Association of cytokine patterns and clinical/laboratory parameters, medication and periodontal burden in patients with rheumatoid arthritis (RA)

S Patschan,G Schmalz,O Ritter,D Patschan,D Ziebolz,E Henze,L Bothmann

doi:10.1007/s10266-020-00517-9

S Patschan, G Schmalz + Show 5 more

Open Access

https://doi.org/10.1007/s10266-020-00517-9

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Abstract

To evaluate serum levels of the following cytokines in rheumatoid arthritis subjects with periodontal disease: Interleukin-6, -10, -17, and -23. Patients with rheumatoid arthritis frequently suffer from periodontal disease. Both diseases partly result from a dysregulated immune response. The current study aimed to quantify Interleukin-6, -10, -17, and -23 levels in rheumatoid arthritis. It should be investigated if the periodontal disease would have additional modifying effects. A total of 157 patients were included. Serum levels of IL-6, -10, -17, and -23 were measured by ELISA. Serum IL-10 increased with longer duration of morning stiffness and with higher rheumatoid factor and anti-cyclic citrullinated peptide titres. IL-10 was also elevated with longer duration of prednisolone (< 5 mg daily) and leflunomide therapy. Subjects with lower erythrocyte sedimentation rate/longer leflunomide therapy displayed more missing teeth/more clinical attachment loss. IL-17 was higher in subjects with fewer missing teeth if the following criteria were fulfilled: shorter prednisolone (< 5 mg) and methotrexate therapy, more swollen joints, longer morning stiffness. IL-23 finally was increased in subjects with higher rheumatoid factor and in those with higher periodontal probing depth/clinical attachment loss in the following situations: lower rheumatoid factor and shorter leflunomide therapy. Subjects suffering from dental/periodontal burden show an aberrant systemic cytokine availability of serum IL-6, IL-10, IL-17 and IL-23 related to disease activity and medication. This examination underlines the complexity of potential interactions between disease activity and medication related to periodontal burden.

Highlights

Rheumatoid arthritis (RA) causes synovial inflammation, subsequently followed by joint destruction and disablement if treatment has been initiated too late and/or is inefficient
The current study aimed to examine whether the cytokine level of Interleukin-6, -10, -17, and -23 in serum would be associated with RA-related clinical and laboratory findings
Inclusion criteria: diagnosis of rheumatoid arthritis according to the clinical symptoms in conjunction with laboratory and/or radiographic findings or by applying the 2010 revised ACR (American College of Rheumatology)-/EULAR (European League Against Rheumatism)-classification criteria of the disease [19]; age > 18 and < 90 years; gender: male or female; disease-modifying anti-rheumatic drug (DMARD) therapy with either conventional drugs and/or biologic drugs

Summary

Introduction

Rheumatoid arthritis (RA) causes synovial inflammation, subsequently followed by joint destruction and disablement if treatment has been initiated too late and/or is inefficient. Odontology (2020) 108:441–449 than conventional disease-modifying anti-rheumatic drugs (cDMARDs) such as methotrexate and leflunomide. These medications show a certain potential to influence periodontal inflammation and disease burden [16]. The current study aimed to examine whether the cytokine level of Interleukin-6, -10, -17, and -23 in serum would be associated with RA-related clinical and laboratory findings. It should be investigated if clinical signs of PD would have an additional modifying effect on these associations. The study was part of a large-scaled project on periodontal health in RA, several associated analyzes were published previously [16]

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