Significant association of rheumatoid arthritis-related inflammatory markers with non-surgical periodontal therapy

J Formos Med Assoc. 2018 Nov;117(11):1003-1010. doi: 10.1016/j.jfma.2017.11.006. Epub 2017 Nov 22.

Abstract

Background/purpose: Chronic periodontitis (CP) and rheumatoid arthritis (RA) are the most common chronic inflammatory diseases and their immunopathogenesis is similar. The aim of this study was to evaluate the effect of non-surgical periodontal treatment on the serum levels of RA-related inflammatory markers in patients with chronic periodontitis.

Methods: Thirty-one Taiwanese adults with CP were included. Demographics and periodontal parameters, including probing depth, clinical attachment level, and number of remaining teeth in the oral cavity, were recorded. All subjects received non-surgical periodontal treatment such as scaling and subgingival root planing. Serum samples were collected before and after the treatment. Serum levels of anti-citrullinated protein antibodies (ACPA), rheumatoid factor, tumor necrosis factor-α (TNF-α), C-reactive protein, interleukin-1β (IL-1β), and Interleukin-6 (IL-6) were measured using an enzyme-linked immunosorbent assay.

Results: Non-surgical periodontal treatment significantly reduced the serum ACPA (p = 0.015) and TNF-α levels (p = 0.026) in CP patients, particularly in patients with generalized CP. Furthermore, there was a significant and positive correlation between the number of extracted teeth and the reduction in the serum ACPA (p = 0.05) and IL-1β levels (p = 0.029) after non-surgical periodontal treatment.

Conclusion: Non-surgical periodontal therapy may aid in the control of RA-related inflammatory markers in patients with CP. A large-scale study with well-defined populations is needed to clarify the benefit of non-surgical periodontal therapy.

Keywords: Anti-citrullinated protein antibodies; Non-surgical periodontal treatment; Periodontitis; Tumor necrosis factor-α.

MeSH terms

  • Adult
  • Anti-Citrullinated Protein Antibodies / blood
  • Arthritis, Rheumatoid / blood*
  • Biomarkers / blood*
  • Chronic Periodontitis / blood*
  • Chronic Periodontitis / therapy*
  • Dental Scaling*
  • Female
  • Humans
  • Interleukin-1beta / blood
  • Male
  • Middle Aged
  • Regression Analysis
  • Subgingival Curettage*
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Anti-Citrullinated Protein Antibodies
  • Biomarkers
  • IL1B protein, human
  • Interleukin-1beta
  • Tumor Necrosis Factor-alpha