Background Although several studies have suggested the association between periodontitis, infection by Porphyromona gingivalis and elevated Rheumatoid Arthritis disease activity, its relationship with oral and plasma peptidyl-arginine deiminase (PAD) activity and citrullination of soluble blood proteins remains still poorly known.
Objectives To evaluate the relationship between periodontal activity, P. gingivalis infection, PAD activity and clínical disease activity of Rheumatoid Arthritis (RA) patients.
Methods All RA patients included in the present study fulfilled the ACR 2010 criteria, signed an informed consent form and were followed at the rheumatology clinic for one year. Periodontal evaluation and oral and peripheral blood samples were obtained the same day as the rheumatology evaluation by the periodontal screening recording index (PSR). PAD-activity was performed using a colorimetric assay employing as substrate BAEE (Sigma) and as positive control recombinant human PAD4 (Cayman Chem). Citrullination was evaluated by WB of immunoprecipitated saliva and blood fibrinogen, employing polyclonal anti-citrulline antibody (Millipore). Plasma pro-inflammatory cytokines and aCCP levels were evaluated by ELISA. Descriptive statistics were employed to evaluate differences between groups and Spearman correlation was used to associate them with clinical parameters.
Results A preliminar analysis was done in 48 RA patients whose mean age (41.2 vs. 43 years), BMI (26.8 vs. 27.2) and time since onset of disease (8.5±10.9 vs. 5.44±3.8) were statistically similar between those with high disease activity (DAS28 >3.4) and low disease activity (DAS28 ≤3.4). In contrast to other studies, high disease activity patients were significant associated with a low index of periodontitis (1.57±1.06; p<0.02), while high disease activity patients were associated with severe periodontitis (3.0±1.23). Otherwise, high disease activity patients showed a mean decrease of 1.5 DAS28 units after one year of follow-up, while low disease activity RA patients showed a lower therapeutic response (change of <0.5 DAS28 units). Evaluation of P. gingivalis, PAD activity, fibronectin citrullination are currently performed
Conclusions Preliminarly, our results suggest that high RA disease activity is negatively associated with severe periodontitis, although the same patients showed a higher therapeutic response after one year of follow up, in comparison to low disease activity RA patients.
Acknowledgements This work was supported by a grant from SEP/CONACYT CB-2010 (#155392).
Disclosure of Interest None declared
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