IntroductionSaliva has been increasingly used as a diagnostic medium for disease detection and monitoring. The aim of this observational, prospective, pilot study was to investigate whether salivary concentrations of CRP and IL-6 correlate with those in serum and with the clinical course of a rheumatic disease.Materials and methodsNineteen patients with rheumatic disease newly scheduled for anti-TNFα therapy were included. Patients received anti-TNFα treatment (adalimumab, certolizumab, golimumab or infliximab) as per standard protocols. CRP and IL-6 were measured with high-sensitivity immunoassays before and after 12 weeks of therapy, according to standard regimens. The data were analyzed with nonparametric statistics.ResultsConcentrations of CRP in saliva correlated significantly with those in serum (R = 0.62; p < 0.0001) and decreased markedly after successful response to treatment. In patients with a limited response to treatment salivary CRP levels increased. In contrast to CRP, the salivary concentrations of IL-6 did not change significantly over the course of therapy and they did not correlate with serum IL-6 concentrations. Salivary levels of neither CRP nor IL-6 corresponded to parameters of oral health and hygiene.ConclusionsSalivary CRP but not IL-6 could be of potential use for monitoring the rheumatic disease activity.
Dentistry, is one of the intensively and rapidly growing branches of medicine. This prompts dentists to take an interdisciplinary approach to their patients. Thus, the dentist, being a general practitioner, can make significant contributions to the early diagnosis of systemic disease and the faster implementation of appropriate treatment. In view of the aforementioned, we undertook research on the relationship of pathological changes observed in the oral cavity with diseases of the connective tissue system. Collagenosis is a chronic autoimmune disease initiated by many factors, among which the genetic factor and viral infections are mentioned. The changes observed in the oral cavity may be a picture of the disease, a complication of the disease or a side effect of the treatment. The aim of the study is, thus, too present the pathological changes in the oral cavity which often accompany collagenosis, and to discuss the risk factors of connective tissue system diseases and methods of dental treatment.
BackgroundSaliva has been increasingly used as a diagnostic medium for disease detection and monitoring. Since saliva contains many of mediators of inflammation, collagen breakdown and/or bone remodelling, they may be of potential use for the rheumatic disease monitoring.1, 2 ObjectivesThe aim of this pilot study was to investigate whether and how well salivary concentrations of CRP and IL-6 correlate with those in serum and with the clinical course of a rheumatic disease.MethodsThe nineteen consenting patients with rheumatoid arthritis or ankylosing spondylitis, newly scheduled for anti-TNFα therapy, were analysed. CRP and IL-6 were measured with high-sensitivity immunoassays before and after 12 weeks of anti-TNFα therapy, according to standard regimens. Disease activity and oral health parameters were also assessed.ResultsThe patients’ baseline characteristics were summarised in Table 1.Abstract AB1183 – Table 1Patients’ baseline characteristicsDemographic and clinical features Age (years)46 (36–61) Men (%)10 (53%)Oral health parametersPlaque Index (PLI)0.7 (0.4–1.0)Approximal Plaque Index (API) (%)75.0 (42.9–100.0)Sulcus Bleeding Index (SBI)0.0 (0.0–0.3)Gingival Index (GI)0.4 (0.0–1.0)Probing Pocket Depth (PD) (mm)0.8 (0.6–1.3)Clinical Attachment Level (CAL)1.4 (0.6–2.0)DMFT index18.5 (15.0–26.0)The treatment resulted in a significant improvement in the clinical status and standard biochemical parameters in the majority of patients (table 2).Abstract AB1183 – Table 2Selected parameters before and after treatment.Before treatment (n=19)After 12 weeks of treatment (n=19)P-value(Wilcoxon-test) DAS28(ESR) (for RA; n=10)6.2 (5.5–6.4)3.5 (2.8–4.5)0.005BASDAI (for AS; n=9)7.9 (6.6–8.6)2.8 (2.0–4.2)0.008ESR (mm/h)30 (8–70)6 (4–24)0.002WBC (103/l)9.3 (8.2–9.9)8.0 (6.4–9.7)0.015Serum CRP (mg/l)10.24 (4.65–24.31)1.52 (0.54–4.13)0.010Serum IL-6 (pg/ml)14.23 (5.03–34.61)2.32 (1.49–25.14)0.044Salivary CRP (mg/l)0.30 (0.02–3.72)0.05 (0.00–1.87)0.098Salivary IL-6 (pg/ml)1.91 (0.94–2.43)1.48 (0.98–2.78)0.811Concentrations of CRP in saliva correlated significantly with those in serum (R=0.62; p<0.001) and decreased markedly after successful response to treatment (n=15) (1.7±0. 2.2 mg/L vs. 0.8±1.4 mg/L; p<0.001). In patients with a limited or no response to treatment (n=4) salivary CRP levels increased (0.4±0.8 mg/L vs. 2.6±2.4 mg/L; p=0.250).In contrast to CRP, the salivary concentrations of IL-6 did not change significantly over the course of therapy and they did not correlate with serum IL-6 concentrations. Salivary levels of neither CRP nor IL-6 corresponded to parameters of oral health and hygiene.ConclusionsThese data indicate, that salivary CRP but not IL-6 could be of potential use for monitoring the rheumatic disease activity.References[1] Buczko P, Zalewska A, Szarmach I. Saliva and oxidative stress in oral cavity and in some systemic disorders. Journal of physiology and pharmacology: an official journal of the Polish Physiological Society. 2015;66(1):3–9.[2] Mirrielees J, Crofford LJ, Lin Y, Kryscio RJ, Dawson DR, 3r...
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