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Mendelian Randomization Studies in Psoriasis and Psoriatic Arthritis: A Systematic Review. J Invest Dermatol 2023; 143:762-776.e3. [PMID: 36822971 DOI: 10.1016/j.jid.2022.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 02/25/2023]
Abstract
Psoriasis (PSO) and psoriatic arthritis (PSA) are inflammatory diseases with complex genetic and environmental contributions. Although studies have identified environmental and clinical associations with PSO/PSA, causality is difficult to establish. Mendelian randomization (MR) employs the random assortment of genetic alleles at birth to evaluate the causal impact of exposures. We systematically reviewed 27 MR studies in PSO/PSA examining health behaviors, comorbidities, and biomarkers. Exposures, including smoking, obesity, cardiovascular disease, and Crohn's disease, were causal for PSO and PSA, whereas PSO was causally associated with several comorbidities. These findings provide insights that can guide preventive counseling and precision medicine.
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Lei H, Chen X, Wang Z, Xing Z, Du W, Bai R, He K, Zhang W, Wang Y, Zheng Y. Exploration of the underlying comorbidity mechanism in psoriasis and periodontitis: a bioinformatics analysis. Hereditas 2023; 160:7. [PMID: 36765431 PMCID: PMC9912623 DOI: 10.1186/s41065-023-00266-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/12/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Increasing evidence indicates that psoriasis (PSO) and periodontitis (PD) are likely to occur together, however, the underlying mechanism remains unclear. MATERIALS AND METHODS The expression profiles of PSO (lesion vs non-lesion, GSE30999, GSE14905) and PD (affected vs unaffected gingival tissue, GSE16134, GSE10334) were downloaded from the GEO database. First, we investigated the common differentially expressed genes (DEGs) of PSO and PD. Then, GO and KEGG enrichment analysis, protein interaction network (PPI) construction, and hub gene identification analysis were carried out. Finally, GO and KEGG enrichment analysis, miRNA interaction analysis, and transcription factors (TFs) interaction analysis for hub genes were performed. RESULTS Eighteen DEGs were identified for further analysis, including 15 up-regulated genes and 3 down-regulated genes. 9 hub genes were then identified via Cytohubba, including IL1B, CXCL1, CXCL8, MMP12, CCL18, SELL, CXCL13, FCGR3B, and SELE. Their functions are mainly enriched in two aspects: neutrophil chemotaxis and migration, chemokine activation and interaction. The enriched signaling pathways includes three categories: host defense, inflammation-related signaling pathways, and disease-related pathways. 9 common miRNAs based on experimental evidence and 10 common TFs were further identified in both PSO and PD. CONCLUSION Our study revealed possible comorbidity mechanisms in PSO and PD from the perspective of bioinformatics tentatively. The data can present new insight for joint prevention and treatment of in PSO and PD, as well as provide data support for further prospective studies.
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Affiliation(s)
- Hao Lei
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xin Chen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Ziyang Wang
- Department of Medicine, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Zixuan Xing
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Wenqian Du
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Ruimin Bai
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Ke He
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Wen Zhang
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yan Wang
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yan Zheng
- Department of Dermatology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
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Hussein M, Farag YMK, Sonis S. Psoriasis and oral health in adult United States population: a cross-sectional study. BMC Oral Health 2023; 23:66. [PMID: 36732740 PMCID: PMC9896729 DOI: 10.1186/s12903-022-02689-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To detect the association between psoriasis as an exposure and oral health conditions as outcomes represented by periodontal and dentition status. This was addressed by analysis of a large number of adults in the United States. METHODS By using The National Health and Nutrition Examination Survey datasets from 2009 to 2014, we performed a cross-sectional analysis of 11,726 participants included in our study population. For participants aged ≥ 30 years, the psoriasis status was assessed from the medical questionnaire. We used data from periodontal and oral examinations to assess the oral conditions of our participants. We examined the association between psoriasis as exposure and moderate/severe periodontitis and non-functional dentition as outcomes. RESULTS The weighted prevalence of psoriasis was 3%, 44% for moderate/severe periodontitis, and 20.5% for non-functional dentition. The fully adjusted model showed no significant association between psoriasis and moderate/severe periodontitis (Prevalence Ratio 1.02, 95% CI 0.9-1.2, p = 0.8). There was no statistically significant association between psoriasis and non-functional dentition except in the fully adjusted model it became statistically significant (Prevalence Ratio 0.8, 95% CI 0.7-0.9, p = 0.04). CONCLUSION Our results showed no association between psoriasis and periodontal or dentition status except in a fully adjusted model for non-functional dentition.
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Affiliation(s)
- Mai Hussein
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Ministry of Health and Population, Cairo, Egypt.
| | - Youssef M. K. Farag
- grid.38142.3c000000041936754XHarvard Medical School, 25 Shattuck Street, Boston, MA 02115 USA ,grid.21107.350000 0001 2171 9311Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Stephen Sonis
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital/Dana Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA USA ,Primary Endpoint Solutions, LLC, Waltham, MA USA
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Nijakowski K, Gruszczyński D, Kolasińska J, Kopała D, Surdacka A. Periodontal Disease in Patients with Psoriasis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811302. [PMID: 36141573 PMCID: PMC9516998 DOI: 10.3390/ijerph191811302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 05/05/2023]
Abstract
Psoriasis is a chronic, inflammatory, and recurrent skin disease. As with periodontitis, the development and progression of lesions depend on immunological, genetic, and environmental factors. This systematic review was designed to answer the question: "Is there a relationship between psoriasis and periodontal disease?". Following the inclusion and exclusion criteria, sixteen studies were included in this systematic review (according to PRISMA statement guidelines). Based on the meta-analysis, psoriasis patients showed a more than two-fold increase in the odds of periodontal disease. Almost one-third of these patients suffered from periodontitis of varying severity. Despite the heterogeneity of the included studies, psoriasis is associated with a higher risk of periodontitis, and especially with advanced progression.
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Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Correspondence:
| | - Dawid Gruszczyński
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Julia Kolasińska
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Dariusz Kopała
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Baurecht H, Freuer D, Welker C, Tsoi LC, Elder JT, Ehmke B, Leitzmann MF, Holtfreter B, Baumeister SE. Relationship between periodontitis and psoriasis: A two-sample Mendelian randomization study. J Clin Periodontol 2022; 49:573-579. [PMID: 35362630 DOI: 10.1111/jcpe.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/25/2022] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
AIM Observational research suggests that periodontitis affects psoriasis. However, observational studies are prone to reverse causation and confounding, which hampers drawing causal conclusions and the effect direction. We applied the Mendelian randomization (MR) method to comprehensively assess the potential bi-directional association between periodontitis and psoriasis. MATERIALS AND METHODS We used genetic instruments from the largest available genome-wide association study of European descent for periodontitis (17,353 cases, 28,210 controls) to investigate the relationship with psoriasis (13,229 cases, 21,543 controls), and vice versa. Causal Analysis Using Summary Effect (CAUSE) estimates and inverse variance-weighted (IVW) MR analyses were used for the primary analysis. Robust MR approaches were used for sensitivity analyses. RESULTS Both univariable methods, CAUSE and IVW MR analyses, did not reveal any impact of periodontitis on psoriasis (CAUSE odds ratio [OR] = 1.00, p = 1.00; IVW OR = 1.02, p = .6247), or vice versa (CAUSE OR = 1.01, p = .5135; IVW OR = 1.00, p = .7070). The null association was corroborated by pleiotropy-robust methods with ORs close to 1 and p-values >.59. Overall, MR analyses did not suggest any effect of periodontitis on psoriasis. Similarly, there was no evidence to support an effect of psoriasis on periodontitis. CONCLUSIONS Within the limitations of this MR study, the outcomes supported neither periodontitis affecting psoriasis nor psoriasis affecting periodontitis.
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Affiliation(s)
- Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Dennis Freuer
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany
| | - Christine Welker
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA.,Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - James T Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Münster, Münster, Germany
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Han JH, Park JW, Han KD, Park JB, Kim M, Lee JH. Smoking and Periodontitis Can Play a Synergistic Role in the Development of Psoriasis: A Nationwide Cohort Study. Dermatology 2021; 238:554-561. [PMID: 34535604 DOI: 10.1159/000518296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/26/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory disorder involving the periodontium. The precise nature of the association between periodontitis and psoriasis has not been determined. OBJECTIVE This nationwide population-based study investigated the relationship between periodontitis and the risk of psoriasis. METHODS A health screening database, which is a sub-dataset of the Korean National Health Insurance System database, was used in this study. Subjects with (n = 1,063,004) and without (n = 8,655,587) periodontitis who underwent health examinations from January to December 2009 were followed for 9 years. RESULTS In multivariable analysis, compared to the non-periodontitis group, periodontitis patients had a significantly higher risk of developing psoriasis (hazard ratio 1.116, 95% confidence interval 1.101-1.13). Non-smokers with periodontitis had an 11% increase in risk of psoriasis and smokers with periodontitis had a 26.5% increase in risk of psoriasis compared to non-smokers without periodontitis. CONCLUSION Our study highlights periodontitis as a potential independent risk factor for psoriasis, increasing awareness of the synergistic role of smoking and periodontitis in the pathogenesis of psoriasis.
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Affiliation(s)
- Ju Hee Han
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Woo Park
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jun Beom Park
- Department of Periodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Miri Kim
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Association between Periodontal Disease and Comorbidities in Saudi's Eastern Province. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5518195. [PMID: 33954171 PMCID: PMC8068527 DOI: 10.1155/2021/5518195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 12/19/2022]
Abstract
The incidence of periodontal diseases is associated with multiple comorbidities that influence a patient's treatment planning. This study evaluates the relation between periodontal disease and multiple comorbidities reported in the Saudi population from the Eastern province. This study was conducted on 190 patients, who visited the periodontology clinics at Imam Abdulrahman Bin Faisal University, Saudi Arabia. Demographic data, smoking habits, past medical and dental histories, blood pressure, random blood glucose, and recent haemoglobin A1c were recorded. A comprehensive periodontal examination included the number of missing teeth, pocket depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and mobility of all teeth except third molars. Radiographic bone loss was measured on standardized full-mouth periapical radiographs. Multivariable regression models were calculated aiming to see the association between different comorbidities and alveolar bone loss with confounders controlled. Out of 190 periodontitis patients, 56 (29.5%) were males and 134 (70.5%) were females. More than half of the patients (60%) were between 26 and 50 years, 30% of them had diabetes, and 18% were smokers. The risk of alveolar bone loss was higher in persons who had diabetes and those who had both diabetes and coronary heart disease than those who did not, although the association was not statistically significant (B = 1.26, 95%CI = −0.30, 2.82, and B = 2.86, 95%CI = −1.25, 6.96, respectively). The risk of alveolar bone loss was significantly higher among persons with diabetes and hypertension (B = 2.82 and 95%CI = 0.89, 4.75). Collectively, the risk of alveolar bone loss in periodontitis patients increases with diabetes in the presence of other comorbidities regardless of smoking or gender.
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Ucan Yarkac F, Ogrum A, Gokturk O. Effects of non-surgical periodontal therapy on inflammatory markers of psoriasis: A randomized controlled trial. J Clin Periodontol 2019; 47:193-201. [PMID: 31571243 DOI: 10.1111/jcpe.13205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 12/31/2022]
Abstract
AIM The purpose of this randomized controlled clinical study was to evaluate the effect of non-surgical mechanical periodontal therapy on the inflammatory status and severity of psoriasis in subjects with psoriasis. MATERIAL AND METHODS The study population consisted of 92 periodontitis patients with psoriasis vulgaris suffering from an untreated periodontal disease. Two randomized groups were formed from these patients: immediate periodontal therapy (test group, n = 46) and delayed periodontal therapy (control group, n = 46). Periodontal clinical measures, on salivary interleukin 2, interleukin 6 and secretory immunoglobulin A levels and the Psoriasis Area and Severity Index (PASI) scores were evaluated at baseline and on the 8th week in control and test groups. RESULTS Eight weeks after completion of non-surgical periodontal therapy (test group) or initial examination (control group), a significant decrease was observed in interleukin 2, interleukin 6 level and in PASI score, whereas a significant increase was observed in secretory immunoglobulin A levels in the test group (p < .05). CONCLUSION Within the limits of this study, the results suggest that effective periodontal therapy improves the psoriasis condition in patients afflicted by both diseases.
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Affiliation(s)
- Fatma Ucan Yarkac
- Faculty of Dentistry, Periodontology, Necmettin Erbakan University, Konya, Turkey
| | - Atiye Ogrum
- Faculty of Medicine, Dermatology and Venereology, Gaziosmanpasa University, Tokat, Turkey
| | - Ozge Gokturk
- Faculty of Dentistry, Periodontology, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Wang Y, Kang W, Shang L, Song A, Ge S. N-WASP knockdown upregulates inflammatory cytokines expression in human gingival fibroblasts. Arch Oral Biol 2019; 110:104605. [PMID: 31751919 DOI: 10.1016/j.archoralbio.2019.104605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The neuronal wiskott-aldrich syndrome protein (N-WASP) is a member of the wiskott-aldrich syndrome protein (WASP) family. N-WASP plays a vital role in promoting cell migration, receptor signaling and immune inflammatory responses. This study aimed to observe the changes in the expression of inflammatory factors and involving pathways after N-WASP knockdown in human gingival fibroblasts (HGFs). DESIGN Gingival inflammatory condition of N-WASP knockout mice was evaluated by H&E staining. N-WASP in HGFs was knockdown by siRNA and the best knockdown efficiency was determined by qRT-PCR and immunofluorescence. The mRNA levels of interleukin (IL)-6, IL-8, C-C motif ligand 2 (CCL2), superoxide dismutase 2 (SOD2) and prostaglandin endoperoxide synthase 2 (PTGS2) were evaluated by qRT-PCR after N-WASP knockdown with or without mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) inhibitors. The protein levels of IL-6, IL-8 and CCL2 were assessed by ELISA. Western blotting was used to detect the activation of NF-κB and MAPK signaling pathways. RESULTS Gingival tissue from N-WASP knockout mice exhibited an inflammatory reaction. The expression of IL-6, IL-8, CCL2, SOD2 and PTGS2 was significantly upregulated after N-WASP knockdown in HGFs for 6, 24 and 48 h, except for the SOD2 at 6 h. N-WASP knockdown significantly activated the signaling pathways of NF-κB and MAPK. The inhibitors of p65, p38, ERK and JNK clearly decreased IL-6, IL-8, CCL2, SOD2 and PTGS2 expression after N-WASP knockdown. CONCLUSION These data indicated that N-WASP deficiency in HGFs increases the production of inflammatory cytokine and is regulated via NF-κB and MAPK signaling pathways.
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Affiliation(s)
- Yijia Wang
- Department of Periodontology, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Wenyan Kang
- Department of Periodontology, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Lingling Shang
- Department of Periodontology, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Aimei Song
- Department of Periodontology, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Shaohua Ge
- Department of Periodontology, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China.
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Qiao P, Shi Q, Zhang R, E L, Wang P, Wang J, Liu H. Psoriasis Patients Suffer From Worse Periodontal Status-A Meta-Analysis. Front Med (Lausanne) 2019; 6:212. [PMID: 31632975 PMCID: PMC6779717 DOI: 10.3389/fmed.2019.00212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/16/2019] [Indexed: 12/31/2022] Open
Abstract
Background and Objective: Patients with psoriasis have a significantly elevated risk of periodontitis compared with the nonpsoriasis controls. However, the data regarding the difference in the periodontal health status of the psoriasis patients and the nonpsoriasis controls are limited and inconsistent; hence, a specialized meta-analysis that quantitatively compared the periodontal status between the psoriasis and nonpsoriasis subjects by evaluating the related clinical periodontal indexes was needed. The aim of this meta-analysis was to quantitatively evaluate whether the periodontal status of psoriasis patients is worse than that of nonpsoriasis subjects. Methods: We searched PubMed and EMBASE for all eligible studies that compared the periodontal status between psoriasis patients and nonpsoriasis subjects. The studies were screened based on pre-established inclusion criteria. After extracting the available periodontal indexes from the included studies, the weighted mean difference (WMD) with 95% confidence intervals (CIs) was calculated by pooling the mean and standard deviations (SD) of each index. Results: In total, 8 studies, including 812 psoriasis patients and 772 nonpsoriasis subjects, were included in our meta-analysis, and the publication dates ranged from 2013 to 2019; eight periodontal indexes were analyzed. The WMD (95% CIs) for each index were: bleeding on probing (%), 9.188 (4.046–14.330, P < 0.001); probing depth (mm), 0.524 (0.183–0.865, P = 0.003); clinical attachment loss (mm), 0.408 (0.051–0.765, P = 0.025); plaque index, 0.186 (−0.170 to 0.543, P = 0.306); gingival index, 0.458 (−0.413 to 1.328, P = 0.303), remaining teeth, −1.709 (−2.106 to −1.312, P < 0.001); missing teeth, 1.130 (0.275–1.985, P = 0.010); the level of alveolar bone loss (mm), 0.400 (0.102–0.698, P = 0.008). Conclusion: In summary, our meta-analysis revealed that psoriasis patients suffer from worse periodontal health than do nonpsoriasis subjects, mainly characterized by worse gingival inflammation, more alveolar bone loss, fewer remaining teeth and more missing teeth. Considering the limitations of this meta-analysis, more high-quality and well-designed studies are needed to validate our conclusions in the future.
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Affiliation(s)
- Pengyan Qiao
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Quan Shi
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Rong Zhang
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lingling E
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Peihuan Wang
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Juncheng Wang
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongchen Liu
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
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Peddis N, Musu D, Ideo F, Rossi-Fedele G, Cotti E. Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review. Aust Dent J 2019; 64:122-134. [PMID: 30811605 DOI: 10.1111/adj.12684] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2019] [Indexed: 12/14/2022]
Abstract
Biologic medications (BMs) are increasingly used for the management of systemic chronic inflammatory diseases. These diseases are often associated with a higher prevalence of apical periodontitis (AP) and periodontitis (P). The purpose of this systematic review was to ascertain the interactions between AP and/or P and BMs. The review was registered in the PROSPERO database (CRD42017054756). Electronic searches were performed on Pubmed Medline, Scopus and The Web of Science from their inception through to 20 March 2018. The references of the articles selected were checked. The keywords were chosen based on a pilot search, which aimed to find the most frequently prescribed BMs. The included studies were appraised qualitatively using appropriate tools. Thirty-five articles met the inclusion criteria, comprising 16 non-randomized clinical studies, 12 in vivo animal studies and 7 case reports. Quality of information was assessed as high in 18 articles, moderate in 16 articles and low in 1 article. BMs in patients suffering from chronic inflammatory diseases seems to inhibit the progression of AP and P, and to enhance the healing response to periodontal and endodontic treatment. A healthier condition of the periodontal tissues seems to be associated with a better response of the patient to BMs therapy.
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Affiliation(s)
- N Peddis
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - D Musu
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - F Ideo
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - G Rossi-Fedele
- Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - E Cotti
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
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12
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Mendes VS, Cota LOM, Costa AA, Oliveira AMSD, Costa FO. Periodontitis as another comorbidity associated with psoriasis: A case-control study. J Periodontol 2018; 90:358-366. [PMID: 30387155 DOI: 10.1002/jper.18-0394] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 10/10/2018] [Accepted: 10/16/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The association between periodontitis and immuno-mediated inflammatory diseases has been widely studied and recognized each more over the past few years. The aim of this study was to evaluate the potential association between psoriasis and periodontitis, as well as the influence of risk variables in this association. METHODS This case-control study included 756 individuals, 397 with psoriasis, and 359 controls. A full-mouth periodontal examination was performed, recording therefore plaque index, probing depth, clinical attachment level, and bleeding on probing. The influence of risk variables was tested by univariate analysis and multivariate logistic regression. RESULTS A high prevalence of periodontitis was observed among cases (46.1%) when compared to controls (33.1%). Individuals with psoriasis presented a 1.72 higher chance of having periodontitis than controls (OR = 1.72; 95% CI 1.28-2.32; p < 0.001) in the univariate analysis, but with no significance in the multivariate model. The prevalence of periodontitis increased significantly according to the severity of psoriasis [mild form (44.4%); moderate (46.3%); and advanced (47.1%)] when compared to the control group (33.1%). The final multivariate logistic model showed that the number of teeth (OR = 1.08; 95% CI 1.01-1.14; p = 0.018), smoking (OR = 1.91; 95% CI 1.19-3.07; p = 0.008), and body mass index (OR = 1.13; 95% CI 1.11-1.16; p < 0.001) remained significantly associated with the occurrence of periodontitis. CONCLUSIONS The prevalence of periodontitis was higher in individuals with psoriasis than in controls. Severity of psoriasis also presented a strong relationship with all periodontal clinical parameters.
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Affiliation(s)
- Victor Silva Mendes
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Almeida Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Painsi C, Hirtenfelder A, Lange-Asschenfeldt B, Quehenberger F, Wolf P. The Prevalence of Periodontitis Is Increased in Psoriasis and Linked to Its Inverse Subtype. Skin Pharmacol Physiol 2017; 30:324-328. [DOI: 10.1159/000481544] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 09/15/2017] [Indexed: 01/06/2023]
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