Article Text

THU0119 Rheumatoid Arthritis and Periodontal Disease: Association between Salivary Citrulline, ACPA Levels and Clinical Presentation
  1. I. Tar1,
  2. Έ. Csösz2,
  3. Έ. Veiszenbacher3,
  4. E. Végh4,
  5. K. Bágyi5,
  6. K. Lundberg6,
  7. N. Kharlamova6,
  8. I. Márton1,
  9. Z. Szekanecz4
  1. 1Department of Periodontology, University of Debrecen, Faculty of Dentistry
  2. 2Center for Molecular Medicine, University of Debrecen, Faculty of Medicine, Debrecen, Hungary
  3. 3Faculty of Dentistry, Medical and Pharmacological University of Tirgu Mures, Tirgu Mures, Romania
  4. 4Department of Rheumatology, University of Debrecen, Faculty of Medicine
  5. 5Department of Restorative Dentistry, University of Debrecen, Faculty of Dentistry, Debrecen, Hungary
  6. 6Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden


Background Periodontitis and other dental conditions have been associated with the pathogenesis of rheumatoid arthritis (RA). In addition, these dental pathologies are also important comorbidities for RA.

Objectives We wished to evaluate the periodontal involvement of rheumatoid arthritis (RA) patients, and we correlated with various laboratory biomarkers including lipids, autoantibodies, serum vitamin D levels, markers of bone metabolism in relation with the periodontal condition and cariological indices; and also correlated them with salivary citrulline and anti citrullinated protein autoantibody levels with the above mentioned clinical and blood test findings.

Methods Twenty-three RA patients were recruited for the study. Saliva samples were taken following whole scale periodontal and cariological examination. Protein concentration, peptidyl-citrulline and anti-cyclic citrullinated protein (anti-CCP) levels were measured from saliva samples. Blood test results were provided by rheumatologists. Citrullinated enolase protein-1 (CEP-1) level from serum was also measured.

Results Periodontal diagnoses (scores) seem to have a positive dependency on LDL (R=0.722, p=0.008), PTH1 (R=0.586, p=0.022), D3 vitamin level (R=0.586, 0.022), the sum of D3/D2 (R=0.634, p=0.011) respectively, in these patients. Anti-CEP-1 positive patients had significantly higher periodontal scores (2.71±0.11 vs 2.50±0.09, p<0.05) compared to anti-CEP-1 negative subjects. Interestingly, anti-CEP-1 positive patients had significantly higher triglyceride levels compared to seronegative ones (1.81±0.17 vs 1.42±0.05 mmol/l; p<0.05). Salivary citrulline and salivary anti-CCP, (p=0.007, R: 0.583) level has a correlation with the maximum of clinical probing depth.

Conclusions Our results may add further pieces to the mosaic of RA-periodontitis connection. The possible role of antimicrobial immunity, as well as the possible role of lipids and bone metabolism have also been delineated. Future therapies should aim the disruption of this framework.

Disclosure of Interest None declared

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.