Rheumatoid arthritis and periodontal disease: What are the similarities and differences?

Abstract

Rheumatoid arthritis (RA) and periodontal disease (PD) are chronic inflammatory diseases that share similar osteoclasia, human leukocyte antigen-DR4 allelic genes and immunological profile, and characteristic cytokines. Smoking can contribute to more severe RA and PD; secretion of pro-inflammatory mediators destroys the soft synovial membrane and periodontium, respectively. Anti-citrullinated protein antibodies and anti-α-enolase antibody are characteristic of these two diseases. Some studies suggest that PD may be associated with RA. Anti-Porphyromonas gingivalis (P. gingivalis) antibody, but no P. gingivalis bacterium can be detected in RA patients' joint fluid. Anti-P. gingivalis antibody has been seen as a biomarker of RA. Both diseases share some nosogenesis and common pathological pathways. However, there are differing views on the connection between the two diseases. Interferon-inducible-16 (IFI16) is a genic marker of RA; moreover, the association between IFI16 and PD is rare. Some studies suggest PD is related to periodontal parameters and patient's pathological status rather than RA. Disease frequency in men and women differ between these two diseases. The expression of interleukin-17 (IL-17) receptor only associates with different genders in PD (PD of different sexes have different IL-17 expressions). Periodontal local treatment only affects clinical periodontal status, and it does not alter circulating levels of IL-6, tumor necrosis factor-alpha or C-reactive protein which are associated with RA. This review examines the similarities and differences between these two diseases and explores possible interactions. Importantly, we will discuss whether PD is a feature of RA and whether this knowledge provides helpful information in future treatment of both diseases.

Rheumatoid arthritis and periodontitis in adults: Using the Korean National Health Insurance Service‒National Sample Cohort

“…These findings were similar to those in previous studies 19,25 where it was shown that RA was common in females and older-aged participants. Interestingly, non-smokers had a higher prevalence of RA in our study although the findings from some previous studies contradict ours, 22,26 while findings from other studies corroborate ours. 27 In addition, the non-drinkers in our study had a higher prevalence of RA, different from the outcome of the previous study.…”

“…RA and periodontitis are chronic inflammatory diseases that share similar etiologies: human leukocyte antigen-DR4 allelic genes, a specific immunological profile, and characteristic cytokines. 22 Cross-sectional analysis performed in this study indicated that the prevalence of periodontitis in RA patients (19.6%) was higher than in the participants without RA (16.6%) ( Table 1), and the prevalence of RA in periodontitis patients (6.2%) was higher than in the individuals without periodontitis (5.2%) ( Table 2). These findings are in agreement with our previous study 19 where the prevalence of periodontitis in RA patients (28.4%) was higher than that in participants without RA (27.9%).…”

Rheumatoid arthritis patients' oral health and disease activity

“…Some studies discuss the relationship between the periodontal disease and rheumatoid disease. Both diseases have the same risk factors, such as genetic predisposition, abnormal host inflammatory response, infection and inflammation, and smoking, and are characterized by increased secretion of pro‐inflammatory mediators . Additionally, there is the question of whether PD can be a feature of RA .…”

“…Current findings strongly support the hypothesis that chronic periodontal disease could be related to the initiation and maintenance of the autoimmune inflammatory responses that occur in RA. It was also stated that periodontal treatment decreased disease activity score, including Disease Activity Score of 28 joints—C‐reactive protein (DAS28‐CRP), immunoglobulin G (IgG) serum level to Porphyromonas gingivalis and citrulline …”

Evaluation of Oral Health Status and Oral Care of Patients with Rheumatoid Arthritis

“…The relation between oral health and general health is currently widely described and documented [ 1 , 2 ]. In several studies, oral infection with periodontal disease (PD) has been associated with systemic conditions, such as diabetes, cardiovascular disease, pulmonary infection, liver diseases, strokes, ankylosing spondylitis, and rheumatoid arthritis (RA) [ 3 , 4 ].…”