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Kozlitina IA, Admakin OI, Morozova NS, Zakharova NB, Morozova OL. Cytokine profile of gingival crevicular fluid in children with impaired immunological surveillance system. SECHENOV MEDICAL JOURNAL 2023. [DOI: 10.47093/2218-7332.2022.13.3.34-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Aim. To study the cytokine profile of the gingival crevicular fluid (GCF) in children with a juvenile rheumatoid arthritis (JRA).Materials and methods. We examined 20 children with JRA and 10 patients without somatic pathology aged 6 to 16 years old. The condition of periodontal tissues was assessed by periodontal indices – gingival index GI (Loe, Silness, 1963) and gingival bleeding index GBI. Biomaterial sampling from the gingival sulcus was carried out using special endodontic absorbent paper points. Enzyme immunoassay for IL-18, IL-10, IL-1ß, IL-1RA, MCP-1, VEGFs in the GCF was performed using the test kits of Vector-Best LLC (Novosibirsk, Russia).Results. Mean GI index in the JRA group was 0.31 ± 0.10 and in the control group – 0.20 ± 0.05 (p < 0.05), mean GBI index – 19.90 ± 3.14 and 10.80 ± 2.60 respectively (p < 0.05), which was accompanied by a more pronounced degree of inflammation of periodontal tissues. The GCF concentration of IL-18 in the JRA group was 6.70 (4.97–7.92) pg/ml, in the control group – 11.25 (8.70–13.10) pg/ml (p < 0.05), while the concentration of IL-1ß was 15.30 (13.79–17.18) pg/ml in the JRA group and 5.36 (5.32–5.54) pg/ml in the control group.The IL-10 concentration in the JRA group was 3.60 (2.89–4.45) pg/ml, which was comparable to the values of the control group. The concentration of IL-1RA was lower in the JRA group than in the control group: 3638.5 (2397.5–4133.5) pg/ml and 4951.0 (4303.0–5455.0) pg/ml respectively. The total GCF chemokine concentration for MCP-1 was determined at the level of 15.65 (14.15–17.39) pg/ml and 15.50 (12.80–21.20) pg/ml for the main and control groups and for VEGF – 49.60 (41.95–54.50) pg/ml in the JRA group and 12.00 (11.00–13.00) pg/ml in control group.Conclusion. In children with juvenile rheumatoid arthritis, an imbalance of pro- and anti-inflammatory cytokines in GCF plays a role in the development of gingivitis: an increased of IL-1ß concentration – a triggering factor of pro-inflammatory chains, a decreased concentration of IL-1RA – an anti-inflammatory cytokine, an increased concentration of VEGF – a marker of hypoxia.
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Affiliation(s)
- Iu. A. Kozlitina
- Sechenov First Moscow State Medical University (Sechenov University)
| | - O. I. Admakin
- Sechenov First Moscow State Medical University (Sechenov University)
| | - N. S. Morozova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - N. B. Zakharova
- Saratov State Medical University named after V.I. Razumovsky
| | - O. L. Morozova
- Sechenov First Moscow State Medical University (Sechenov University)
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Gil EG, Åstrøm AN, Lie SA, Rygg M, Fischer J, Rosén A, Bletsa A, Luukko K, Shi XQ, Halbig J, Frid P, Cetrelli L, Tylleskär K, Rosendahl K, Skeie MS. Dental plaque and gingival bleeding in adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis. Acta Odontol Scand 2023; 81:50-65. [PMID: 35635806 DOI: 10.1080/00016357.2022.2078505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes. MATERIAL AND METHODS In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10-16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual. RESULTS 144 and 159 adolescents with JIA were evaluated according to OHI-S and GBI; corresponding numbers of controls were 154 and 161. Plaque and gingival bleeding were more frequent in individuals with JIA than controls. Adjusted analyses showed association between JIA status and OHI-S > 0 (OR = 2.33, 95% CI: 1.47 - 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 - 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups. CONCLUSIONS Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding.
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Affiliation(s)
| | | | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway, Vestland, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Xie-Qi Shi
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Josefine Halbig
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway
| | - Paula Frid
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lena Cetrelli
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Karin Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karen Rosendahl
- Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Marit Slåttelid Skeie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
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3
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Cetrelli L, Bletsa A, Lundestad A, Gil EG, Fischer J, Halbig J, Frid P, Angenete O, Lillevoll I, Rosén A, Tylleskär KB, Luukko K, Nordal E, Åstrøm AN, Skeie MS, Feuerherm AJ, Sen A, Rygg M. Vitamin D, oral health, and disease characteristics in juvenile idiopathic arthritis: a multicenter cross-sectional study. BMC Oral Health 2022; 22:333. [PMID: 35941635 PMCID: PMC9361556 DOI: 10.1186/s12903-022-02349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background Vitamin D deficiency has been associated with autoimmune diseases and oral health. Knowledge about the association between vitamin D status and oral conditions in JIA is limited. We aimed to investigate vitamin D status in a cohort of Norwegian children and adolescents with JIA and possible associations between serum vitamin D levels, clinical indicators of oral health, and JIA disease characteristics. Methods This multi-center, cross-sectional study, included individuals with JIA aged 4–16 years from three geographically spread regions in Norway. Demographic data, age at disease onset, disease duration, JIA category, disease status, medication, and vitamin D intake were registered. One blood sample per individual was analyzed for 25(OH) vitamin D, and the level of insufficiency was defined as < 50 nmol/L. A clinical oral examination was performed applying commonly used indices in epidemiological studies of dental caries, dental erosion, enamel defects, gingival bleeding, and oral hygiene. Serum vitamin D was used as exposure variable in multivariable regression analyses to estimate the associations between insufficient vitamin D level, JIA disease status, and oral conditions, with adjustments for age, sex, geographical region, BMI, seasonal blood sampling, and parental education. Results Among the 223 participants with JIA, 97.3% were Caucasians, 59.2% were girls, and median age was 12.6 years. Median disease duration was 4.6 years, and 44.4% had oligoarticular JIA. Mean serum vitamin D level was 61.4 nmol/L and 29.6% had insufficient levels. Vitamin D levels did not differ between sexes, but between regions, iso-BMI categories, age groups, and seasons for blood sampling. Insufficient vitamin D levels were associated with dentin caries (adjusted OR 2.89, 95% CI 1.43–5.86) and gingival bleeding (adjusted OR 2.36, 95% CI 1.10–5.01). No associations were found with active JIA disease or more severe disease characteristics. Conclusion In our study, nearly 30% had vitamin D insufficiency, with a particularly high prevalence among adolescents. Vitamin D insufficiency was associated with dentin caries and gingival bleeding, but not with JIA disease activity. These results point to the need for a multidisciplinary approach in the follow-up of children with JIA, including an increased focus on vitamin D status and oral health. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02349-1.
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Affiliation(s)
- Lena Cetrelli
- Center of Oral Health Services and Research (TkMidt), Trondheim, Norway. .,The Public Dental Health Service, Trøndelag County, Trondheim, Norway. .,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Athanasia Bletsa
- Oral Health Centre of Expertise in Western Norway (TkV), Bergen, Norway.,Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Anette Lundestad
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olavs University Hospital, Trondheim, Norway
| | - Elisabet Grut Gil
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Josefine Halbig
- Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Medicine, The Arctic University of Norway, Tromsø (UiT), Norway
| | - Paula Frid
- Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø (UiT), Norway.,Division of Oral and Maxillofacial Surgery, Department of Otorhinolaryngology, University Hospital North Norway, Tromsø, Norway
| | - Oskar Angenete
- Department of Radiology and Nuclear Medicine, St Olav Hospital HF, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingrid Lillevoll
- Center of Oral Health Services and Research (TkMidt), Trondheim, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Karin B Tylleskär
- The Children's Clinic at Haukeland University Hospital, Bergen, Norway
| | - Keio Luukko
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ellen Nordal
- Department of Clinical Medicine, The Arctic University of Norway, Tromsø (UiT), Norway.,Department of Pediatrics, University Hospital of Northern Norway, Tromsø, Norway
| | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Western Norway (TkV), Bergen, Norway.,Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Marit Slåttelid Skeie
- Center of Oral Health Services and Research (TkMidt), Trondheim, Norway.,Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Abhijit Sen
- Center of Oral Health Services and Research (TkMidt), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olavs University Hospital, Trondheim, Norway
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Salivary biomarkers in children with juvenile idiopathic arthritis and healthy age-matched controls: a prospective observational study. Sci Rep 2022; 12:3240. [PMID: 35217774 PMCID: PMC8881454 DOI: 10.1038/s41598-022-07233-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 02/09/2022] [Indexed: 11/08/2022] Open
Abstract
Monitoring the immune system's regulation and signaling using saliva could be of interest for clinicians and researchers. Saliva, a biofluid with close exchange with serum, is influenced by circadian variance and oral factors such as masticatory function. This study investigated the detectability and concentration of cytokines and chemokines in saliva in children with juvenile idiopathic arthritis (JIA) as well as saliva flow and the influence of orofacial pain on saliva flow. Of the 60 participants (7-14 years old) enrolled, 30 had a diagnosis of JIA and active disease, and 30 were sex- and age-matched healthy controls. Demographic data and three validated questions regarding presence of orofacial pain and dysfunction were recorded. Stimulated whole saliva was collected and analyzed using a customized R&D bead-based immunoassay with 21 targeted biomarkers. Fourteen of these were detectable and showed similar levels in both children with JIA and controls: TNF-alpha, TNFRSF1B, MMP-2, MMP-3, IL-1alpha, IL-1beta, IL-6R alpha, IL-8, S100A8, CCL2, CCL3, IL-10, CCL11, and CXCL9. In addition, there was no difference in salivary flow rate between groups, but there was an association between orofacial pain and reduced saliva flow rate for both groups.Trial registration: ClinicalTrials.gov Protocol id: 2010/2089-31/2.
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Gil EG, Åstrøm AN, Lie SA, Rygg M, Fischer J, Rosén A, Bletsa A, Luukko K, Shi XQ, Halbig J, Frid P, Cetrelli L, Tylleskär K, Rosendahl K, Skeie MS. Dental caries in children and adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis. BMC Oral Health 2021; 21:417. [PMID: 34433437 PMCID: PMC8390188 DOI: 10.1186/s12903-021-01758-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore whether caries is more prevalent among children and adolescents with JIA compared to controls; examine presence of caries according to JIA group, socio-behavioral and intraoral characteristics, and the extent to which surface-specific caries varies between and within individuals; assess whether surface-specific caries varies according to JIA group and dentition; and investigate whether disease-specific clinical features of JIA are associated with presence of caries. Methods In this comparative cross-sectional study, calibrated dentists examined index teeth (primary 2. molars, 1. permanent molars) of 4–16-year-olds with JIA (n = 219) and matched controls (n = 224), using a detailed caries diagnosis system (including enamel caries). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-behavioral information collected by questionnaires. Multilevel mixed-effect logistic regressions reporting odds ratios (OR) with 95% confidence interval (CI) were applied (caries at surface level as outcome variable). Potential confounders were adjusted for, and the effect of dependency of surface-specific caries data was estimated by calculating intra-class correlation coefficients (ICC). Results At individual level, no significant difference in caries prevalence was found between individuals with JIA and controls, regardless of inclusion of enamel caries. Proportion of enamel lesions exceeded dentine lesions. JIA was not associated with presence of caries, but in both groups, low maternal educational level was associated with presence of caries (OR: 2.07, 95% CI: 1.24–3.46). Occlusal and mesial surfaces, compared to buccal surfaces, had generally higher OR according to presence of caries than distal and lingual surfaces (ICC = 0.56). Surface-specific caries in the permanent dentition differed significantly according to group affiliation. Some JIA disease-specific variables were suggested to associate with presence of caries. Conclusions No overall difference in caries prevalence between individuals with JIA and controls was observed, but for both groups, low maternal educational level and tooth surface associated with presence of caries. Associations between JIA disease-specific variables and presence of caries cannot be excluded. Due to predominance of enamel lesions, the potential of preventative dental strategies is considerable. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01758-y.
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Affiliation(s)
- Elisabeth G Gil
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.
| | - Anne N Åstrøm
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olav's Hospital, Trondheim, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway-Vestland, Bergen, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Xie-Qi Shi
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Josefine Halbig
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway
| | - Paula Frid
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lena Cetrelli
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Center for Oral Health Services and Research (TKMidt), Trondheim, Norway
| | - Karin Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karen Rosendahl
- Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Marit S Skeie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Center for Oral Health Services and Research (TKMidt), Trondheim, Norway
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Frid P, Baraniya D, Halbig J, Rypdal V, Songstad NT, Rosèn A, Berstad JR, Flatø B, Alakwaa F, Gil EG, Cetrelli L, Chen T, Al-Hebshi NN, Nordal E, Al-Haroni M. Salivary Oral Microbiome of Children With Juvenile Idiopathic Arthritis: A Norwegian Cross-Sectional Study. Front Cell Infect Microbiol 2020; 10:602239. [PMID: 33251163 PMCID: PMC7672027 DOI: 10.3389/fcimb.2020.602239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background The oral microbiota has been connected to the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. The objective of this study was to characterize the salivary oral microbiome associated with juvenile idiopathic arthritis (JIA), and correlate it with the disease activity including gingival inflammation. Methods Fifty-nine patients with JIA (mean age, 12.6 ± 2.7 years) and 34 healthy controls (HC; mean age 12.3 ± 3.0 years) were consecutively recruited in this Norwegian cross-sectional study. Information about demographics, disease activity, medication history, frequency of tooth brushing and a modified version of the gingival bleeding index (GBI) and the simplified oral hygiene index (OHI-S) was obtained. Microbiome profiling of saliva samples was performed by sequencing of the V1-V3 region of the 16S rRNA gene, coupled with a species-level taxonomy assignment algorithm; QIIME, LEfSe and R-package for Spearman correlation matrix were used for downstream analysis. Results There were no significant differences between JIA and HC in alpha- and beta-diversity. However, differential abundance analysis revealed several taxa to be associated with JIA: TM7-G1, Solobacterium and Mogibacterium at the genus level; and Leptotrichia oral taxon 417, TM7-G1 oral taxon 352 and Capnocytophaga oral taxon 864 among others, at the species level. Haemophilus species, Leptotrichia oral taxon 223, and Bacillus subtilis, were associated with healthy controls. Gemella morbillorum, Leptotrichia sp. oral taxon 498 and Alloprevotella oral taxon 914 correlated positively with the composite juvenile arthritis 10-joint disease activity score (JADAS10), while Campylobacter oral taxon 44 among others, correlated with the number of active joints. Of all microbial markers identified, only Bacillus subtilis and Campylobacter oral taxon 44 maintained false discovery rate (FDR) < 0.1. Conclusions In this exploratory study of salivary oral microbiome we found similar alpha- and beta-diversity among children with JIA and healthy. Several taxa associated with chronic inflammation were found to be associated with JIA and disease activity, which warrants further investigation.
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Affiliation(s)
- Paula Frid
- Department of ENT, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, Tromsø, Norway.,Public Dental Service Competence Centre of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Divyashri Baraniya
- Oral Microbiome Laboratory, Kornberg School of Dentistry, Temple University, Philadelphia, PA, United States
| | - Josefine Halbig
- Public Dental Service Competence Centre of North Norway, Tromsø, Norway.,Department of Clinical Dentistry, UiT the Arctic University of Norway, Tromsø, Norway
| | - Veronika Rypdal
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Nils Thomas Songstad
- Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Annika Rosèn
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Johanna Rykke Berstad
- Department of ENT, Division of Oral and Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Berit Flatø
- Department of Rheumatology and Infectious Diseases, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | - Fadhl Alakwaa
- Department of Computational Medicine and Bioinformatics, University Michigan, Ann Arbor, MI, United States
| | | | - Lena Cetrelli
- Center of Oral Health Services and Research (TkMidt), Trondheim, Norway
| | - Tsute Chen
- Department of Microbiology, Forsyth Institute, Cambridge, MA, United States
| | - Nezar Noor Al-Hebshi
- Oral Microbiome Laboratory, Kornberg School of Dentistry, Temple University, Philadelphia, PA, United States
| | - Ellen Nordal
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Mohammed Al-Haroni
- Department of Clinical Dentistry, UiT the Arctic University of Norway, Tromsø, Norway
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7
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Merle CL, Hoffmann R, Schmickler J, Rühlmann M, Challakh N, Haak R, Schmalz G, Ziebolz D. Comprehensive Assessment of Orofacial Health and Disease Related Parameters in Adolescents with Juvenile Idiopathic Arthritis-A Cross-Sectional Study. J Clin Med 2020; 9:jcm9020513. [PMID: 32069957 PMCID: PMC7074230 DOI: 10.3390/jcm9020513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/03/2020] [Accepted: 02/11/2020] [Indexed: 12/11/2022] Open
Abstract
Background: The aim of this cross-sectional study was to investigate oral health and functional status of adolescents with juvenile idiopathic arthritis (JIA) and its possible link to disease specific parameters. Methods: Patients with JIA were recruited (November 2012–October 2014) and disease specific information was extracted from patients’ records. Oral examination included: dental findings (decayed-, missing- and filled-teeth-index (dmf-t/DMF-T)), gingival inflammation (papilla-bleeding-index (PBI)) and periodontal screening index (PSI). Functional examination followed Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Additionally, modified Helkimo’s Clinical Dysfunction Index and radiographic scoring were recorded. Results: 59 JIA patients were included. The mean dmf-t/DMF-T was 2.6. Only one patient showed no signs of gingival inflammation, while 57.6% had a maximum PSI of 2 or less. Positive functional findings were assessed clinically in more than half of the patients. Major diagnosis by RDC/TMD was osteoarthrosis. Patients with at least one positive anamnestic or clinical functional finding revealed significantly higher radiographic scores (CI = 0.440, p = 0.022). Patients with increased c-reactive-protein had a significantly higher PBI (Z = –2.118, p = 0.034) and increased radiographic scores (CI = 0.408, p = 0.043). Conclusions: Adolescents suffering from JIA show high levels of caries experience and gingival inflammation. Temporomandibular joint dysfunction is often seen in JIA patients. Consequently, special dental care programs would be recommendable.
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Affiliation(s)
- Cordula Leonie Merle
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Robin Hoffmann
- Dental Practice Pröpper, Flachsenberg, Hoffmann, 34119 Kassel, Germany;
| | - Jan Schmickler
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Michael Rühlmann
- Medical Practice for Pediatricy And Pediatric Rheumatology M. Rühlmann, 37073 Goettingen, Germany;
- Department of Pediatricy II (Pediatric Neurology), University of Goettingen, 37075 Goettingen, Germany
| | - Nadia Challakh
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
- Correspondence: ; Tel.: +49-341-97-21211
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8
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Skeie MS, Gil EG, Cetrelli L, Rosén A, Fischer J, Åstrøm AN, Luukko K, Shi X, Feuerherm AJ, Sen A, Frid P, Rygg M, Bletsa A. Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. BMC Oral Health 2019; 19:285. [PMID: 31856793 PMCID: PMC6921440 DOI: 10.1186/s12903-019-0965-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/21/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Observational studies examining the association between oral health and juvenile idiopathic arthritis (JIA) among children and adolescents have reported inconsistent findings. The aims of this systematic review and meta-analysis were to ascertain a potential difference in oral health and oral health-related quality of life (OHRQoL) among children and adolescents with JIA and healthy peers, and to assess the association of prevalence of oral diseases/conditions, temporomandibular disorders (TMD), including temporomandibular joint (TMJ) diseases, in relation to activity and severity of JIA. METHOD Medline Ovid, Embase, CINAHL, SweMed+ and Cochrane Library were searched up to 25 November 2018. All articles published in English, German and Scandinavian languages focusing on children and adolescents with JIA and without JIA in relation to oral health measures, were considered. Two authors independently evaluated observational studies for inclusion. The study quality was assessed using modified Newcastle Ottawa Scale. Meta-analysis was performed for studies focusing on dental caries as an outcome. RESULTS Nineteen articles met the inclusion criteria, covering a range of oral diseases/conditions and OHRQoL. Eighteen studies had cross-sectional design. No mean difference of dmft/DMFT indices (decayed/missed/filled teeth) was observed between the JIA - and healthy group. None of the oral health measures including dental erosive wear, enamel defects, dental maturation and OHRQoL, indicated better oral health among children and adolescents with JIA compared to healthy group. However, periodontal conditions and TMD were more predominant among children and adolescents with JIA compared to healthy peers. CONCLUSIONS Based on the cross-sectional studies, periodontal diseases and TMD were found to be more frequent in children and adolescents with JIA compared to healthy peers. Furthermore, more high-quality studies with large sample size are needed before we infer any concrete conclusion regarding the association between the prevalence of oral and TMJ diseases or oral conditions in relation to activity and severity of JIA.
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Affiliation(s)
- Marit S Skeie
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway.
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
| | - Elisabeth G Gil
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Lena Cetrelli
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Xieqi Shi
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
- Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Astrid J Feuerherm
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Abhijit Sen
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Public health and Nursing, Faculty of Medical and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paula Frid
- Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromso, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway
- Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North, Tromso, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
- Oral Health Centre of Expertise in Western Norway- Hordaland, Trondheim, Norway
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9
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Grevich S, Lee P, Leroux B, Ringold S, Darveau R, Henstorf G, Berg J, Kim A, Velan E, Kelly J, Baltuck C, Reeves A, Leahey H, Hager K, Brittnacher M, Hayden H, Miller S, McLean J, Stevens A. Oral health and plaque microbial profile in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17:81. [PMID: 31842923 PMCID: PMC6916162 DOI: 10.1186/s12969-019-0387-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/04/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The oral microbiota has been implicated in the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. This study tested for associations between oral health, microbial communities and juvenile idiopathic arthritis (JIA). METHODS A cross-sectional exploratory study of subjects aged 10-18 years with oligoarticular, extended oligoarticular and polyarticular JIA was conducted. Control groups included pediatric dental clinic patients and healthy volunteers. The primary aim was to test for an association between dental health indices and JIA; the secondary aim was to characterize the microbial profile of supragingival plaque using 16S rRNA gene sequencing. RESULTS The study included 85 patients with JIA, 62 dental patients and 11 healthy child controls. JIA patients overall had significantly more gingival inflammation compared to dental patients, as evidenced by bleeding on probing of the gingiva, the most specific sign of active inflammation (p = 0.02). Overall, however, there was a trend towards better dental hygiene in the JIA patients compared to dental patients, based on indices for plaque, decay, and periodontitis. In the JIA patients, plaque microbiota analysis revealed bacteria belonging to genera Haemophilus or Kingella elevated, and Corynebacterium underrepresented. In poly JIA, bacteria belonging to the genus Porphyromonas was overrepresented and Prevotella was underrepresented. CONCLUSION Increased gingival inflammation in JIA was independent of general oral health, and thus cannot be attributed to poor dental hygiene secondary to disability. The variation of microbial profile in JIA patients could indicate a possible link between gingivitis and synovial inflammation.
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Affiliation(s)
- Sriharsha Grevich
- Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. .,Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
| | - Peggy Lee
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Brian Leroux
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Sarah Ringold
- 0000 0000 9026 4165grid.240741.4Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105 USA ,0000000122986657grid.34477.33Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000 0000 9026 4165grid.240741.4Center for Clinical and Translational Research, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Richard Darveau
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Gretchen Henstorf
- 0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Joel Berg
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Amy Kim
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Elizabeth Velan
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Joseph Kelly
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Camille Baltuck
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Anne Reeves
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Hannah Leahey
- 0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Kyle Hager
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Mitchell Brittnacher
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Hillary Hayden
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Samuel Miller
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000000122986657grid.34477.33Department of Genome Sciences, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000000122986657grid.34477.33Department of Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Jeffrey McLean
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Anne Stevens
- 0000 0000 9026 4165grid.240741.4Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105 USA ,0000000122986657grid.34477.33Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
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10
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Frid P, Nordal E, Bovis F, Giancane G, Larheim TA, Rygg M, Pires Marafon D, De Angelis D, Palmisani E, Murray KJ, Oliveira S, Simonini G, Corona F, Davidson J, Foster H, Steenks MH, Flato B, Zulian F, Baildam E, Saurenmann RK, Lahdenne P, Ravelli A, Martini A, Pistorio A, Ruperto N. Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2017; 69:677-686. [PMID: 27564918 DOI: 10.1002/acr.23003] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/15/2016] [Accepted: 08/02/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the demographic, disease activity, disability, and health-related quality of life (HRQOL) differences between children with juvenile idiopathic arthritis (JIA) and their healthy peers, and between children with JIA with and without clinical temporomandibular joint (TMJ) involvement and its determinants. METHODS This study is based on a cross-sectional cohort of 3,343 children with JIA and 3,409 healthy peers, enrolled in the Pediatric Rheumatology International Trials Organisation HRQOL study or in the methotrexate trial. Potential determinants of TMJ involvement included demographic, disease activity, disability, and HRQOL measures selected through univariate and multivariable logistic regression. RESULTS Clinical TMJ involvement was observed in 387 of 3,343 children with JIA (11.6%). Children with TMJ involvement, compared to those without, more often had polyarticular disease course (95% versus 70%), higher Juvenile Arthritis Disease Activity Score (odds ratio [OR] 4.6), more disability, and lower HRQOL. Children with TMJ involvement experienced clearly more disability and lower HRQOL compared to their healthy peers. The multivariable analysis showed that cervical spine involvement (OR 4.6), disease duration >4.4 years (OR 2.8), and having more disability (Childhood Health Assessment Questionnaire Disability Index >0.625) (OR 1.6) were the most important determinants for TMJ involvement. CONCLUSION Clinical TMJ involvement in JIA is associated with higher disease activity, higher disability, and impaired HRQOL. Our findings indicate the need for dedicated clinical and imaging evaluation of TMJ arthritis, especially in children with cervical spine involvement, polyarticular course, and longer disease duration.
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Affiliation(s)
- Paula Frid
- University Hospital of North Norway, UiT The Arctic University of Norway, and Public Dental Competence Center of Northern Norway, Tromsø, Norway
| | - Ellen Nordal
- University Hospital of North Norway, and UiT The Arctic University of Norway, Tromsø, Norway
| | - Francesca Bovis
- Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy
| | | | - Tore A Larheim
- UiT The Arctic University of Norway, Tromsø, and University of Oslo, Oslo, Norway
| | - Marite Rygg
- Norwegian University of Science and Technology and St. Olavs University Hospital, Trondheim, Norway
| | | | - Donato De Angelis
- Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy
| | - Elena Palmisani
- Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy
| | - Kevin J Murray
- Princess Margaret Hospital for Children, Perth, Australia
| | - Sheila Oliveira
- Universidade Federal do Rio de Janeiro, and Instituto de Puericultura e Pediatria Martagao Gesteira, Rio de Janeiro, Brazil
| | | | - Fabrizia Corona
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Helen Foster
- Newcastle University, Newcastle Hospitals NHS Foundation Trust, and Great North Children's Hospital, Newcastle Upon Tyne, UK
| | | | - Berit Flato
- Oslo University Hospital and University of Oslo, Oslo, Norway
| | | | - Eileen Baildam
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | | | - Pekka Lahdenne
- Children's Hospital and Helsinki University Central Hospital, Helsinki, Finland
| | - Angelo Ravelli
- Università di Genova, Istituto Giannina Gaslini, and PRINTO Coordinating Center, Genoa, Italy
| | - Alberto Martini
- Università di Genova, Istituto Giannina Gaslini, and PRINTO Coordinating Center, Genoa, Italy
| | | | - Nicolino Ruperto
- Istituto Giannina Gaslini and PRINTO Coordinating Center, Genoa, Italy
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11
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Lucchese A, Manuelli M, Matarese G, Isola G, Bassani L, Perillo L, Gastaldi G, Gherlone E. Artrite idiopatica giovanile: implicazioni odontostomatologiche. DENTAL CADMOS 2016. [DOI: 10.1016/s0011-8524(16)30079-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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de Oliveira Perestrelo B, Feres de Melo AR, de Sant'Anna GR, Leite MF. Compromised salivary parameters of children with juvenile idiopathic arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:262-8. [PMID: 26868468 DOI: 10.1016/j.oooo.2015.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/20/2015] [Accepted: 11/28/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the salivary parameters of individuals with juvenile idiopathic arthritis (JIA) and determine if there is a correlation with the simplified oral hygiene index (OHI-S). STUDY DESIGN Stimulated whole saliva was collected from children, aged 6 to 12 years, with JIA (n = 36) and compared with saliva from a control group (CG) composed of healthy children matched by demographic characteristics (n = 36). Salivary parameters evaluated were amylase and peroxidase activities, calcium, phosphate, and total sialic acid concentration. Data were compared by two-tailed Student's t test, and salivary parameters were evaluated for correlations with OHI-S by Spearman's correlation. RESULTS The JIA group had a statistically significant reduction in all salivary parameters: α-amylase (20%) (CG, 9.84 ± 4.23; JIA 4.80 ± 3.10) and peroxidase (55%) (CG, 35.05 ± 14.97; JIA, 15.78 ± 6.44) activities, total sialic acid (25%) (CG, 0.024 ± 0.01; JIA, 0.010 ± 0.04), calcium (13%) (CG, 6.26 ± 2.26; JIA, 5.44 ± 2.26) and phosphate (50%) (CG, 10.88 ± 1.49; JIA, 5.45 ± 0.88) concentration compared with the CG (P ≤ .05). There were no significant correlations between the salivary parameters and OHI-S in either group. CONCLUSION JIA patients showed a reduction of different salivary parameters involved in maintaining oral health.
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Affiliation(s)
| | | | | | - Mariana Ferreira Leite
- Department of Pediatric Dentistry at the University Cruzeiro do Sul, São Paulo, SP, Brazil.
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13
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Lange L, Thiele GM, McCracken C, Wang G, Ponder LA, Angeles-Han ST, Rouster-Stevens KA, Hersh AO, Vogler LB, Bohnsack JF, Abramowicz S, Mikuls TR, Prahalad S. Symptoms of periodontitis and antibody responses to Porphyromonas gingivalis in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2016; 14:8. [PMID: 26861944 PMCID: PMC4748489 DOI: 10.1186/s12969-016-0068-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 02/01/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The association between rheumatoid arthritis (RA) and periodontitis is well established. Some children with juvenile idiopathic arthritis (JIA) phenotypically resemble adults with RA, characterized by the presence of anti-cyclic citrullinated peptide (CCP) antibodies. We sought to investigate an association between CCP-positive JIA and symptoms of periodontitis and antibodies to oral microbiota. METHODS Antibodies to oral pathogens Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum were measured using ELISA in 71 children with CCP-positive JIA and 74 children with CCP-negative JIA. Oral health history was collected from 37 children with CCP-positive JIA and 121 children with CCP-negative JIA. T-tests, Chi-square tests, Mann-Whitney U tests, and multivariable regression were used to compare the groups. RESULTS Compared to those with CCP-negative JIA, children with CCP-positive JIA were more likely to be female, older and non-Caucasian. Anti-P. gingivalis (p <0.003) and anti-P. intermedia (p <0.008) IgG antibody titers were higher in the CCP-positive cohort. Differences in P. gingivalis antibody titers remained significant after adjusting for age (p = 0.007). Children with CCP-positive JIA more likely reported tender/bleeding gums (43 % vs. 24 %, p < 0.02) compared to children with CCP-negative JIA. After controlling for age at collection, the odds of having tender/bleeding gums were 2.2 times higher in the CCP-positive group compared (95 % CI 0.98 - 4.83; p = 0.056). CONCLUSIONS Children with CCP-positive JIA have higher antibody titers to P. gingivalis and more symptoms of poor oral health, supporting a possible role for periodontitis in the etiology of CCP-positive JIA.
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Affiliation(s)
- Lauren Lange
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
| | - Geoffrey M. Thiele
- VA Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, NE USA
| | - Courtney McCracken
- Department of Pediatrics Emory University School of Medicine, 1760 Haygood Dr. NE, Atlanta, GA, 30322, USA.
| | - Gabriel Wang
- Department of Pediatrics Emory University School of Medicine, 1760 Haygood Dr. NE, Atlanta, GA, 30322, USA.
| | | | - Sheila T. Angeles-Han
- Department of Pediatrics Emory University School of Medicine, 1760 Haygood Dr. NE, Atlanta, GA 30322 USA ,Children’s Healthcare of Atlanta, Atlanta, GA USA
| | - Kelly A. Rouster-Stevens
- Department of Pediatrics Emory University School of Medicine, 1760 Haygood Dr. NE, Atlanta, GA 30322 USA ,Children’s Healthcare of Atlanta, Atlanta, GA USA
| | - Aimee O. Hersh
- University of Utah School of Medicine, Salt Lake City, UT USA
| | - Larry B. Vogler
- Department of Pediatrics Emory University School of Medicine, 1760 Haygood Dr. NE, Atlanta, GA 30322 USA ,Children’s Healthcare of Atlanta, Atlanta, GA USA
| | | | - Shelly Abramowicz
- Department of Pediatrics Emory University School of Medicine, 1760 Haygood Dr. NE, Atlanta, GA, 30322, USA. .,Children's Healthcare of Atlanta, Atlanta, GA, USA. .,Department of Surgery, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA, USA.
| | - Ted R. Mikuls
- VA Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, NE USA
| | - Sampath Prahalad
- Department of Pediatrics Emory University School of Medicine, 1760 Haygood Dr. NE, Atlanta, GA, 30322, USA. .,Children's Healthcare of Atlanta, Atlanta, GA, USA. .,Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA.
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14
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Juvenile idiopathic arthritis activity and function ability: deleterious effects in periodontal disease? Clin Rheumatol 2015; 35:81-91. [DOI: 10.1007/s10067-015-3125-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/11/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
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15
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Santos D, Silva C, Silva M. Oral health and quality of life of children and adolescents with juvenile idiopathic arthritis according to their caregivers' perceptions. SPECIAL CARE IN DENTISTRY 2015; 35:272-8. [PMID: 26255878 DOI: 10.1111/scd.12129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to assess the correlation between oral health indicators and oral health-related quality of life (OHRQoL) of children and adolescents with juvenile idiopathic arthritis (JIA) according to their caregivers' perceptions. Parents or guardians (mean age, 40.6 years; standard deviation [SD] = 10.97 years) of children and adolescents with JIA (n = 17; mean age, 9.8 years; SD = 2.86) and parents or guardians of healthy children and adolescents (n = 15; mean age, 10.7 years; SD = 2.16) filled the short form of the Brazilian Parental-Caregiver Questionnaire (SF: 13 - B-PCPQ). Dental evaluations were performed on all children. There was no significant difference in SF: 13 - B-PCPQ scores of the two groups. Children and adolescents with JIA had fewer caries in their primary dentition and more gingival bleeding after probing than those without JIA. The frequency of temporomandibular disorders was 50.0% for JIA patients and 46.7% for their healthy counterparts. There was no correlation between oral health indicators and SF: 13 - B-PCPQ scores. As perceived by caregivers, JIA did not negatively impact the well-being of their children and adolescents as related to oral health, and their OHRQoL did not correlate with oral health status.
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Affiliation(s)
- Débora Santos
- Master of Science, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Carlos Silva
- Medical Doctor, Professor of the Department of Pediatrics, School of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Marlete Silva
- Doctor of Dental Science, Associated Professor of Fixed Prosthodontics and Occlusion, Faculty of Dentistry, Federal University of Uberlândia, Minas Gerais, Brazil
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16
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Fabri GMC, Savioli C, Siqueira JT, Campos LM, Bonfá E, Silva CA. [Periodontal disease in pediatric rheumatic diseases]. REVISTA BRASILEIRA DE REUMATOLOGIA 2014; 54:311-7. [PMID: 25627227 DOI: 10.1016/j.rbr.2013.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/23/2013] [Indexed: 12/15/2022] Open
Abstract
Gingivitis and periodontitis are immunoinflammatory periodontal diseases characterized by chronic localized infections usually associated with insidious inflammation This narrative review discusses periodontal diseases and mechanisms influencing the immune response and autoimmunity in pediatric rheumatic diseases (PRD), particularly juvenile idiopathic arthritis (JIA), childhood-onset systemic lupus erythematosus (C-SLE) and juvenile dermatomyositis (JDM). Gingivitis was more frequently observed in these diseases compared to health controls, whereas periodontitis was a rare finding. In JIA patients, gingivitis and periodontitis were related to mechanical factors, chronic arthritis with functional disability, dysregulation of the immunoinflammatory response, diet and drugs, mainly corticosteroids and cyclosporine. In C-SLE, gingivitis was associated with longer disease period, high doses of corticosteroids, B-cell hyperactivation and immunoglobulin G elevation. There are scarce data on periodontal diseases in JDM population, and a unique gingival pattern, characterized by gingival erythema, capillary dilation and bush-loop formation, was observed in active patients. In conclusion, gingivitis was the most common periodontal disease in PRD. The observed association with disease activity reinforces the need for future studies to determine if resolution of this complication will influence disease course or severity.
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Affiliation(s)
- Gisele M C Fabri
- Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Faculdade de Odontologia, Universidade Federal de Juiz de Fora, MG, Brasil
| | - Cynthia Savioli
- Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - José T Siqueira
- Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Lucia M Campos
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Eloisa Bonfá
- Divisão de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Clovis A Silva
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Divisão de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Feres de Melo AR, Ferreira de Souza A, de Oliveira Perestrelo B, Leite MF. Clinical oral and salivary parameters of children with juvenile idiopathic arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:75-80. [PMID: 24332330 DOI: 10.1016/j.oooo.2013.08.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/16/2013] [Accepted: 08/24/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate clinical oral and salivary parameters of individuals with juvenile idiopathic arthritis (JIA). STUDY DESIGN Clinical parameters and whole saliva were collected from children aged 6 to 12 years with JIA (n = 36) and from a healthy, matched control group (n = 36). The clinical and salivary parameters evaluated were the dental caries (decayed, missing, or filled teeth), gingival and simplified oral hygiene indices, salivary flow rate, pH, buffer capacity, total protein, and secretory immunoglobulin A concentrations. RESULTS JIA individuals presented poorer oral hygiene (P ≤ .05) but no difference in the dental caries and gingival indices. JIA patients presented an increase in total protein concentration (86%) and buffer capacity in the range of pH 6.9 to 6.0 (10%) and a reduction in initial pH (6%), buffer capacity in the range of pH ≥ 7.0 (50%), and immunoglobulin A concentration (27%) (P ≤ .05). CONCLUSIONS JIA is associated with poor oral hygiene and salivary changes, including reductions in immune factors and an altered profile of salivary buffer capacity.
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Rutger Persson G. Rheumatoid arthritis and periodontitis - inflammatory and infectious connections. Review of the literature. J Oral Microbiol 2012; 4:JOM-4-11829. [PMID: 22347541 PMCID: PMC3280043 DOI: 10.3402/jom.v4i0.11829] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Revised: 01/23/2012] [Accepted: 01/23/2012] [Indexed: 12/20/2022] Open
Abstract
An association between oral disease/periodontitis and rheumatoid arthritis (RA) has been considered since the early 1820s. The early treatment was tooth eradication. Epidemiological studies suggest that the prevalence of RA and periodontitis may be similar and about 5% of the population are aged 50 years or older. RA is considered as an autoimmune disease whereas periodontitis has an infectious etiology with a complex inflammatory response. Both diseases are chronic and may present with bursts of disease activity. Association studies have suggested odds ratios of having RA and periodontitis varying from 1.8:1 (95% CI: 1.0–3.2, NS) to 8:1 (95% CI: 2.9–22.1, p<0.001). Genetic factors are driving the host responses in both RA and periodontitis. Tumor necrosis factor-α, a proinflammatory cytokine, regulates a cascade of inflammatory events in both RA and periodontitis. Porphyromonas gingivalis is a common pathogen in periodontal infection. P. gingivalis has also been identified in synovial fluid. The specific abilities of P. gingivalis to citrullinate host peptides by proteolytic cleavage at Arg-X peptide bonds by arginine gingipains can induce autoimmune responses in RA through development of anticyclic citrullinated peptide antibodies. In addition, P. gingivalis carries heat shock proteins (HSPs) that may also trigger autoimmune responses in subjects with RA. Data suggest that periodontal therapies combined with routine RA treatments further improve RA status.
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Affiliation(s)
- G Rutger Persson
- Department of Periodontics and Department of Oral Medicine, University of Washington, Seattle, WA, USA; Oral Health Sciences, University of Kristianstad, Kristianstad, Sweden; and Department of Periodontology, University of Bern, Bern, Switzerland
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Soory M. Association of periodontitis with rheumatoid arthritis and atherosclerosis: Novel paradigms in etiopathogeneses and management? Open Access Rheumatol 2010; 2:1-16. [PMID: 27789992 PMCID: PMC5074770 DOI: 10.2147/oarrr.s10928] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
There is increasing documentation of a link between inflammatory periodontal disease affecting the supporting structure of teeth, rheumatoid arthritis, and coronary artery disease. Periodontitis is initiated predominantly by Gram-negative bacteria and progresses as a consequence of the host inflammatory response to periodontal pathogens. Lipopolysaccharide, a cell wall constituent stimulates the production of inflammatory cytokines via the activation of signaling pathways perpetuating inflammatory pathogenesis in a cyclical manner in susceptible individuals; with an element of autoimmune stimulation, not dissimilar to the sequential events seen in RA. Periodontitis, also implicated as a risk factor for cardiovascular disease, promotes mechanisms for atherosclerosis by enhancing an imbalance in systemic inflammatory mediators; more direct mechanisms attributed to microbial products are also implicated in both RA and atherogenesis. Severe periodontal disease characterized by clinical and radiographic parameters has been associated with ischemic stroke risk, significant levels of C-reactive protein and serum amyloid A, amongst others common to both periodontitis and atherosclerosis. Existing data supports the hypothesis that persistent localized infection in periodontitis may influence systemic levels of inflammatory markers and pose a risk for RA and atherosclerosis. A common nucleus of activity in their pathogeneses provides novel paradigms of therapeutic targeting for reciprocal benefit.
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Affiliation(s)
- Mena Soory
- King's College London Dental Institute, Denmark Hill, London UK
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