Abstract
ObjectivesAn interrelationship between rheumatoid arthritis (RA) and periodontitis has been suggested due to their common pathogenic mechanisms. Protein carbamylation and neutrophil extracellular traps (NETs) formation have been shown to be related to autoimmune conditions, including RA, but their association with periodontitis has not been elucidated. Therefore, we assessed whether or not circulating levels of carbamylated protein (CarP) and NETs are associated with periodontitis severity and influenced by periodontal treatment.MethodsWe conducted a retrospective case-control study that included 40 patients with RA and periodontitis, 30 patients with periodontitis, and 43 systemically and periodontally healthy controls to assess the circulating levels of CarP and NETs and rheumatologic and periodontal conditions. The same assessments were also performed in 22 patients with RA and periodontitis after 2 months of periodontal treatment, including oral hygiene instruction and full-mouth supragingival scaling.ResultsPatients with RA and periodontitis showed significantly higher serum levels of CarP and NETs than the control group (P = 0.04 and P < 0.001, respectively). The serum levels of CarP and NETs were significantly correlated positively with the mean values of probing depth (P = 0.01 and P = 0.007, respectively) and clinical attachment level (P = 0.007 and P = 0.001, respectively) in the 40 patients with RA and periodontitis. Multiple logistic regression analyses also revealed significantly positive associations between the serum levels of CarP and NETs and moderate to severe periodontitis (P = 0.03 and P = 0.001, respectively). Furthermore, periodontal treatment significantly decreased the serum levels of CarP and NETs in patients with RA and periodontitis (P = 0.03 and P = 0.02).ConclusionThe circulating levels of CarP and NETs are associated with periodontitis severity and influenced by periodontal treatment in patients with RA.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that causes damage to the cartilage and bone as well as disability [1]
The circulating levels of carbamylated protein (CarP) and neutrophil extracellular traps (NETs) are associated with periodontitis severity and influenced by periodontal treatment in patients with RA
The present study was approved by the Ethics Committee of Niigata University (Permit Number 2017–0114) and Niigata Rheumatic Center (Permit Number 2017–009), which is in accordance with the Declaration of Helsinki and conformed to the STROBE guidelines [26]
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that causes damage to the cartilage and bone as well as disability [1]. Periodontitis is a chronic inflammatory disease that results from dysbiosis of oral microbiota, causing the loss of the connective tissue and alveolar bone support of the teeth [3]. Treatments for both diseases influence each other in that periodontal treatment improves the clinical and biochemical measures for RA [8], and targeted therapy for RA ameliorates the periodontal condition [9]. These observations imply that RA and periodontitis are interrelated through their common pathogenic mechanisms
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