Anti-cyclic citrullinated peptide antibodies (ACPA) are formed by the action of host-generated antigens and are part of the etiology of rheumatoid arthritis (RA). They are a sensitive and highly specific indicator of RA. MATERIALS AND METHODS In the study involved 105 subjects aged 32 to 85 years (Mean age 50,6 ±13,07), divided into four groups: Group I – with periodontitis (P) and without RA, with diagnosed osteoarthritis – 26 patients; Group II – with P and RA – 28 patients; Group III – without P and with RA – 26 patients; Group IV – without P and without RA – 25 individuals. All patients underwent clinical and laboratory tests for the diagnosis of RA and osteoarthritis, a clinical periodontal examination, and unstimulated whole saliva was collected. RESULTS We found significantly higher salivary ACPA levels in RA patients compared to healthy subjects (p <0.0001). In P patients we found significantly higher levels of ACPA in saliva than in healthy subjects (p <0.0001). Among P patients, we found a significant correlation between ACPA concentration in saliva and the following indicators: PISA; PD; BOP, respectively (p<0.001), (p =0.003), (p =0.007). Among RA patients, our results showed a significant correlation of ACPA concentration in saliva with the following indicators: serum ACPA concentration (p <0.0001); serum RF concentration (p <0.0001); DAS-28 (CRP) (p=0.009). CONCLUSION Based on the established correlation between salivary ACPA levels and RA indicators, a high concentration of ACPA in saliva may be suggested as an easily accessible indicator of RA, but further studies are needed to ascertain this possibility. The established association between periodontal parameters and salivary ACPA levels confirms the effect of periodontal inflammation on salivary ACPA concentration and justifies the treatment of P as a way of preventing and controlling RA.

Antibodies against cyclic citrullinated peptides (ACPA) have significant prognostic value for the onset or progression of rheumatoid arthritis (RA). Extraarticular citrullination and the production of ACPA as an immune response have been well documented in a number of tissues, including inflamed gingiva associated with periodontal disease. The aim of this study was to analyze the relative value of serum ACPA, determined by anti-CCP test, in the periodontitis (P) associated with RA severity`s assessment. The study included 60 patients with a mean age of 58 ± 10 (34 to 74 years), of whom 44 were women and 16 were men with concomitant P and RA. All patients underwent clinical and laboratory tests for the diagnosis of RA and clinical periodontal examination for the diagnosis of P, after signed informed consent. In the studied cohort we found that the average number of lost teeth was 8 ± 5 (0-18), and the average depth of periodontal pockets in mm was 4.4 ± 1.1. In 50% of patients there was a loss of attachment> 5 mm, and in 43% we found furcation lesions. Fifty-eight patients (96.7%) had a 100% prevalence of probing bleeding (BoP), and 47 patients (78.3%) had PISA ≥ 934.71mm². The mean value of PISA in the studied patients was 1727.04 ± 873.64 (214.37 - 4324.00). We did not find a statistically significant difference in serum ACPA levels depending on the severity of periodontal parameters PD (p = 0.357), CAL (p = 0.589) and PISA (p = 0.788). We found that the ROC-based cutoff values ​​for ACPA were high (123.85 IU / ml) and had low sensitivity and specificity in distinguishing between severe and moderate / mild forms of periodontal disease.