA and 100 sex- and age-matched healthy subjects were included in this study. Sera were first analysed for presence of anti-CCP antibodies and further for IgG and IgA antibodies towards candidate autoantigens in both their native and citrullinated form including: fibrinogen, α-enolase peptide-1 and the C1-epitope of type II collagen (C1III). Antibody specificity was confirmed by cross-reactivity tests. HLA-DR genotyping was performed.Results:72% of patients with RA were anti-CCP positive. Among the candidate autoantigens examined, IgG antibodies to citrullinated fibrinogen were found in 66% of patients’ sera and in 41% for both citrullinated α-enolase peptide-1 and citrullinated C1III. These antibodies were mainly seen in the anti-CCP-positive patient group; they were specific for their respective antigen and displayed limited cross reactivity. IgA responses were also detected, but less frequently than IgG. Anti-CCP and anti-citrullinated protein antibodies were associated with HLA-DRB1*04 rather than with HLA-DRB1*01 alleles.Conclusions:Antibodies directed against several citrullinated antigens are present in CCP-positive RA, with many patients displaying multireactivity. All specific reactivities were primarily associated with the HLA-DRB1*04 alleles, suggesting common pathways of anti-citrulline immunity.

scholarly journals AB0181 EXPLORING THE ROLE OF IL-6 BLOCKADE IN PATIENTS WITH ACTIVE RHEUMATOID ARTHTITIS AND CHRONIC PERIODONTITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1116.1-1116
Author(s):  
C. Ancuta ◽  
E. Ancuta ◽  
R. Chirieac ◽  
O. Tanculescu ◽  
C. Iordache
Keyword(s):  
Rheumatoid Arthritis ◽  
Periodontal Disease ◽  
Inflammatory Mediators ◽  
Chronic Periodontitis ◽  
Current Evidence ◽  
Clinical Activity ◽  
Dramatic Decrease ◽  
Periodontal Status ◽  
Periodontal Inflammation ◽  
Prospective Longitudinal

Background:Recent data have renewed the interest in common pathobiologic pathways in autoimmune rheumatic conditions and periodontal disease, especially on dual impact of innovative anti-rheumatic drugs in modulating both inflammatory and immune articular as well as periodontal damage. Although consistent data about TNF inhibitors and chronic periodontitis are already published, the influence of IL-6 blockade.Objectives:We aimed to explore the influence of weekly subcutaneously IL-6 receptor inhibitor tocilizumab on periodontal health in a local cohort of patients with rheumatoid arthritis (RA) and chronic periodontitis (PD).Methods:We performed a prospective longitudinal 6 months study in 68 patients with moderate-to-severe RA starting tocilizumab (TCZ) in accordance to local recommendations. Extensive rheumatologic (clinical activity, inflammatory, serological biomarkers) and dental (plaque index PI, gingival index GI, bleeding on probing BOP, pocket probing depth PPD, clinical attachment level CAL) assessments were done. Changes in RA activity and periodontal status were reassessed after 3 and 6 months.Results:51 RA and concomitant t of 68 patients in our initial cohort were finally analyzed. Aggressive periodontal disease was reported particularly in disease subsets with excessive inflammatory (serum C reactive protein level) and serologic biomarkers (anti-citrullinated peptide antibodies ACPA). Furthermore, significant correlations between periodontal status, clinical disease activity and ACPA levels were also demonstrated (p<0.05). We also noticed consistent improvement was noticed in both RA-related parameters sand periodontal inflammation (GI and sites with bleeding of probing) after only 3 months (p < 0.05), while PPD improved after 6 months; overall, CAL presented only slight changes without statistical any significance as well as teeth count and plaque levels (p > 0.05).Conclusion:IL-6 inhibition is able to improve periodontal outcomes in patients with RA and concomitant PD, essentially related to dramatic decrease in serum inflammatory mediators.References:[1]de Molon Scaf, R., Rossa, C.; Thurlings, R.M.; Cirelli, J.A.; Koenders, M.I. Linkage of Periodontitis and Rheumatoid Arthritis: Current Evidence and Potential Biological Interactions, Int. J. Mol. Sci. 2019, 20, 4541.[2]Genco, R.J.; Sanz, M. Clinical and public health implications of periodontal and systemic diseases: An overview. Periodont. 20002020, 83 (1), 08 May.[3]Rinaudo-Gaujous, M.; Blasco-Baque, V.; Miossec, P. et al. Infliximab induced a dissociated response of severe periodontal biomarkers in rheumatoid arthritis patients. J Clin Med2019. 8, 751.[4]Eezammuddeen, N.N.; Vaithilingam, R.D.; Mohamad Hassan, N.H.; Bartold, IL-6 inhibition is able to improve periodontal outcomes in patients with RA and concomitant PD, essentially related to dramatic decrease in serum inflammatory mediators.Disclosure of Interests:CODRINA ANCUTA Speakers bureau: ABBVIE, PFIZER, UCB, NOVARTIS, LILLY, SANDOZ, Consultant of: ABBVIE, PFIZER, UCB, NOVARTIS, LILLY, SANDOZ, EUGEN ANCUTA: None declared, Rodica Chirieac Speakers bureau: ABBVIE, PFIZER, UCB, NOVARTIS, LILLY, SANDOZ, OANA TANCULESCU: None declared, CRISTINA IORDACHE: None declared

scholarly journals POS0355 ASSOCIATIONS BETWEEN HLA-DRB1 SHARED EPITOPES ALLELES AND ANTI-RA33 ANTIBODIES IN DIFFERENT SUBSETS OF RHEUMATOID ARTHRITIS IN MALAYSIAN POPULATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 408.1-408
Author(s):  
A. F. Nurul-Aain ◽  
S. S. Ch’ng ◽  
H. Baharuddin ◽  
M. Mohd Zain ◽  
I. S. Lau ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Control Study ◽  
Director General ◽  
Serum Samples ◽  
Ministry Of Health ◽  
Malaysian Population ◽  
The Relationship ◽  
Shared Epitopes ◽  
Population Controls ◽  
Control Study

Background:The mechanisms affecting anti-RA33 antibody’s involvement in RA pathogenesis is still unclear. Refining our understanding of anti-RA33’s role in RA in relation to known RA-associated genes and serological elements is needed.Objectives:We investigated the relationship between RA-associated HLA-DRB1 epitope (SE) allele and presence of anti-RA33 antibodies in different serological subsets of rheumatoid arthritis in a Malaysian population.Methods:Serum samples from 550 RA cases comprising seronegative (negative for anti-CCP2, IgG and IgM, n=250), seropositive (triple-autoantibody positive, n=150), singular anti-CCP2 positive (n=100), and double RF positive RA (n=50) were chosen from the Malaysian Epidemiological Investigations of RA (MyEIRA) case-control study. Three hundred MyEIRA population controls were used for comparison. All serum samples were assayed using a commercial anti-RA33 ELISA kit. All genetic samples were genotyped for four-digit HLA-DRB1 alleles using the PCR-SSO method on Luminex platform.Results:The proportions of anti-RA33 positive was 20.9% in all RA cases (i.e. 34% in RF only positive RA; 25% in seropositive RA; 18% in seronegative RA and 18% in anti-CCP2 only positive RA). The HLA-DRB1 shared epitope alleles were significantly associated with anti-RA33 positive in the seropositive RA subgroup (OR=6.9, 95% CI 1.4-34.8; p=0.02). We observed significant association between anti-RA33 negative and HLA-DRB1 SE alleles among the seropositive RA patients (OR=4.5, 95% CI 2.8-7.2; p<0.001) and among CCP only positive RA (OR=4.4; 95% CI 2.6-7.4; p<0.01). No association was observed between anti-RA33 status and HLA-DRB1 SE alleles in seronegative RA and RF only positive RA.Conclusion:The HLA-DRB1 SE alleles increased the risk of seropositive and CCP only positive RA independent of anti-RA33 positivity.References:[1]Boeters, Debbie M et al. “The 2010 ACR/EULAR criteria are not sufficiently accurate in the early identification of autoantibody-negative rheumatoid arthritis: Results from the Leiden-EAC and ESPOIR cohorts.” Seminars in arthritis and rheumatism vol. 47,2 (2017): 170-174.[2]de Brito Rocha, Sara et al. “Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis.” Advances in rheumatology (London, England) vol. 59,1 2. 17 Jan. 2019.Acknowledgements:The authors would like to thank the Director General of Health, Ministry of Health Malaysia for supporting this study. The authors are also indebted to participants for their kind participation. This study was financially supported by the Ministry of Health, Malaysia (JPP-IMR 08-012).Disclosure of Interests:None declared

scholarly journals Galectin-1: a Potential Biomarker Differentiating Between Early Rheumatoid Arthritis and Spondyloarthritis

2021 ◽  
Author(s):  
Ana Triguero-Martínez ◽  
Emilia Roy-Vallejo ◽  
Eva Tomero ◽  
Nuria Montes ◽  
Hortensia de la fuente ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Synovial Fluid ◽  
Inflammatory Diseases ◽  
Serum Levels ◽  
Clinical Parameters ◽  
Diagnostic Biomarker ◽  
Serum Samples ◽  
Healthy Donors ◽  
Potential Biomarker ◽  
Fluid Levels

Abstract Background: Galectin 1 (Gal1) is a lectin highly expressed in immune cells that plays a key immunoregulatory role in autoimmunity and resolution of chronic inflammation. Immune-mediated inflammatory diseases (IMIDs) are a broad group of disorders that share pathogenic mechanisms involving components of acquired and innate immunity. Although IMIDs can develop at onset similar features such as peripheral arthritis, they show differences in their evolution and response to treatments. Therefore, additional diagnostic biomarkers are needed in order to get a better classification of patients with early arthritis, especially those not fulfilling specific classification criteria. In this regard, we have recently described that Gal1 serum levels are increased in rheumatoid arthritis (RA) patients compared to healthy donors (HD). Thus, the objective of this work was to evaluate Gal1 levels in serum and synovial fluid from spondyloarthritis (SpA) patients in comparison with RA patients in order to determine their value as a diagnostic biomarker.Methods: We studied Gal1 levels in serum samples from SpA (n=55) and RA patients (n=52). In addition, 49 HD were studied. We also measured Gal1 synovial fluid levels in RA (n=26), osteoarthritis (OA) (n=26) and peripheral SpA (n=26). In SpA patients, clinical parameters were also collected in order to evaluate their association with Gal1 serum levels. Results: We found that SpA patients showed significantly lower Gal1 serum levels than RA patients and similar levels to the general population. In SpA patients, Gal1 synovial fluid levels were similar to those of OA patients and significantly lower than in RA patients. In addition, we did not find any correlation between Gal1 serum levels and clinical parameters of severity in SpA patients.Conclusions: Our results suggest that Gal1 might be a potential diagnostic biomarker of RA that could allow distinguishing between SpA and RA patients.

COVID-19 in children: Pathogenesis and current status

2020 ◽  
Author(s):  
Lawrence Frenkel ◽  
Fernando Gomez ◽  
Joseph A Bellanti
Keyword(s):  
Respiratory Disease ◽  
Respiratory Symptoms ◽  
Distress Syndrome ◽  
Clinical Course ◽  
Current Status ◽  
Current Evidence ◽  
Initial Description ◽  
Relationship Of ◽  
Inflammatory Syndrome ◽  
The Relationship

Background: Since its initial description in December 2019 in Wuhan, China, coronavirus disease 2019 (COVID-19) has rapidly progressed into a worldwide pandemic, which has affected millions of lives. Unlike the disease in adults, the vast majority of children with COVID-19 have mild symptoms and are largely spared from severe respiratory disease. However, thereare children who have significant respiratory disease, and some may develop a hyperinflammatory response similar to thatseen in adults with COVID-19 and in children with Kawasaki disease (KD), which has been termed multisystem inflammatory syndrome in children (MIS-C).Objective: The purpose of this report was to examine the current evidence that supports the etiopathogenesis of COVID-19 in children and the relationship of COVID-19 with KD and MIS-C as a basis for a better understanding of the clinical course, diagnosis, and management of these clinically perplexing conditions.Results: The pathogenesis of COVID-19 is carried out in two distinct but overlapping phases of COVID-19: the first triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) itself and the second by the host immune response. Children with KD have fewer of the previously described COVID-19–associated KD features with less prominent acute respiratory distress syndrome and shock than children with MIS-C.Conclusion: COVID-19 in adults usually includes severe respiratory symptoms and pathology, with a high mortality. Ithas become apparent that children are infected as easily as adults but are more often asymptomatic and have milder diseasebecause of their immature immune systems. Although children are largely spared from severe respiratory disease, they canpresent with a SARS-CoV-2–associated MIS-C similar to KD.

Cardiovascular Risk in Rheumatoid Arthritis and Mechanistic Links: From Pathophysiology to Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 431-446 ◽  
Author(s):  
George E. Fragoulis ◽  
Ismini Panayotidis ◽  
Elena Nikiphorou
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Cvd Risk ◽  
The Past ◽  
Increased Risk ◽  
Cv Disease ◽  
Obesity Hypertension ◽  
Inflammatory Burden

Rheumatoid arthritis (RA) is an autoimmune inflammatory arthritis. Inflammation, however, can spread beyond the joints to involve other organs. During the past few years, it has been well recognized that RA associates with increased risk for cardiovascular (CV) disease (CVD) compared with the general population. This seems to be due not only to the increased occurrence in RA of classical CVD risk factors and comorbidities like smoking, obesity, hypertension, diabetes, metabolic syndrome, and others but also to the inflammatory burden that RA itself carries. This is not unexpected given the strong links between inflammation and atherosclerosis and CVD. It has been shown that inflammatory cytokines which are present in abundance in RA play a significant role in every step of plaque formation and rupture. Most of the therapeutic regimes used in RA treatment seem to offer significant benefits to that end. However, more studies are needed to clarify the effect of these drugs on various parameters, including the lipid profile. Of note, although pharmacological intervention significantly helps reduce the inflammatory burden and therefore the CVD risk, control of the so-called classical risk factors is equally important. Herein, we review the current evidence for the underlying pathogenic mechanisms linking inflammation with CVD in the context of RA and reflect on the possible impact of treatments used in RA.

Evaluation of Serum Calprotectin Level and Disease Activity in Patients with Rheumatoid Arthritis

2019 ◽  
Vol 15 (4) ◽  
pp. 316-320
Author(s):  
Mir Amir Aghdashi ◽  
Seyedmostafa Seyedmardani ◽  
Sholeh Ghasemi ◽  
Zohre Khodamoradi
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Unknown Etiology ◽  
Tender Joint Count ◽  
Serum Samples ◽  
Tender Joint ◽  
Cross Sectional ◽  
Calprotectin Level ◽  
Remission Phase

Background: Rheumatoid Arthritis (RA) is the most common type of chronic inflammatory arthritis with unknown etiology marked by a symmetric, peripheral polyarthritis. Calprotectin also can be used as a biomarker of disease activity in inflammatory arthritis and other autoimmune diseases. Objective: In this study, we evaluated the association between serum calprotectin level and severity of RA activity. Methods: A cross-sectional study was conducted on 44 RA patients with disease flare-up. Serum samples were obtained from all patients to measure calprotectin, ESR, CRP prior to starting the treatment and after treatment period in the remission phase. Based on Disease Activity Score 28 (DAS28), disease activity was calculated. Results: Of 44 RA patients, 9(20.5%) were male and 35(79.5%) were female. The mean age of our cases was 53±1.6 years. Seventeen (38.6%) patients had moderate DAS28 and 27(61.4%) had high DAS28. The average level of calprotectin in the flare-up phase was 347.12±203.60 ng/ml and 188.04±23.58 ng/ml in the remission phase. We did not find any significant association between calprotectin and tender joint count (TJC; P=0.22), swollen joint count (SJC; P=0.87), and general health (GH; P=0.59), whereas significant associations were found between the calprotectin level and ESR (p=0.001) and DAS28 (p=0.02). The average calprotectin level in moderate DAS28 (275.21±217.96 ng/ml) was significantly lower than that in high DAS28 (392.4±183.88 ng/ml) (p=0.05). Conclusion: We showed that the serum level of calprotectin can be a useful and reliable biomarker in RA activity and its severity. It also can predict treatment response.

Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations

2020 ◽  
Vol 18 (2) ◽  
pp. 135-150
Author(s):  
Harsha S. Nagarajarao ◽  
Chandra P. Ojha ◽  
Archana Kedar ◽  
Debabrata Mukherjee
Keyword(s):  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Narrow Channel ◽  
Paradoxical Embolism ◽  
Current Evidence ◽  
Foramen Ovale ◽  
The Right ◽  
The Relationship ◽  
Current Guidelines

: Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit-like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between the right and left atria in approximately 25-27% of adults. : In this review, we examine the clinical relevance of the PFO with analysis of the latest trials evaluating catheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examining the use of antiplatelet medications versus anticoagulants for stroke prevention in those patients with PFO who do not qualify for closure per current guidelines.

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