Upregulation of circulating inflammatory biomarkers under the influence of periodontal disease in rheumatoid arthritis patients
Abstract
Objectives Periodontal disease (PD) and rheumatoid arthritis (RA) are chronic immuno-inflammatory conditions with osteolysis being a hallmark feature. The influence of PD on RA's systemic inflammatory status and disease activity remains unclear. The objective of this study was to assess the systemic inflammation and disease activity of RA under the influence of PD. Methods In this case-control study, 38 RA patients (19 with PD and 19 without PD) were compared to 38 non-RA patients and 12 healthy controls. Periodontal parameters (bleeding on probing (BOP), probing pocket depth (PPD), PPD Total, PPD Disease and marginal bone loss (MBL) were determined. Serological analyses included quantification of 92 inflammatory biomarkers using a multiplex proximity extension assay, anti-citrullinated protein antibodies (ACPA), rheumatoid factor (IgM-RF) and erythrocyte sedimentation rate (ESR). RA disease activity was determined using Disease Activity Score for 28 joints (DAS28). All RA patients were on medication. Results IgM-RF was higher in RA patients with PD. PD conditions were more severe in the non-RA group. Inflammatory biomarkers (IL-10RB, IL-18, CSF-1, NT-3, TRAIL, PD-L1, LIF-R, SLAMF1, FGF-19, TRANCE, CST5, STAMPB, SIRT2, TWEAK, CX3CL1, CXCL5, MCP-1) were significantly higher in RA patients with PD than RA without PD. DAS28 associated with twice as many inflammatory biomarkers in RA patients with PD whereas IgM-RF and ACPA associated more frequently with biomarkers in the RA without PD group. IgM-RF correlated inversely with BOP. Conclusion Periodontal disease augments systemic inflammation in RA. A profound influence exists independent of autoimmune status.
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In patients with periodontitis and rheumatoid arthritis, CX3CL1 levels are statistically significantly increased compared to systemically and periodontally healthy controls.
“finding a statistically significant increase in their levels compared to their control groups represented by systemically and periodontally healthy patients.”
From Potential Impact of Prosthetic Biomaterials on the Periodontium: A Comprehensive Review (2023) · cites this paper as [170]
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- Authors
- Panezai, J., Ali, A., Ghaffar, A., Benchimol, D., Altamash, M., Klinge, B., Engström, P.-E., & Larsson, A.
- Affiliations
- Balochistan University of Information Technology, Engineering and Management Sciences (PK)
- Karolinska Institutet (SE)
- Altamash Institute of Dental Medicine (PK)
- Uppsala University (SE)
- Corresponding author
- Panezai, Jeneen
- Venue
- Cytokine
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 131
- Pages
- 155117
- ISSN
- 1043-4666 (ISSN-L)
- OpenAlex
- W3023432543
- Cited by
- 37
- References
- 51
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 8 · 2023: 7 · 2022: 4 · 2021: 10 · 2020: 3
- FWCI
- 4.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cytokine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Keywords
- periodontal disease, rheumatoid arthritis, systemic inflammation, inflammatory markers, disease activity, IgM rheumatoid factor, anti-citrullinated protein antibodies, bleeding on probing, marginal bone loss, osteolysis, cytokines, DAS28
- MeSH terms
- Anti-Citrullinated Protein Antibodies, Adult, Aged, Arthritis, Rheumatoid, Female, Humans, Male, Middle Aged, Periodontal Diseases, Biomarkers, Up-Regulation, Case-Control Studies, Cytokines, Inflammation Mediators, Chemokines, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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