Acpa in Saliva and Their Association With Periodontitis and Rheumatoid Arthritis

Bolyarova-Konova, T.; Stefanov, L; Kolarov, Zlatimir; Tanev, Dobromir; Yankova, Petya

doi:10.35465/28.1.2020.pp20-30

Cited by 6 publications

(11 citation statements)

References 6 publications

(20 reference statements)

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“…On the other hand, data on the presence of citrullinated proteins and antibodies against them in periodontal tissues are known, as well as a positive relationship between the severity of periodontal inflammation and their concentration [25,26]. Confirmation of these facts is another study of ours, in which we found a significant positive correlation between the salivary ACPA levels and the severity of some periodontal indicators (PD and BoP) in patients with P, as well as a significant positive relationship between the ACPA concentration in saliva and RA-indicators ACPA in serum, RF in serum and DAS 28 (CRP) in patients with concomitant P and RA [27]. It is likely that the local production of ACPA in inflamed periodontal tissues could lead to a change in immune tolerance to citrullinated peptides and in predisposed individuals and existing rheumatoid disease to aggravate its course by stimulating systemic production of ACPA.…”

Section: Discussionsupporting

confidence: 87%

Serum anti-CCP antibodies in periodontitis associated with rheumatoid arthritis - relative value for the severity of periodontitis

Stefanov¹,

Bolyarova-Konova²,

Kolarov

et al. 2020

BRJ

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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.

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Section: Discussionsupporting

confidence: 87%

Serum anti-CCP antibodies in periodontitis associated with rheumatoid arthritis - relative value for the severity of periodontitis

Stefanov¹,

Bolyarova-Konova²,

Kolarov

et al. 2020

BRJ

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“…Two studies reported on the level of ACPA in saliva of RA patients with PD in comparison to RA patients without PD 34,57 . Both studies found the ACPA level was slightly lower in RA with PD than in RA without PD (Figure 6).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 795 reports which were regarded as irrelevant were excluded following screening of titles and abstracts. After retrieval and assessment of 136 eligible full‐text reports according to the selection criteria, 29 studies 12,13,33–59 were included in the qualitative analysis whereby for the quantitative analysis, data from 28 studies were used (Figure 1). The reasons for the exclusion of 107 articles following full‐text assessment were classified into four domains: (i) use of unclear or self‐reported measures to ascertain RA or PD, (ii) unclear or lack of comparison between RA with and without PD, (iii) absence of reporting on the levels of autoantibodies; and (iv) unpublished data or case reports (Table S2).…”

Section: Resultsmentioning

confidence: 99%

“…The case definitions for RA were relatively standardised as most studies used either the 1987 ACR/RA diagnostic criteria or the more recent 2010 ACR/EULAR criteria. Only one study did not clarify the specific parameters they used to ascertain a case of RA 34 . In general, when RA disease activity was defined as DAS28 > 3.2, the study populations had moderate to high RA disease activity 60 .…”

Section: Resultsmentioning

confidence: 99%

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Influence of periodontitis on levels of autoantibodies in rheumatoid arthritis patients: A systematic review

Eezammuddeen

Vaithilingam

Hassan

2022

J of Periodontal Research

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Background and objective: Periodontitis (PD) is a dysbiotic disease of tooth-supporting structures that has been associated with various systemic diseases including rheumatoid arthritis (RA). To date, evidence demonstrated increased prevalence of RA among PD patients and postulated PD to have a role in the development of autoantibodies in RA patients. Therefore, a systematic review was conducted to assess the available evidence to ascertain the effect of PD on levels of autoantibodies in the serum, saliva and gingival crevicular fluid (GCF) of RA patients. Material and methods: The systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Relevant literature was searched from PubMed, Web of Science, Scopus and Ebscohost databases from inception until 31 August 2020. The risk of bias in each study was determined based on the Newcastle-Ottawa Scale tool. Resultsfrom random-effect meta-analyses were presented as summary estimates of odds ratios (ORs) for seropositivity and standardised mean difference (SMD) of autoantibody levels with 95% confidence intervals. Sensitivity tests and meta-regression were performed to assess the robustness of the results and potential cause of heterogeneity. Results:The electronic and manual searches gathered 932 articles. Following screening and full-text assessment, a total of 29 studies were included in the analysis. Twentyeight published observational studies were included in the quantitative analysis in the form of random-effect meta-analysis which revealed that PD was associated with anticitrullinated proteins autoantibodies (ACPAs) and Rheumatoid Factor (RF) seropositive RA patients (OR for ACPA seropositivity: 1.82; 95% CI: 1.13-2.93) (OR for RF seropositivity: 1.53; 95% CI: 1.05-2.24). Also, RA patients with PD had increased serum levels of ACPA and RF. However, high heterogeneity among studies' results, partially ascribed to the unstandardised case definition of PD and laboratory testing of autoantibodies.Apart from ACPA and RF in serum, studies which reported on other RA-related autoantibodies, as well as autoantibody levels in saliva and GCF were scarce. Conclusion:RA patients with PD tend to have greater ACPA and RF levels in their serum when compared with the RA patients without PD supporting the plausible role of PD in the development of systemic autoimmunity in RA patients.

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“…Similar to SpA, the pathogenesis of inflammation in rheumatoid arthritis (RA) is mediated by a number of effector cytokines (IL-6, IL-7, IL-10, IL-12, IL-15, IL-21, IL-23, IFNα and IFNβ) that signal using JAK [25,26,27]. The efficacy of treatment with Jak inhibitors has been demonstrated in multiple clinical trials in RA [28,29,30,31,32].…”

Section: Jak Inhibitorsmentioning

confidence: 99%

New therapeutic options for the treatment of ankylosing spondylitis.

Boyadzhieva¹,

Stoilov²,

Geneva-Popova³

et al. 2022

RBJ

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The pathogenesis of spondyloarthritis (SpA) is multifactorial and involves multiple immune cells and cytokines that are signaled by Janus kinase (JAK). Inhibition of JAK signaling pathways has emerged as a new therapeutic option for patients with inflammatory joint diseases. Despite the proven effect of treatment with anti-IL-17, as well as TNFα inhibitors, some patients with ankylosing spondylitis cannot reach minimal disease activity or remission. This necessitated the development of a new class of molecules, and in recent years more and more clinical studies have proven their role in the treatment of both rheumatoid arthritis and ankylosing spondylitis. JAK inhibition is a promising therapeutic strategy for the treatment of SpA and its application has potential in patients with axial, polyarticular, or extraarticular manifestations of the disease in psoriatic arthritis and ankylosing spondylitis. The present literature review aims to highlight the new therapeutic options offered by this class of target synthetic disease-modifying antirheumatic drugs and to summarize the clinical trial data for tofacitinib, upadacitinib and filgotinib reported to date.

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Acpa in Saliva and Their Association With Periodontitis and Rheumatoid Arthritis

Cited by 6 publications

References 6 publications

Serum anti-CCP antibodies in periodontitis associated with rheumatoid arthritis - relative value for the severity of periodontitis

Serum anti-CCP antibodies in periodontitis associated with rheumatoid arthritis - relative value for the severity of periodontitis

Influence of periodontitis on levels of autoantibodies in rheumatoid arthritis patients: A systematic review

New therapeutic options for the treatment of ankylosing spondylitis.

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