Periodontitis is associated with disease severity and anti-double stranded DNA antibody and interferon-gamma levels in patients with systemic lupus erythematosus

Abstract

ObjectivesTo analyse the correlation between periodontitis severity and disease activity, anti-double stranded DNA (anti-dsDNA) antibody, and interferon-gamma (IFN-γ) levels in patients with systemic lupus erythematous (SLE).MethodsWe selected 61 patients with SLE (age 18–55 years) selected from a hospital in Malang, Indonesia. Clinical examination and laboratory tests were performed to assess disease activity. The severity of SLE was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), while periodontitis severity was measured according to the Periodontal Index (PI) criteria. Levels of anti-dsDNA and IFN-γ were determined using an enzyme-linked immunosorbent assay. Optical density at 450 nm was measured using an automated plate reader.ResultsThe mean age of the subjects with SLE was 29 years, and mean disease duration was 2.8 years. Fifty-four of 61 (88.53%) subjects with SLE had periodontitis according to the PI. SLE subjects exhibited other clinical manifestations such as lupus nephritis, vasculitis, arthritis, mucocutaneous manifestation, fatigue, fever, and/or leukopenia. SLE severity was assessed according to the average SLEDAI score (17.70 ± 12.70), and average anti-dsDNA (122.6 ± 81.01 U/mL), and IFN-γ (14.64 ± 11.17 pg/mL) levels. There was a significantly positive correlation between periodontitis score and SLEDAI score (r = 0.927; p ≤ 0.0001), anti-dsDNA antibody (r = 0.948; p ≤ 0.0001), and IFN-γ (r = 0.951; p ≤ 0.0001) levels.ConclusionResults of the present study demonstrated that periodontitis was associated with SLE disease activity, and was a biomarker of immune aging. Furthermore, this biomarker could be a reliable predictor of periodontal condition and prognosis of periodontitis and can also help in selecting the most appropriate treatment strategy for periodontitis in patients with SLE.

Role of Lymphocytes CD4/CD8 Ratio and Immunoglobulin G Cytomegalovirus as Potential Markers for Systemic Lupus Erythematosus Patients with Periodontal Disease

“…Clinical signs of advanced periodontitis are attachment loss, inflammation of the gingiva, and bone breakdown, which are found to be higher (88.53%) in SLE patients than control. 6,7 Periodontitis starts as gingival inflammation at the gingival margin and causes irreversible damage to the periodontium. Inflammation severity may vary among individuals based on the degree of bacterial infection, and dysregulation of host inflammatory response may substantially contribute to its extent.…”

Oral Hygiene and Dental Caries Status on Systemic Lupus Erythematosus Patients: A Cross-Sectional Study

“…A previous study found this autoantibody affects vulnerable in oral health and infection. Higher anti-ds-DNA was found before had a strong positive correlation with poor oral hygiene and periodontitis in SLE patients [6].…”

“…Higher SLE activity disease also resulting in poor oral hygiene due to immune response. Recent studies also found the activity of SLE had a strong positive correlation with infection, especially periodontitis [6,7,22,23].…”

“…Oral manifestations have been found frequently in SLE patients, including recurrent infections or mouth ulcers, severe gingivitis, temporomandibular joint disorder, osteonecrosis of the mandible, hyposalivation (decrease of salivary flow), and excessive dental caries [12]. A previous study found poor oral hygiene as a result of abnormalities in immune response in SLE patients [6]. Autoantibodies are resulting in oral bacteria changing, and biofilm with virulence microbe forming, such as dominant streptococcus mutants and porphyromonas gingivalis finding [12].…”

“…Poor dental health in SLE patients is found from high debris, calculus to high dental plaque. Poor dental health could cause an infection resulting in dental caries until missing teeth [5,6].…”