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Ma KSK, Chan SY, Van Dyke TE, Wang SI, Wei JCC, Ashina S. Tooth Loss and Chronic Pain: A Population-based Analysis of the National Health and Nutrition Examination Survey. THE JOURNAL OF PAIN 2024; 25:104529. [PMID: 38588761 DOI: 10.1016/j.jpain.2024.104529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
Poor oral health conditions in adults are associated with chronic pain. A nationwide cross-sectional study was conducted to investigate the link between tooth loss and chronic pain. The study involved 8,662 participants from the National Health and Nutrition Examination Survey. Tooth count was categorized into 4 groups, and chronic pain was defined as persistent pain lasting over 3 months despite treatment. Location of the chronic pain, demographics, comorbidities, lifestyle determinants, and dietary intake were retrieved. Univariate and multivariate logistic regression were used to explore cross-sectional associations between tooth count and chronic pain. Compared to participants with more than 20 teeth, those with severe tooth loss presented greater odds of chronic pain (adjusted odds ratio [aOR] = 2.111, 95% confidence intervals (CI) = 1.213-3.676 for patients with 1-8 teeth). Edentulous participants presented with significantly higher odds of chronic pain in the lower extremities (78.4%) and buttocks (49.5%). In the multivariate model, apart from rheumatic arthritis (aOR = 4.004, 95% CI = 2.766-5.798), variables of higher chronic pain included smoking (aOR = 1.518, 95% CI = 1.228-1.878), and hypertension (aOR = 1.463, 95% CI = 1.013-2.112). On the contrary, being Mexican American (aOR = .603, 95% CI = .414-.880) was associated with lower odds of chronic pain. The findings suggested a significant link between chronic pain and tooth loss, independent of ethnicity, lifestyle determinants, and immune-mediated inflammatory diseases including rheumatoid arthritis. PERSPECTIVE: A U.S. nationwide study examined tooth loss and chronic pain. Those with severe tooth loss had increased odds of chronic pain. Edentulous individuals presented higher odds of pain in lower extremities and buttocks. This study highlighted the link between tooth loss and chronic pain, independent of comorbidities and lifestyle factors.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Shu-Yen Chan
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Shiow-Ing Wang
- Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Sait Ashina
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Beth Israel Deaconess Medical Center Comprehensive Headache Center, Harvard Medical School, Boston, Massachusetts; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Chiu CY, Yuh DY, Yeh LC, Lin IJ, Chung CH, Li CH, Chien WC, Chen GS. Association between geniquin therapy and the risk of developing periodontal disease in patients with primary Sjögren's syndrome: A population-based cohort study from Taiwan. PLoS One 2024; 19:e0305130. [PMID: 39110690 PMCID: PMC11305530 DOI: 10.1371/journal.pone.0305130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/23/2024] [Indexed: 08/10/2024] Open
Abstract
Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease that causes dysfunction of salivation and harmful oral conditions. The association between periodontal disease (PD) and pSS with or without geniquin therapy remains controversial. This study evaluated the association between geniquin therapy and the risk of subsequent development of PD in pSS patients. From Taiwan's National Health Insurance Research Database, we selected a control cohort of 106,818 pSS patients, followed up from 2000 to 2015, matched (1:4) by age and index year with 427,272 non-pSS patients. We also analyzed 15,149 pSS patients receiving geniquin therapy (cohort 1) and 91,669 pSS patients not receiving geniquin therapy (cohort 2). After adjusting for confounding factors, multivariate Cox proportional hazards regression analysis was used to compare the risk of PD over the 15-year follow-up. In the control cohort, 11,941 (11.2%) pSS patients developed PD compared to 39,797 (9.3%) non-pSS patients. In cohorts 1 and 2, 1,914 (12.6%) pSS patients receiving geniquin therapy and 10,027 (10.9%) pSS patients not receiving geniquin therapy developed PD. The adjusted hazard ratio (HR) for subsequent PD in pSS patients was 1.165 (95% confidence interval [CI] = 1.147-1.195, p < 0.001) and in pSS patients receiving geniquin therapy was 1.608 (95% CI = 1.526-1.702, p < 0.001). The adjusted HR for PD treatment was 1.843. Patients diagnosed with pSS showed an increased risk of developing subsequent PD and receiving PD treatment than patients without pSS, while pSS patients receiving geniquin therapy showed even higher risks.
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Affiliation(s)
- Chun-Yuan Chiu
- Department of Orthodontics and Pediatrics Dentistry, Tri-Service General Hospital, Taipei, Taiwan
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Da-Yo Yuh
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
- Department of Periodontology, Tri-Service General Hospital, Taipei, Taiwan
| | - Li-Chyun Yeh
- School of Early Childhood Care and Education, University of Kang-Ning, Taipei, Taiwan
| | - Iau-Jin Lin
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Hsing Li
- Department of Orthodontics and Pediatrics Dentistry, Tri-Service General Hospital, Taipei, Taiwan
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Gunng-Shinng Chen
- Department of Orthodontics and Pediatrics Dentistry, Tri-Service General Hospital, Taipei, Taiwan
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
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Zhang R, Ma H, Wang D, Zhang H. Immune-mediated inflammatory diseases and periodontal disease: a bidirectional two-sample mendelian randomization study. BMC Immunol 2024; 25:39. [PMID: 38943064 PMCID: PMC11212394 DOI: 10.1186/s12865-024-00634-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/24/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Previous observational studies have shown a bidirectional association between immune-mediated inflammatory disorders (IMID) and periodontal disease. However, evidence regarding the causal role of IMID and periodontal disease is still lacking. Therefore, we conducted a bidirectional two-sample Mendelian randomization (MR) study to uncover the potential genetic causal effects between IMID and periodontal disease. METHODS Bidirectional two-sample MR analysis was employed. Data for ten IMIDs were sourced from genome-wide association studies (GWAS) conducted by the FinnGen Consortium (range from 1023 to 36321 cases) and UK Biobank (UKB) (range from 150 to 17574 cases). Furthermore, GWAS data for periodontal disease were obtained from the FinnGen Consortium (87497 cases), UKB (458 cases), and Gene Lifestyle Interactions in Dental Endpoints (GLIDE) consortium (17,353 periodontitis cases). Subsequently, the causal relationships were analyzed by random effects inverse variance weighting, weighted median, and MR-Egger. Sensitivity analyses were performed using the Cochrane Q test, funnel plot, and Mr-Egger intercept test to ensure robustness. Eventually, replication analysis and meta-analysis across different databases were carried out. RESULTS Systemic lupus erythematosus (SLE) [IVW: OR = 1.079 (95% CI: 1.032-1.128) and P < 0.001], Sjogren syndrome [IVW: OR = 1.082 (95% CI: 1.012-1.157) and P = 0.022] and hypothyroidism [IVW: OR = 1.52 (95% CI: 1.13-2.04) and P = 0.005] may increase the risk of periodontal disease. In addition, periodontal disease may reduce the risk of SLE [IVW: OR = 0.8079 (95% CI: 0.6764-0.9650) and P = 0.019] and hyperthyroidism [IVW: OR = 5.59*10-9 (95% CI: 1.43*10-15-2.18*10-2) and P = 0.014]. Meta-analysis indicated a causal correlation between SLE and an increased risk of periodontal disease: [OR = 1.08 (95% CI: 1.03-1.13), P = 0.0009]. No significant evidence suggests bilateral causal relationships between other IMIDs and periodontal disease. No significant estimation of heterogeneity or pleiotropy is detected. CONCLUSIONS Our study has confirmed a genetic causal relationship between IMIDs and periodontal disease, thereby unveiling novel potential mechanisms underlying IMIDs and periodontal disease. This discovery is promising in fostering interdisciplinary collaboration between clinicians and stomatologists to facilitate appropriate and precise screening, prevention, and early treatment of IMIDs and periodontal disease.
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Affiliation(s)
- Rui Zhang
- Department of General Stomatology, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
| | - Hairong Ma
- College of Stomatology, Ningxia Medical University, Yinchuan, 750004, China
| | - Dan Wang
- Department of Stomatology, Qingtongxia Hospital of Traditional Chinese Medicine, Ningxia, 751600, China
| | - Hualin Zhang
- College of Stomatology, Ningxia Medical University, Yinchuan, 750004, China.
- Ningxia Province Key Laboratory of Oral Diseases Research, Ningxia Medical University, Yinchuan, 750004, China.
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Zhao M, Wen X, Liu R, Xu K. Microbial dysbiosis in systemic lupus erythematosus: a scientometric study. Front Microbiol 2024; 15:1319654. [PMID: 38863759 PMCID: PMC11166128 DOI: 10.3389/fmicb.2024.1319654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 05/01/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Mounting evidence suggests microbiota dysbiosis augment autoimmune response. This study aims to provide a systematic overview of this research field in SLE through a bibliometric analysis. Methods We conducted a comprehensive search and retrieval of literature related to microbial researches in SLE from the Web of Science Core Collection (WOSCC) database. The retrieved articles were subjected to bibliometric analysis using VOSviewer and Bibliometricx to explore annual publication output, collaborative patterns, research hotspots, current research status, and emerging trends. Results In this study, we conducted a comprehensive analysis of 218 research articles and 118 review articles. The quantity of publications rises annually, notably surging in 2015 and 2018. The United States and China emerged as the leading contributors in microbial research of SLE. Mashhad University of Medical Sciences had the highest publication outputs among the institutions. Frontiers in Immunology published the most papers. Luo XM and Margolles A were the most prolific and highly cited contributors among individual authors. Microbial research in SLE primarily focused on changes in microbial composition, particularly gut microbiota, as well as the mechanisms and practical applications in SLE. Recent trends emphasize "metabolites," "metabolomics," "fatty acids," "T cells," "lactobacillus," and "dietary supplementation," indicating a growing emphasis on microbial metabolism and interventions in SLE. Conclusion This study provides a thorough analysis of the research landscape concerning microbiota in SLE. The microbial research in SLE mainly focused on three aspects: microbial dysbiosis, mechanism studies and translational studies (microbiota-based therapeutics). It identifies current research trends and focal points, offering valuable guidance for scholars in the field.
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Affiliation(s)
- Miaomiao Zhao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Xiaoting Wen
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Ruiling Liu
- Department of Microbiology and Immunology, Basic Medical College, Shanxi Medical University, Jinzhong, China
| | - Ke Xu
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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Tan PR, Lee AJL, Zhao JJ, Chan YH, Fu JH, Ma M, Tay SH. Higher odds of periodontitis in systemic lupus erythematosus compared to controls and rheumatoid arthritis: a systematic review, meta-analysis and network meta-analysis. Front Immunol 2024; 15:1356714. [PMID: 38629069 PMCID: PMC11019014 DOI: 10.3389/fimmu.2024.1356714] [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: 12/16/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Periodontitis as a comorbidity in systemic lupus erythematosus (SLE) is still not well recognized in the dental and rheumatology communities. A meta-analysis and network meta-analysis were thus performed to compare the (i) prevalence of periodontitis in SLE patients compared to those with rheumatoid arthritis (RA) and (ii) odds of developing periodontitis in controls, RA, and SLE. Methods Pooled prevalence of and odds ratio (OR) for periodontitis were compared using meta-analysis and network meta-analysis (NMA). Results Forty-three observational studies involving 7,800 SLE patients, 49,388 RA patients, and 766,323 controls were included in this meta-analysis. The pooled prevalence of periodontitis in SLE patients (67.0%, 95% confidence interval [CI] 57.0-77.0%) was comparable to that of RA (65%, 95% CI 55.0-75.0%) (p>0.05). Compared to controls, patients with SLE (OR=2.64, 95% CI 1.24-5.62, p<0.01) and RA (OR=1.81, 95% CI 1.25-2.64, p<0.01) were more likely to have periodontitis. Indirect comparisons through the NMA demonstrated that the odds of having periodontitis in SLE was 1.49 times higher compared to RA (OR=1.49, 95% CI 1.09-2.05, p<0.05). Discussion Given that RA is the autoimmune disease classically associated with periodontal disease, the higher odds of having periodontitis in SLE are striking. These results highlight the importance of addressing the dental health needs of patients with SLE. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ identifier CRD42021272876.
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Affiliation(s)
- Ping Ren Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Aaron J. L. Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Joseph J. Zhao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jia Hui Fu
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Margaret Ma
- Division of Rheumatology, Department of Medicine, National University Hospital, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sen Hee Tay
- Division of Rheumatology, Department of Medicine, National University Hospital, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Luchyn I, Zhero S, Jenča A, Jenča A, Petrašova A, Jenčova J. Clinical and laboratory assessment of the state of periapical tissues in systemic lupus erythematosus. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:311-318. [PMID: 38592995 DOI: 10.36740/wlek202402120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Aim: To evaluate changes in clinical and laboratory parameters in patients with SLE depending on the severity and activity of the disease. PATIENTS AND METHODS Materials and Methods: The study included 50 patients with SLE of different age groups, 10 men and 40 women. RESULTS Results: Systemic lupus erythematosus (SLE) is a chronic disease that belongs to the group of rheumatic diseases and is characterised by autoimmune tissue damage. Chronic inflammatory periodontal diseases remain one of the most common dental pathologies. Chronic gingivitis and periodontitis in SLE are described as one of the earliest and most striking symptoms of the disease. Approximately the same trend was found in patients with SLE depending on the degree of clinical and laboratory activity of the disease. Patients with minimal, 1 degree of activity (characterized by the longest duration of SLE) showed the greatest decrease in bone mineral density (up to 2.25 points), and patients with higher activity had a significantly shorter duration of SLE and, accordingly, a smaller decrease in bone mineral density: in patients with 2 degrees of activity (1.79 points), with 3 degrees of activity (1.94 points). CONCLUSION Conclusions: In patients with acute SLE, the maximum value of the Muhlemann-Cowell index was 2.31 points, in patients with subacute SLE - 1.89 points, and in patients with chronic SLE - 1.58 points. CPITN values increase inversely with the nature of the course of SLE, which is associated with the duration of the underlying disease.
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Affiliation(s)
- Ivan Luchyn
- UZHHOROD NATIONAL UNIVERSITY, UZHHOROD, UKRAINЕ
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Sahebari M, Allaf FL, Nasrabadi N, Ghazi A, Khodashahi M, Absalan F, Mozafari PM, Abbasi S. Periodontal Disease in Patients with Newly Diagnosed Systemic Lupus Erythematosus. Mediterr J Rheumatol 2023; 34:315-321. [PMID: 37941865 PMCID: PMC10628881 DOI: 10.31138/mjr.20230724.pd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 11/10/2023] Open
Abstract
Statement of the Problem Most of the studies assessing the relationship between systemic lupus erythematosus (SLE) and periodontal disorder are focused on patients with previously diagnosed SLE whose periodontal hygiene may be influenced by immunosuppressive therapies. Purpose This study aimed to evaluate the frequency of periodontal disease among patients with newly diagnosed lupus before starting immunosuppressive therapy and its association with presenting laboratory and clinical symptoms of lupus. Materials and Method This case-control cross-sectional study was conducted on 36 consecutive newly diagnosed SLE patients before starting any treatment. The control group consisted of first-degree relatives of the patients whose demographic and social characteristics matched with the patients and who had no personal history of a disease. Periodontal indices included community periodontal index (CPI) and plaque index (PI). Results Participants in both groups had some degree of periodontal disorder. The mean value of CPI was 1.47±0.82 and 1.31±0.72 in SLE patients and healthy subjects (P=0.84), respectively. Moreover, the mean values of PI were 1.15±0.55 and 1.17±0.46 in SLE patients and controls, (P=0.37), respectively. Besides, the frequency of periodontal disorders based on CPI score (positive: higher than two) was 22.2% in SLE patients and 16.7% in controls (P=0.55). Moreover, there was no association between periodontal disease and lupus-related clinical and laboratory characteristics in our patients. Conclusion The frequency of periodontal disorders is similar between newly diagnosed lupus patients without undergoing immunomodulatory therapies and healthy controls with the same demographic and social characteristics. Moreover, periodontitis was not associated with clinical and laboratory symptoms of our patients.
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Affiliation(s)
- Maryam Sahebari
- Rheumatic Diseases Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Nahid Nasrabadi
- Dental Research Centre, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala Ghazi
- Oral and Maxillofacial Diseases Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mandana Khodashahi
- Rheumatic Diseases Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Pegah Mosannen Mozafari
- Oral and Maxillofacial Diseases Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shaghayegh Abbasi
- Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Sobieszczański J, Mertowski S, Sarna-Boś K, Stachurski P, Grywalska E, Chałas R. Root Canal Infection and Its Impact on the Oral Cavity Microenvironment in the Context of Immune System Disorders in Selected Diseases: A Narrative Review. J Clin Med 2023; 12:4102. [PMID: 37373794 DOI: 10.3390/jcm12124102] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
The oral cavity has a specific microenvironment, and structures such as teeth are constantly exposed to chemical and biological factors. Although the structure of the teeth is permanent, due to exposure of the pulp and root canal system, trauma can have severe consequences and cause the development of local inflammation caused by external and opportunistic pathogens. Long-term inflammation can affect not only the local pulp and periodontal tissues but also the functioning of the immune system, which can trigger a systemic reaction. This literature review presents the current knowledge on root canal infections and their impact on the oral microenvironment in the context of immune system disorders in selected diseases. The result of the analysis of the literature is the statement that periodontal-disease-caused inflammation in the oral cavity may affect the development and progression of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, or Sjogren's syndrome, as well as affecting the faster progression of conditions in which inflammation occurs such as, among others, chronic kidney disease or inflammatory bowel disease.
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Affiliation(s)
- Jarosław Sobieszczański
- Preclinical Dentistry Lab, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
| | - Katarzyna Sarna-Boś
- Department of Dental Prosthetics, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
| | - Piotr Stachurski
- Department of Pediatric Dentistry, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
| | - Renata Chałas
- Department of Oral Medicine, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
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Haque M, Ahmad R. Oral health alterations: Glimpse into its connection to inflammatory rheumatic diseases. ADVANCES IN HUMAN BIOLOGY 2023. [DOI: 10.4103/aihb.aihb_11_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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Zhan Y, Liu Q, Zhang B, Huang X, Lu Q. Recent advances in systemic lupus erythematosus and microbiota: from bench to bedside. Front Med 2022; 16:686-700. [DOI: 10.1007/s11684-022-0957-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 08/18/2022] [Indexed: 11/19/2022]
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Akiyama K, Aung KT, Talamini L, Huck O, Kuboki T, Muller S. Therapeutic effects of peptide P140 in a mouse periodontitis model. Cell Mol Life Sci 2022; 79:518. [DOI: 10.1007/s00018-022-04537-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/25/2022]
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Dias LNDS, Coêlho MDC, Persuhn DC, Ribeiro ILA, Freire EAM, de Oliveira NFP, de Aquino SG. DNMT3B (rs2424913) polymorphism is associated with systemic lupus erythematosus alone and with co-existing periodontitis in a Brazilian population. J Appl Oral Sci 2022; 30:e20210567. [PMID: 35507987 PMCID: PMC9064189 DOI: 10.1590/1678-7757-2021-0567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/14/2022] [Accepted: 02/23/2022] [Indexed: 11/21/2022] Open
Abstract
The association between Periodontitis and Systemic Lupus Erythematosus (SLE) has been primarily based on their similar pathophysiology and both are associated with genetic polymorphisms. OBJECTIVES To investigate an association between the methylation-related gene polymorphisms DNMT3B (rs2424913) and MTHFR (rs1801133) to Systemic Lupus Erythematosus (SLE) and Periodontitis. METHODOLOGY In total, 196 individuals of all genders aged 24 to 60 years old were allocated into four groups based on their systemic and periodontal status, namely: Healthy control (n=60), periodontitis (n=51), SLE (n=47), and SLE + periodontitis (n=38). Individuals with SLE were stratified according to disease activity (SLEDAI) in inactive or active. We performed polymorphism analysis using PCR-RFLP with genomic DNA from mouthwash. We analyzed data using Fisher's Exact, Chi-square test, and regression models. RESULTS Periodontal status were similar in subjects with periodontitis alone and combined with SLE. SLE patients with periodontitis had a longer SLE diagnosis than SLE only (p=0.001). For DNMT3 B polymorphism, the periodontitis, SLE, and Inactive SLE + periodontitis groups showed a higher frequency of T allele and TT genotypes compared to healthy controls (p<0.05). Regression analyses showed that the TT genotype is a strong risk factor for periodontitis (OR=4.53; CI95%=1.13-18.05) and also for SLE without periodontitis (OR=11.57; CI95%=3.12-42.84) and SLE with periodontitis (OR=5.27; CI95%=1.25-22.11) when compared to control. CONCLUSION SLE patients with periodontitis had a longer length of SLE diagnosis. The DNMT3B (rs2424913) polymorphism was associated with periodontitis and SLE alone or combined with periodontitis. Our study contributes to understanding the genetic mechanisms involved in periodontitis and SLE susceptibility.
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Affiliation(s)
- Larissa Nadine da Silva Dias
- Universidade Federal da ParaíbaCentro de Ciências da SaúdePrograma de Pós Graduação em OdontologiaJoão PessoaPBBrasilUniversidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós Graduação em Odontologia, João Pessoa, PB, Brasil.
| | - Marina de Castro Coêlho
- Universidade Federal da ParaíbaCentro de Ciências da SaúdePrograma de Pós Graduação em OdontologiaJoão PessoaPBBrasilUniversidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós Graduação em Odontologia, João Pessoa, PB, Brasil.
| | - Darlene Camati Persuhn
- Universidade Federal da ParaíbaCentro de Ciências Exatas e da NaturezaDepartamento de Biologia MolecularJoão PessoaPBBrasilUniversidade Federal da Paraíba - UFPB, Centro de Ciências Exatas e da Natureza, Departamento de Biologia Molecular, João Pessoa, PB, Brasil.
| | - Isabella Lima Arrais Ribeiro
- Universidade Federal da ParaíbaCentro de Ciências da SaúdePrograma de Pós Graduação em OdontologiaJoão PessoaPBBrasilUniversidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós Graduação em Odontologia, João Pessoa, PB, Brasil.
| | - Eutilia Andrade Medeiros Freire
- Universidade Federal da ParaíbaCentro de Ciências MédicasDepartamento de Medicina InternaJoão PessoaPBBrasilUniversidade Federal da Paraíba - UFPB, Centro de Ciências Médicas, Departamento de Medicina Interna, João Pessoa, PB-Brasil.
| | - Naila Francis Paulo de Oliveira
- Universidade Federal da ParaíbaCentro de Ciências da SaúdePrograma de Pós Graduação em OdontologiaJoão PessoaPBBrasilUniversidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós Graduação em Odontologia, João Pessoa, PB, Brasil.
- Universidade Federal da ParaíbaCentro de Ciências Exatas e da NaturezaDepartamento de Biologia MolecularJoão PessoaPBBrasilUniversidade Federal da Paraíba - UFPB, Centro de Ciências Exatas e da Natureza, Departamento de Biologia Molecular, João Pessoa, PB, Brasil.
| | - Sabrina Garcia de Aquino
- Universidade Federal da ParaíbaCentro de Ciências da SaúdeDepartamento de Odontologia Clínica e SocialJoão PessoaPBBrasilUniversidade Federal da Paraíba- UFPB, Centro de Ciências da Saúde, Departamento de Odontologia Clínica e Social, João Pessoa, PB, Brasil.
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Zamora-Pasadas M, Marfil-Álvarez R, González-Bustos P, Magán-Fernández A, Mesa F. Periodontitis is associated with higher subclinical atherosclerosis in patients with systemic lupus erythematosus. J Periodontal Res 2022; 57:479-486. [PMID: 35293616 PMCID: PMC9311157 DOI: 10.1111/jre.12977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/07/2022] [Accepted: 01/26/2022] [Indexed: 12/11/2022]
Abstract
AIM To determine periodontitis prevalence in patients with systemic lupus erythematosus (SLE) and to assess whether periodontitis in SLE patients is associated with a greater subclinical atherosclerosis. METHODS An observational case-control study was conducted in SLE (cases) and patients without any rheumatic diseases (controls), matched for sex. Sociodemographic and cardiometabolic variables were gathered, and SLE activity was assessed through several indexes. Periodontal examination registered probing pocket depth, clinical attachment level, bleeding on probing, plaque index, and tooth loss. Subclinical atherosclerosis was assessed by measuring the carotid-femoral pulse wave velocity (PWV) by Doppler velocimetry, homocysteine levels, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Bivariate analyses and logistic regression were used to assess the association of any of the studied variables with SLE. RESULTS Seventy-one cases and 72 controls were included in the study. Thirty-nine SLE patients (54.9%) were diagnosed with periodontitis, compared with 16 controls (22.2%). High levels of PWV (≥7.7 m/s, 75th percentile) were shown by 44.3% of the cases vs. 22.4% of the controls (p = .011). Among SLE patients, those with periodontitis showed higher PWV values (8.1 ± 1.52 vs. 7.16 ± 1.11 m/s, p = .006) and higher homeostasis model assessment index (indicative of insulin resistance) (1.7 ± 0.73 vs. 2.92 ± 3.05, p = .028) compared to those with periodontal health. Logistic regression showed that waist circumference (OR 1.06, 95% CI 1.01-1.12, p = .015); ESR (OR 1.09, 95% CI 1.03-1.16, p = .003); and bleeding on probing (OR 1.1, 95% CI 1.01-1.19, p = .018) were associated with the risk of SLE. CONCLUSION Systemic lupus erythematosus patients showed a higher periodontitis percentage than controls. Higher PWV values were found in SLE patients with periodontitis, indicating a higher prevalence of subclinical atherosclerosis. Patients with higher gingival bleeding showed a higher risk of SLE.
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Affiliation(s)
- Mónica Zamora-Pasadas
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, University Hospital Virgen de las Nieves, Granada, Spain
| | - Rafael Marfil-Álvarez
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
| | - Pablo González-Bustos
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, University Hospital Virgen de las Nieves, Granada, Spain
| | | | - Francisco Mesa
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
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Antibodies to Porphyromonas gingivalis Are Increased in Patients with Severe Periodontitis, and Associate with Presence of Specific Autoantibodies and Myocardial Infarction. J Clin Med 2022; 11:jcm11041008. [PMID: 35207282 PMCID: PMC8875626 DOI: 10.3390/jcm11041008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 02/06/2023] Open
Abstract
There is accumulating data suggesting that periodontitis is associated with increased risk of systemic and autoimmune diseases, including cardiovascular disease, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and there is an unmet need to identify these individuals early. With the periodontal bacteria Porphyromonas gingivalis (Pg) as one of the key drivers of periodontitis, we set out to investigate whether antibodies to Pg virulence factor arginine gingipain (Rgp) could serve as a biomarker for periodontitis patients at increased risk of autoimmunity and systemic disease. We measured serum anti-Rgp IgG in three study populations: PAROKRANK (779 individuals with myocardial infarction (MI); 719 controls), where 557 had periodontitis, and 312 were positive for autoantibodies associated with RA/SLE; the PerioGene North pilot (41 periodontitis; 39 controls); and an SLE case/control study (101 SLE; 100 controls). Anti-Rgp IgG levels were increased in severe periodontitis compared to controls (p < 0.0001), in individuals positive for anti-citrullinated protein antibodies (p = 0.04) and anti-dsDNA antibodies (p = 0.035), compared to autoantibody-negative individuals; and in MI patients versus matched controls (p = 0.035). Our data support longitudinal studies addressing the role of anti-Rgp antibodies as biomarkers for periodontitis patients at increased risk of developing autoimmunity linked to RA and SLE, and mechanisms underpinning these associations.
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15
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Maybodi FR, Bashiri H, Sezavar K, Owlia F. Effect of periodontal treatment on serum inflammatory parameters and disease activity in patients with systemic lupus erythematosus: A randomized controlled trial. J Indian Soc Periodontol 2022; 26:564-569. [PMID: 36582961 PMCID: PMC9793920 DOI: 10.4103/jisp.jisp_607_21] [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: 10/11/2021] [Revised: 04/04/2022] [Accepted: 05/08/2022] [Indexed: 12/07/2022] Open
Abstract
Background Several descriptive studies have shown an association between periodontitis and systemic lupus erythematosus (SLE), but clinical trials evaluating the effect of periodontal treatment on serological inflammatory parameters or disease activity in SLE patients are very limited. The aim of this study was to see how periodontal treatment affects the status of SLE patients. Materials and Methods Ninety patients with active SLE and periodontitis were randomly assigned to one of two groups: case (oral hygiene instructions + scaling and root planning) or control (oral hygiene instructions only). Periodontal parameters, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and SLE Disease Activity Index (SLEDAI) levels were monitored at baseline and 3 months later. Results Periodontal parameters in the case group were significantly reduced both statistically and clinically after 3 months. However, in the control group, these indices decreased statistically (P < 0.05) but not clinically. The score of SLEDAI in both the groups showed a significant downward trend (P < 0.05) from the start of the study, but the differences in this index between the two groups were not statistically significant (P = 0.894). Although there was a significant decrease in CRP and ESR (P = 0.001) after 3 months in the case group, indicating a positive effect of periodontal treatment on inflammation reduction, there was no significant decrease in CRP and ESR in the control group. Conclusion According to our findings, it appears to be no statistically significant association between periodontal treatment and SLEDAI level. However, this treatment seems to be effective in reducing acute phase biomarkers such as CRP and ESR.
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Affiliation(s)
- Fahimeh Rashidi Maybodi
- Department of Periodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamidreza Bashiri
- Department of Periodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kimiya Sezavar
- Department of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,Address for correspondence: Dr. Kimiya Sezavar, Department of Periodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran. E-mail:
| | - Fatemeh Owlia
- Department of Periodontics, Faculty of Dentistry, Birjand University of Medical Science, Birjand, Iran
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16
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Hussain SB, Leira Y, Zehra SA, Botelho J, Machado V, Ciurtin C, D'Aiuto F, Orlandi M. Periodontitis and Systemic Lupus Erythematosus: A systematic review and meta-analysis. J Periodontal Res 2021; 57:1-10. [PMID: 34608627 DOI: 10.1111/jre.12936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/30/2021] [Accepted: 09/07/2021] [Indexed: 12/11/2022]
Abstract
This systematic review and meta-analysis evaluated the association between periodontitis (PD) and systemic lupus erythematosus (SLE). A systematic search was conducted through the following electronic databases: Cochrane Library, MEDLINE, EMBASE, Scopus, LILACS, CINAHL and SIGLE (System for Information on Grey Literature in Europe) for relevant publications up to September 2020 with no language restriction. The association between PD and SLE was assessed by the prevalence of PD in SLE patients (both sex and females only) as the primary outcome. Secondary outcomes included differences in common gingival parameters including probing pocket depth (PPD), clinical attachment level (CAL), disease activity index (SLEDAI) scores of SLE patients with or without PD. A total of 1183 citations and 22 full text articles were screened. Eighteen articles were included in the qualitative synthesis, and 13 in the quantitative analysis. SLE diagnosis was associated with greater odds of PD (OR = 1.33, 95% Confidence Interval [CI]: 1.20-1.48), but these were non-significant when examined in females (OR = 3.20, 95%CI: 0.85-12.02). Patients with SLE exhibited no differences in PPD (SMD: -0.09 mm, 95%CI: -0.45-0.27) and CAL (SMD: 0.05 mm, 95%CI: -0.30-0.40) when compared with systemically healthy controls. PD diagnosis was, however, associated with higher SLEDAI scores in patients suffering from SLE (SMD: 0.68, 95% CI: 0.03-1.32). PD and SLE are both inflammatory diseases and their association could be bi-directional. This review suggested that the patients with SLE have greater odds of suffering with PD. Further investigations are required to assess the association between PD and SLE.
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Affiliation(s)
- Syed Basit Hussain
- Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom
| | - Yago Leira
- Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom
| | - Syeda Ambreen Zehra
- Department of Dental Physical Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - João Botelho
- Periodontology Department, Egas Moniz-Cooperativa de Ensino Superior, Almada, Portugal.,Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Almada, Portugal
| | - Vanessa Machado
- Periodontology Department, Egas Moniz-Cooperativa de Ensino Superior, Almada, Portugal.,Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Almada, Portugal
| | - Coziana Ciurtin
- Department of Rheumatology, University College London Hospital, London, United Kingdom
| | - Francesco D'Aiuto
- Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom
| | - Marco Orlandi
- Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom
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Sete MRC, Carlos JC, Mello-Neto JM, Lira-Junior R, Brito F, Bostrom EA, Sztajnbok FR, Figueredo CM. Impact of chronic gingivitis management on the cytokine and anti-PPAD expressions in juvenile systemic lupus erythematosus: A six-month follow-up. J Periodontal Res 2021; 56:1132-1140. [PMID: 34510434 DOI: 10.1111/jre.12924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/26/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate how chronic gingivitis treatment impacts the oral and circulating cytokine expressions after six-month follow-up in patients with juvenile systemic lupus erythematosus (jSLE) and also to evaluate the circulating expression of anti-Porphyromonas gingivalis peptidylarginine deiminase antibodies (anti-PPAD) before and after treatment. BACKGROUND Juvenile systemic lupus erythematosus patients present a worse periodontal condition associated with higher gingival crevicular fluid (GCF) levels of interleukin (IL)-1β, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein (MCP)-1. MATERIALS AND METHODS Twenty-one adolescents with jSLE (mean age: 16.2 ± 1.5 years) were recruited. Participants were rheumatologically and periodontally examined. All individuals were clinically diagnosed with gingival inflammation. Chronic gingivitis treatment consisted of supragingival scaling, prophylaxis and oral hygiene instructions. The cytokine levels were determined by bead-based multiplex assays and the anti-PPAD levels by ELISA. Gingival crevicular fluid (GCF) and serum samples were collected at baseline and 6 months after treatment. RESULTS We observed a reduction in attachment loss, SLE Disease Activity Index (SLEDAI), IL-1β, IL-10 and MCP-1 GCF levels, and the IL-4 and IL-5 serum levels 6 months after periodontal treatment. On the contrary, a significant increase in GCF expression of IL-4, IL-12, IL-17, IFN-γ and serum levels of anti-PPAD antibody was observed. CONCLUSION Juvenile systemic lupus erythematosus patients seem to positively benefit from periodontal treatment by a significantly reduced CAL, a GCF reduction of pro-inflammatory cytokines and an increasing of anti-inflammatory ones. However, an increase in the GCF expression of IL-17 and the serum expression of anti-PPAD antibody 6 months after periodontal treatment might negatively affect the treatment outcome of such patients in the long term.
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Affiliation(s)
- Manuela Rubim C Sete
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Juliana C Carlos
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Joao M Mello-Neto
- Faculty of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Ronaldo Lira-Junior
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Fernanda Brito
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Elisabeth A Bostrom
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Flavio R Sztajnbok
- Unit of Rheumatology, Adolescent Health Studies Center (NESA), Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Carlos Marcelo Figueredo
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Faculty of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
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Wu SY, Wu CY, Chen MH, Huang HY, Chen YH, Tsao YP, Lai YL, Lee SY. Periodontal conditions in patients with Sjögren's syndrome: A meta-analysis. J Dent Sci 2021; 16:1222-1232. [PMID: 34484591 PMCID: PMC8403803 DOI: 10.1016/j.jds.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/27/2020] [Indexed: 12/19/2022] Open
Abstract
Sjögren's syndrome (SS) is a chronic autoimmune rheumatic disease characterized by a progressive lymphocytic infiltration of salivary glands, resulting in xerostomia and other oral diseases. The pathogenesis and mechanisms of SS on periodontal tissues are not well understood. Furthermore, results of two systemic reviews and meta-analyses in which compared periodontal parameters of patients with SS to healthy subjects were different. To determine whether periodontal conditions in SS were different from healthy controls, we re-examined the issue with a random-effect model, avoiding recruiting active controls and inadequate data conversion. Outcome measures included probing pocket depth (PPD), clinical attachment loss (CAL), plaque index (PI), and gingival index (GI). Recruited individuals comprised 198 patients with SS and 180 subjects for healthy controls. Quantitative analysis revealed higher PI (WMD = 0.76, 95% CI: 0.30, 1.23) and GI (WMD of total = 0.50, 95% CI: 0.01, 0.98) in SS patients who were not categorized into primary or secondary types of SS. PPD and CAL in SS patients was comparable with control subjects. However, heterogeneity was observed among included studies. Thus, results from this and previous analyses should be interpretated carefully, and a well-designed observational study regarding this issue should be conducted.
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Affiliation(s)
- Shih-Yun Wu
- Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Yi Wu
- Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Oral Biology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Corresponding author. Institute of Oral Biology, National Yang Ming Chiao Tung University No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan.
| | - Ming-Han Chen
- Division of Allergy Immunology Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsin-Yi Huang
- Biostatistics Task Force, Taipei Veterans General Hospital, Taiwan
| | - Yu-hsuan Chen
- Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Po Tsao
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Lin Lai
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Endodontics and Periodontology, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Yuan Lee
- Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Rotstein I, Katz J. Prevalence of periapical abscesses in patients with systemic lupus erythematosus. SPECIAL CARE IN DENTISTRY 2021; 42:15-19. [PMID: 34240444 DOI: 10.1111/scd.12630] [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: 03/09/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
AIMS To assess the prevalence of periapical abscesses in patients with systemic lupus erythematosus (SLE), and to evaluate the effect of glucocorticoids (GCs) used to treat SLE, on the prevalence of such lesions. METHODS Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for SLE and periapical abscess was retrieved by searching the appropriate query in the database. The odd ratio (OR) of periapical abscesses and its association with SLE and intake of GCs were calculated and analyzed statistically. RESULTS The prevalence of periapical abscesses in patients treated with GCs was 1.5% compared to 0.39% in patients who were not treated with GCs. The OR for periapical abscesses in patients treated with GCs was 2.53 compared with OR of 0.66 in patients not treated with GCs. The differences were statistically significant (p < .0001). The prevalence of periapical abscesses in patients with SLE was 1.88%. The OR was 3.18 and the difference statistically significant (p < .0001). CONCLUSIONS Under the conditions of this study, it appears that the prevalence of periapical abscesses is higher in patients with SLE. Patients receiving GCs therapy, either for SLE or for other conditions, may present higher prevalence of periapical abscesses.
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Affiliation(s)
- Ilan Rotstein
- Endodontics and Orthodontics, Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, California, USA
| | - Joseph Katz
- Oral Medicine, Department of Oral Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, Florida, USA
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Kapferer-Seebacher I, Foradori L, Zschocke J, Schilke R. Rare Genetic Disorders Affecting the Periodontal Supporting Tissues in Adolescence. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In adolescents periodontal destruction may be the primary manifestation of an as yet unrecognized rare systemic disease, and it may be up to the periodontist to make the correct tentative diagnosis. Many genetic diseases that present with primary periodontal manifestations in adolescence affect immune function, sometimes with only mild or absent systemic features. They include periodontal Ehlers-Danlos syndrome (lack of attached gingiva, various connective tissue abnormalities), Papillon-Lefèvre syndrome (palmoplantar hyperkeratosis), and plasminogen deficiency (fibrin deposition within mucous membranes). Other immune disorders with severe periodontitis manifesting in adolescence are usually diagnosed in early childhood due to unmistakeable systemic features. They include Cohen syndrome (developmental disorder, truncal obesity, and microcephaly), Hermansky-Pudlak Syndrome (oculocutaneous albinism, bleeding diathesis, and other systemic manifestations), glycogen storage disease type 1b, and Chediak-Higashi syndrome (pyogenic infections, albinism, and neuropathy). The structural integrity of periodontal tissue is affected in genodermatoses such as Kindler syndrome, a type of epidermolysis bullosa. In primary hyperoxaluria, inflammatory periodontal destruction is associated with renal calculi. Breakdown of periodontal tissues independent of dental plaque biofilm-induced periodontitis is found in hypophosphatasia (highly variable skeletal hypomineralization) or isolated odontohypophosphatasia, hypophosphatemic rickets and primary hyperparathyroidism. Finally, alveolar osteolysis mimicking localized periodontitis may be due to neoplastic processes, e.g., in neurofibromatosis type 1 (typical skin features including café au lait macules and neurofibromas), Langerhans cell histiocytosis (locally destructive proliferation of bone marrow-derived immature myeloid dendritic cells), and Gorham-Stout disease (diffuse cystic angiomatosis of bone).
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21
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Bolstad AI, Sehjpal P, Lie SA, Fevang BTS. Periodontitis in patients with systemic lupus erythematosus: A nation-wide study of 1990 patients. J Periodontol 2021; 93:364-372. [PMID: 34076274 DOI: 10.1002/jper.21-0181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/16/2021] [Accepted: 05/27/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The aim of this study was to examine the association between systemic lupus erythematosus (SLE) and periodontitis in Norway during a 10-year period from 2008 through 2017. METHODS In this population-based study, 1990 patients were included in the SLE-cohort based on diagnostic codes registered in the Norwegian Patient Registry. The control group (n = 170,332) comprised patients registered with diagnostic codes for non-osteoporotic fractures or hip or knee replacement because of osteoarthritis. The outcome was periodontitis, defined by procedure codes registered in the Control and Payment of Health Refunds database. Logistic regression analyses were performed to estimate odds ratio for periodontitis in patients versus controls adjusted for potential covariates. RESULTS Periodontitis was significantly more common in SLE patients compared to controls (OR 1.78, 95% CI 1.47-2.14) and the difference was highest in SLE-patients 20 to 30 years of age (OR 3.24, 95% CI 1.23 - 8.52). The periodontitis rate in SLE patients was in the same range as for patients with diabetes mellitus type 2. CONCLUSIONS Patients with SLE had an almost doubled risk of periodontitis compared with the control population, and the difference was most accentuated in the young patients. These findings warrant an increased focus on dental health in SLE-patients.
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Affiliation(s)
- Anne Isine Bolstad
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Pria Sehjpal
- Department of Clinical Science, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Bjørg-Tilde Svanes Fevang
- Department of Clinical Science, The Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
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Sojod B, Pidorodeski Nagano C, Garcia Lopez GM, Zalcberg A, Dridi SM, Anagnostou F. Systemic Lupus Erythematosus and Periodontal Disease: A Complex Clinical and Biological Interplay. J Clin Med 2021; 10:jcm10091957. [PMID: 34063235 PMCID: PMC8125164 DOI: 10.3390/jcm10091957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
Reports on the association of periodontal disease (PD) with systemic lupus erythematosus (SLE) have regularly been published. PD is a set of chronic inflammatory conditions linked to a dysbiotic microbial biofilm, which affects the periodontal tissues, resulting eventually in their destruction and contributing to systemic inflammation. SLE is a multi-system chronic inflammatory autoimmune disease that has a wide range of clinical presentations, touching multiple organ systems. Many epidemiological studies have investigated the two-way relationship between PD and SLE, though their results are heterogeneous. SLE and PD are multifactorial conditions and many biological-based hypotheses suggest common physiopathological pathways between the two diseases, including genetics, microbiology, immunity, and environmental common risk factors. By focusing on recent clinical and translational research, this review aimed to discuss and give an overview of the relationship of SLE with PD, as well as looking at the similarities in the immune-pathological aspects and the possible mechanisms connecting the development and progression of both diseases.
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Affiliation(s)
- Bouchra Sojod
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Glenda Melissa Garcia Lopez
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | - Antoine Zalcberg
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Fani Anagnostou
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
- B3OA, CNRS UMR 7052-INSERM U1271, Université de Paris, 75010 Paris, France;
- Correspondence:
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Pires JR, Nogueira MRS, Nunes AJF, Degand DRF, Pessoa LC, Damante CA, Zangrando MSR, Greghi SLA, de Rezende MLR, Sant'Ana ACP. Deposition of Immune Complexes in Gingival Tissues in the Presence of Periodontitis and Systemic Lupus Erythematosus. Front Immunol 2021; 12:591236. [PMID: 33841392 PMCID: PMC8027066 DOI: 10.3389/fimmu.2021.591236] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/19/2021] [Indexed: 11/21/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease characterized by tissue damage and widespread inflammation in response to environmental challenges. Deposition of immune complexes in kidneys glomeruli are associated with lupus nephritis, determining SLE diagnosis. Periodontitis is a chronic inflammatory disease characterized by clinical attachment and bone loss, caused by a microbial challenge – host response interaction. Deposition of immune complex at gingival tissues is a common finding in the course of the disease. Considering that, the primary aim of this study is to investigate the deposition of immune complexes at gingival tissues of SLE patients compared to systemically healthy ones, correlating it to periodontal and systemic parameters. Twenty-five women diagnosed with SLE (SLE+) and 25 age-matched systemically healthy (SLE–) women were included in the study. Detailed information on overall patient's health were obtained from file records. Participants were screened for probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), full-mouth bleeding score (FMBS) and plaque scores (FMPS). Bone loss was determined at panoramic X-ray images as the distance from cementenamel junction to alveolar crest (CEJ-AC). Gingival biopsies were obtained from the first 15 patients submitted to surgical periodontal therapy of each group, and were analyzed by optical microscopy and direct immunofluorescence to investigate the deposition of antigen-antibody complexes. Eleven (44%) patients were diagnosed with active SLE (SLE-A) and 14 (56%) with inactive SLE (LES-I). Mean PD, CAL and FMBS were significantly lower in SLE+ than SLE–(p < 0.05; Mann Whitney). The chronic use of low doses of immunosuppressants was associated with lower prevalence of CAL >3 mm. Immunofluorescence staining of markers of lupus nephritis and/or proteinuria was significantly increased in SLE+ compared to SLE–, even in the presence of periodontitis. These findings suggest that immunomodulatory drugs in SLE improves periodontal parameters. The greater deposition of antigen-antibody complexes in the gingival tissues of patients diagnosed with SLE may be a marker of disease activity, possibly complementing their diagnosis.
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Affiliation(s)
- Julien Rodrigues Pires
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | | | | | | | | | - Carla Andreotti Damante
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | | | - Sebastião Luiz Aguiar Greghi
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | - Maria Lúcia Rubo de Rezende
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | - Adriana Campos Passanezi Sant'Ana
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
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Zian Z, Bouhoudan A, Mourabit N, Azizi G, Bennani Mechita M. Salivary Cytokines as Potential Diagnostic Biomarkers for Systemic Lupus Erythematosus Disease. Mediators Inflamm 2021; 2021:8847557. [PMID: 33776578 PMCID: PMC7979309 DOI: 10.1155/2021/8847557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/05/2021] [Accepted: 03/03/2021] [Indexed: 01/08/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is a complex autoimmune inflammatory disease characterized by an unknown etiology and a highly variable clinical presentation. This clinical heterogeneity might be explained by dysregulation of tolerance to self and apoptotic mechanisms, overproduction of autoantibodies, and abnormal cytokine levels. Cytokine imbalance levels have been associated with disease activity and severity in SLE patients. In the last years, salivary cytokines related to SLE have gained significant attention and researchers have begun to focus on the identification of cytokines in the saliva of SLE patients using it as a diagnostic fluid for the inflammatory process underlying SLE. This review highlights and summarizes recent studies revealing the cytokines that have been identified in the saliva of individuals with SLE. Data reported and discussed in this report may provide useful additional information to better understand the mechanisms associated with the disease.
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Affiliation(s)
- Zeineb Zian
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, Abdelmalek Essaadi University, Tetouan, Morocco
| | - Assia Bouhoudan
- Faculty of Sciences of Tetouan, Abdelmalek Essaadi University, Tetouan, Morocco
| | - Nadira Mourabit
- Higher Institute of Nursing Professions and Technical Health of Tangier, Morocco
| | - Gholamreza Azizi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohcine Bennani Mechita
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, Abdelmalek Essaadi University, Tetouan, Morocco
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Marques CPC, Rodrigues VP, de Carvalho LC, Nichilatti LP, Franco MM, Patrício FJB, Magalhães M, de Andrade MS, Benatti BB. Expression of Toll-like receptors 2 and 4 in the saliva of patients with systemic lupus erythematosus and chronic periodontitis. Clin Rheumatol 2021; 40:2727-2734. [PMID: 33570702 DOI: 10.1007/s10067-020-05560-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/08/2020] [Accepted: 12/21/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the expression of salivary Toll-like receptors (TRL) 2 and 4 in patients with systemic lupus erythematosus (SLE) and chronic periodontitis (CP). METHODS A case-control study was conducted with 77 participants (42 SLE and 35 non-SLE) stratified according to CP diagnosis criteria. Periodontal parameters consisted of clinical attachment level (CAL), probing depth (PD), the visible plaque index (VPI), and the gingival bleeding index (GBI). Salivary TRL 2 and 4 expressions were determined by quantitative real-time polymerase chain reaction (RT-PCR). Statistical analysis included Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation rank, and multiple linear regression. RESULTS Patients with isolated SLE or CP had higher TLR 2 and TLR 4 expression in their saliva samples (P < 0.05). The group with both SLE and CP had lower TLR 2 and 4 expressions (P < 0.05). TLR 2 and TLR 4 showed significant negative correlations with PD, CAL, and GBI in SLE patients, and a significant positive correlation with periodontal parameters in non-SLE patients. CP was independently associated with reduction of TLR2 and TLR4 expression, even after adjusting for clinical data and current drug use. CONCLUSION Reduced TRL 2 and 4 expression in saliva was associated with the presence of CP in SLE patients. Key Points • Patients affected by isolated CP or SLE had higher TLR2 and TLR4 expression. • TLR under-expression may be associated with a worse periodontal status in SLE. • Abnormalities in TLRs expression may increase the susceptibility to periodontitis.
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Affiliation(s)
- Consuelo P C Marques
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil.,School of Medicine, Federal University of Maranhão, Pinheiro, Maranhão, Brazil
| | - Vandilson P Rodrigues
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil. .,Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), President Dutra Hospital of the Federal University of Maranhão, São Luís, Maranhão, Brazil.
| | | | - Louise P Nichilatti
- School of Medicine, Federal University of Maranhão, Pinheiro, Maranhão, Brazil
| | - Mayra M Franco
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Fernando José B Patrício
- Laboratory of Genomic Studies and Histocompatibility, President Dutra Hospital of the Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Marcelo Magalhães
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), President Dutra Hospital of the Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Marcelo S de Andrade
- Laboratory of Genomic Studies and Histocompatibility, President Dutra Hospital of the Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Bruno B Benatti
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Allaf FL, Khodashahi M, Saadati N, Sahebari M. Does periodontitis play a causal role in the Systemic lupus erythematosus? A systematic review. INFORMATICS IN MEDICINE UNLOCKED 2021. [DOI: 10.1016/j.imu.2021.100634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Causal association between periodontitis and risk of rheumatoid arthritis and systemic lupus erythematosus: a Mendelian randomization. Z Rheumatol 2020; 79:929-936. [PMID: 31965238 DOI: 10.1007/s00393-019-00742-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether periodontitis is causally associated with risk of rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). METHODS We performed two-sample Mendelian randomization (MR) analysis using the inverse variance-weighted (IVW), weighted median, and MR-Egger regression methods on publicly available summary statistics datasets using a periodontitis genome-wide association study (GWAS) as an exposure and RA and SLE GWASs on individuals of European descent as outcomes. RESULTS We selected 7 or 20 single-nucleotide polymorphisms from a periodontitis GWAS as instrumental variables for RA or SLE. The IVW method results support a causal association between periodontitis and RA (beta = 0.168, SE = 0.080, p = 0.035) and SLE (beta = 0.0001, SE = 0.0001, p = 0.046) risk; however, the weighted median approach did not indicate a significant causal association. MR-Egger regression revealed that directional pleiotropy was unlikely to be biasing the RA (intercept = -0.115, p = 0.078) or SLE results (intercept = 4.68E-05, p = 0.394); no significant causal association was found between periodontitis and RA and SLE. The MR estimates from the IVW, weighted median, and MR-Egger regression analyses were not consistent. CONCLUSION Only the results of MR analysis by the IVW method indicated that periodontitis is likely causally associated with an increased risk of RA and SLE incidence. Our MR showed weak causal association between periodontitis and RA or SLE. These findings may assist in elucidating the underlying mechanisms of the effects of periodontitis on RA and SLE incidence.
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Teles F, Wang Y, Hajishengallis G, Hasturk H, Marchesan JT. Impact of systemic factors in shaping the periodontal microbiome. Periodontol 2000 2020; 85:126-160. [PMID: 33226693 DOI: 10.1111/prd.12356] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Since 2010, next-generation sequencing platforms have laid the foundation to an exciting phase of discovery in oral microbiology as it relates to oral and systemic health and disease. Next-generation sequencing has allowed large-scale oral microbial surveys, based on informative marker genes, such as 16S ribosomal RNA, community gene inventories (metagenomics), and functional analyses (metatranscriptomics), to be undertaken. More specifically, the availability of next-generation sequencing has also paved the way for studying, in greater depth and breadth, the effect of systemic factors on the periodontal microbiome. It was natural to investigate systemic diseases, such as diabetes, in such studies, along with systemic conditions or states, , pregnancy, menopause, stress, rheumatoid arthritis, and systemic lupus erythematosus. In addition, in recent years, the relevance of systemic "variables" (ie, factors that are not necessarily diseases or conditions, but may modulate the periodontal microbiome) has been explored in detail. These include ethnicity and genetics. In the present manuscript, we describe and elaborate on the new and confirmatory findings unveiled by next-generation sequencing as it pertains to systemic factors that may shape the periodontal microbiome. We also explore the systemic and mechanistic basis for such modulation and highlight the importance of those relationships in the management and treatment of patients.
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Affiliation(s)
- Flavia Teles
- Department of Basic and Translational Sciences, Center for Innovation & Precision Dentistry, School of Dental Medicine & School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Yu Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - George Hajishengallis
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hatice Hasturk
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Julie T Marchesan
- Department of Comprehensive Oral Health, Periodontology, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
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Zhong HJ, Xie HX, Luo XM, Zhang EH. Association between periodontitis and systemic lupus erythematosus: a meta-analysis. Lupus 2020; 29:1189-1197. [PMID: 32635879 DOI: 10.1177/0961203320938447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of this study was to explore the association between periodontitis and systemic lupus erythematosus (SLE). METHODS To identify eligible studies, the PubMed, EMBASE and Web of Science databases were searched from inception to 19 September 2019. Associations of periodontitis, and other periodontal parameters, with SLE were assessed. RESULTS Ten studies involving 80,633 subjects were included in this meta-analysis. Pooled data showed a significant association between periodontitis and SLE (odds ratio=5.32, 95% confidence interval (CI) 1.69-16.78, p = 0.004). In addition, SLE patients had a higher prevalence of bleeding on probing (mean difference = 0.03, 95% CI 0.00-0.06, p = 0.02) and higher mean clinical attachment loss (mean difference = 0.69, 95% CI 0.39-1.00, p < 0.001). However, there were no significant differences between SLE and reference subjects in mean plaque index, gingival index, pocket depth or decayed, missing or filled teeth. CONCLUSIONS This study demonstrates a significant association between periodontitis and SLE, which indicates that avoidance of periodontitis by maintaining oral health may be a simple and economical way to prevent SLE.
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Affiliation(s)
- Hao-Jie Zhong
- Guangdong Medical University, Zhanjiang, PR China
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, PR China
| | - Hui-Xin Xie
- Guangdong Medical University, Zhanjiang, PR China
| | - Xiao-Min Luo
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, PR China
| | - Er-Hua Zhang
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, PR China
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Periodontal Diseases as Putative Risk Factors for Head and Neck Cancer: Systematic Review and Meta-Analysis. Cancers (Basel) 2020; 12:cancers12071893. [PMID: 32674369 PMCID: PMC7409086 DOI: 10.3390/cancers12071893] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
Whether "periodontal disease" can be considered as an independent risk factor for head and neck cancer (HNC) remains controversial. The aim of the current meta-analysis was to quantitatively assess this relationship in order to determine whether this represents a true risk factor, with implications for cancer prevention and management. PubMed, Scopus, and Embase databases were systematically searched. Selective studies were reviewed, and meta-analysis was performed to estimate the pooled odds ratio (OR) with 95% confidence intervals (CIs) on eligible studies using a random effects model. In total, 21 eligible observational studies (4 cohorts and 17 case-controls) were identified for qualitative synthesis after a review of 1051 articles. Significant heterogeneity could be identified in measures utilized for reporting of periodontal disease. Meta-analysis performed on nine studies that employed objective measures for reporting periodontal disease demonstrated a significant association between periodontal disease and HNC [OR 3.17, 95% CI, 1.78-5.64]. A diseased periodontium represents an independent risk marker, and a putative risk factor, for HNC. Prospective studies with standardized measures of periodontal disease severity and extent, integrated with microbiological and host susceptibility facets, are needed to elucidate the mechanisms of this positive association and whether treatment of the former influences the incidence and outcomes for HNC.
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Kato I, Sun J, Larson J, Hastert T, Abrams J. History of Inflammatory Bowel Disease and Self-Reported Oral Health: Women's Health Initiative Observational Study. J Womens Health (Larchmt) 2020; 29:1032-1040. [PMID: 32302514 DOI: 10.1089/jwh.2019.8162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background and Objective: Both periodontal disease and inflammatory bowel disease (IBD), are chronic inflammatory conditions, which are mediated by a complex interplay among a dysbiotic microbiota, dysregulated host immune-inflammatory responses, and lifestyle factors. Despite substantial differences in physical and chemical environments, rather strong correlations have been detected between microbial compositions of the oral cavity and stool. In this study, we tested the hypothesis that oral health conditions are affected by the presence of IBD. Materials and Methods: We analyzed the data from 73,621 women who were enrolled in the Women's Health Initiative observational cohort study and completed a follow-up questionnaire that surveyed oral health status specifically at year 5. Among these, 880 reported IBD at the baseline, including 47% who were symptomatic cases and 27% who were on immunosuppressive treatment. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for the association of IBD and medication status for self-reported oral health outcomes, using logistic regression models, adjusted for selected covariates. Results: IBD was not associated with periodontal disease history itself in a multivariable model; however, poorer self-rated oral health was modestly associated with the presence of IBD (OR = 1.15, 95% CI: 1.01-1.30). Likewise, more frequent eating limitations due to teeth were associated with the presence of IBD history (OR = 1.22, 95% CI: 1.07-1.39). When IBD cases were limited to those who were symptomatic, the associations with these two self-rated oral health outcomes were more pronounced with ORs of 1.28 (95% CI: 1.07-1.54) and 1.36 (95% CI: 1.07-1.54), respectively. Immunosuppressive treatment had little effect on these risk estimates. Conclusions: Among this nation-wide cohort of women 50-79 years of age, history of IBD was associated with poorer perceived oral health status.
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Affiliation(s)
- Ikuko Kato
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jun Sun
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Joseph Larson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Theresa Hastert
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Judith Abrams
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA
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Abstract
The US Surgeon General's report Oral Health in America highlighted ways in which oral health and systemic conditions are associated with each other. An oral examination can reveal signs and symptoms associated with systemic diseases. In this article, multiple systemic diseases including but not limited to viral and immune modulated conditions and associated oral symptoms are discussed.
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Affiliation(s)
- Natasha Bhalla
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA.
| | - Yoav Nudell
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Jaykrishna Thakkar
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Harry Dym
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
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Rezaei M, Bayani M, Tasorian B, Mahdian S. The comparison of visfatin levels of gingival crevicular fluid in systemic lupus erythematosus and chronic periodontitis patients with healthy subjects. Clin Rheumatol 2019; 38:3139-3143. [PMID: 31372850 DOI: 10.1007/s10067-019-04708-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/14/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Visfatin is an adipokine and has a crucial role in pro-inflammatory response. The aim of this study was investigating the visfatin levels of gingival crevicular fluid (GCF) in patients with systemic lupus erythematosus (SLE) and chronic periodontitis and healthy subjects. MATERIALS AND METHODS Sixty non-obese females were selected based on their clinical parameters into four groups: 15 healthy subjects (H-H), 15 systemically healthy individuals with chronic periodontitis (H-CP), 15 SLE patient with CP (SLE-CP), and 15 SLE patients without CP (SLE-H). GCF samples were collected to estimate the levels of visfatin using enzyme-linked immunosorbent assay (ELISA). RESULTS Investigating the amount of visfatin in the GCF showed that there is a significant difference between visfatin amount of GCF in SLE patients and chronic periodontitis (L-CP) in comparison with other groups (P < 0.001). CONCLUSION Visfatin levels have correlated positively with all the clinical periodontal parameters and its levels in (L-CP) group are highest in comparative with other groups. This finding suggests visfatin has a possible role in association between these two inflammatory conditions. Key Point • Visfatin in systemic lupus erythematosus.
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Affiliation(s)
- Maryam Rezaei
- Student Research Committee, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Mojtaba Bayani
- Department of Periodontics, School of Dentistry, Arak University of Medical Science, Arak, Iran.
| | - Baharak Tasorian
- Department of Rheumatology, School of Medicine, Arak University of Medical Science, Arak, Iran
| | - Soroush Mahdian
- Student Research Committee, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
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Al Sharrad A, Said KN, Farook FF, Shafik S, Al-Shammari K. Awareness of the Relationship between Systemic and Periodontal Diseases among Physicians and Dentists in Saudi Arabia and Kuwait: Cross-sectional Study. Open Dent J 2019. [DOI: 10.2174/1874210601913010288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background:Previous studies have shown possible association between periodontal diseases and Diabetes Mellitus (DM), Cardiovascular Disease (CVD) and Adverse Pregnancy Outcomes (APO). Increasing the knowledge of physicians and dentists regarding the association between periodontal disease and systemic diseases should improve their ability to provide a high standard of treatment for the disease and prevent its consequences. In our study, we sought to identify knowledge gaps in the awareness of the relationship between systemic and periodontal diseases among dentists and physicians from the Kingdom of Saudi Arabia and the State of Kuwait.Methods:A cross-sectional study was performed with a convenient sample of selected physicians and dentists in Saudi Arabia and Kuwait using a self-developed structured questionnaire. Physicians’ and dentists’ awareness were assessed regarding current evidence of the relationship between systemic diseases and conditions (DM, CVD, APO) and periodontal diseases.Results:A total of 134 (21.5%) of the identified physicians and 485 (78%) of the identified dentists participated in this study. More than half of the participants (52.1% physicians and 67.5% dentists) agreed that there is a relationship between periodontal diseases and DM, CVD and APO. Dentists had a statistically higher level of awareness compared with the physicians. The findings related to the awareness of the dentist sub groups highlighted that periodontists were significantly more likely to have a good level of knowledge.Conclusion:Within the limitations of this study, we concluded that the awareness of physicians and dentists regarding the relationship between periodontal diseases and systemic diseases (DM, CVD, APO) is generally low, Therefore, improved collaboration between medical and dental health providers is recommended.
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Tsai KL, Liao CC, Chang YS, Huang CW, Huang YC, Chen JH, Lin SH, Tai CC, Lin YF, Lin CY. Low Levels of IgM and IgA Recognizing Acetylated C1-Inhibitor Peptides Are Associated with Systemic Lupus Erythematosus in Taiwanese Women. Molecules 2019; 24:molecules24091645. [PMID: 31027344 PMCID: PMC6539680 DOI: 10.3390/molecules24091645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/20/2019] [Accepted: 04/24/2019] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to identify novel acetylation (Ac) modifications of the C1-inhibitor (C1-INH) and explain the association of the levels of autoantibodies against acetylated C1-INH peptides with the risk of developing systemic lupus erythematosus (SLE). Ac modifications of the C1-INH were identified and validated through in-gel digestion, nano-liquid chromatography-tandem mass spectrometry, immunoprecipitation, and Western blotting by using serum protein samples obtained from patients with SLE and age-matched healthy controls (HCs). In addition, the levels of serum C1-INH, Ac-protein adducts, and autoantibodies against unmodified and acetylated C1-INH peptides were measured. C1-INH levels in patients with SLE were significantly lower than those in HCs by 1.53-fold (p = 0.0008); however, Ac-protein adduct concentrations in patients with SLE were significantly higher than those in HCs by 1.35-fold (p = 0.0009). Moreover, immunoglobulin M (IgM) anti-C1-INH367-385 Ac and IgA anti-C1-INH367-385 Ac levels in patients with SLE were significantly lower than those in HCs. The low levels of IgM anti-C1-INH367-385 (odds ratio [OR] = 4.725, p < 0.001), IgM anti-C1-INH367-385 Ac (OR = 4.089, p = 0.001), and IgA anti-C1-INH367-385 Ac (OR = 5.566, p < 0.001) indicated increased risks for the development of SLE compared with HCs.
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Affiliation(s)
- Kai-Leun Tsai
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
| | - Chen-Chung Liao
- Proteomics Research Center, National Yang-Ming University, Taipei 112, Taiwan.
| | - Yu-Sheng Chang
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
| | - Ching-Wen Huang
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.
| | - Yu-Chu Huang
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.
| | - Jin-Hua Chen
- Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei 11031, Taiwan.
- Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei 11031, Taiwan.
| | - Sheng-Hong Lin
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
| | - Chih-Chun Tai
- Department of Laboratory Medicine, Taipei Medical University-Shuang-Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
| | - Yi-Fang Lin
- Department of Laboratory Medicine, Taipei Medical University-Shuang-Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
| | - Ching-Yu Lin
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Biotechnology and Animal Science, National Ilan University, Ilan 26047, Taiwan.
- PhD Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.
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Bagavant H, Dunkleberger ML, Wolska N, Sroka M, Rasmussen A, Adrianto I, Montgomery C, Sivils K, Guthridge JM, James JA, Merrill JT, Deshmukh US. Antibodies to periodontogenic bacteria are associated with higher disease activity in lupus patients. Clin Exp Rheumatol 2019; 37:106-111. [PMID: 29998833 PMCID: PMC6309750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/17/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Microbial infections and mucosal dysbiosis influence morbidity in patients with systemic lupus erythematosus (SLE). In the oral cavity, periodontal bacteria and subgingival plaque dysbiosis provide persistent inflammatory stimuli at the mucosal surface. This study was undertaken to evaluate whether exposure to periodontal bacteria influences disease parameters in SLE patients. METHODS Circulating antibodies to specific periodontal bacteria have been used as surrogate markers to determine an ongoing bacterial burden, or as indicators of past exposure to the bacteria. Banked serum samples from SLE patients in the Oklahoma Lupus Cohort were used to measure antibody titres against periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola) and commensals (Capnocytophaga ochracea, and Streptococcus gordonii) by ELISA. Correlations between anti-bacterial antibodies and different clinicalparameters of SLE including, autoantibodies (anti-dsDNA, anti-SmRNP, anti-SSA/Ro and anti-SSB/La), complement, and disease activity (SLEDAI and BILAG) were studied. RESULTS SLE patients had varying amounts of antibodies to different oral bacteria. The antibody titres against A. actinomycetemcomitans, P. gingivalis, T. denticola, and C. ochracea were higher in patients positive for anti-dsDNA antibodies, and they showed significant correlations with anti-dsDNA titres and reduced levels of complement. Among the periodontal pathogens, only antibodies to A. actinomycetemcomitans were associated with higher disease activity. CONCLUSIONS Our results suggest that exposure to specific pathogenic periodontal bacteria influences disease activity in SLE patients. These findings provide a rationale for assessing and improving periodontal health in SLE patients, as an adjunct to lupus therapies.
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Affiliation(s)
- Harini Bagavant
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA.
| | - Micah L Dunkleberger
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Nina Wolska
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Magdalena Sroka
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Astrid Rasmussen
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Indra Adrianto
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA. Current affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, USA
| | - Courtney Montgomery
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Kathy Sivils
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Joel M Guthridge
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Judith A James
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Joan T Merrill
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - Umesh S Deshmukh
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA
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Gualtierotti R, Marzano AV, Spadari F, Cugno M. Main Oral Manifestations in Immune-Mediated and Inflammatory Rheumatic Diseases. J Clin Med 2018; 8:jcm8010021. [PMID: 30585183 PMCID: PMC6351952 DOI: 10.3390/jcm8010021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 12/18/2022] Open
Abstract
Oral manifestations are frequent in patients with rheumatic diseases. The aim of this review is to offer readers practical advice concerning the onset, diagnosis and treatment of the main oral manifestations encountered in rheumatological and dental clinics. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, periodontal disease, and dysphagia may be the first expression of a number of rheumatic diseases. Some of these manifestations are aspecific and very frequent, such as oral aphthosis, which can be the first manifestation in patients with systemic lupus erythematosus; some are potentially dangerous, such as jaw claudication during the course of giant cell arteritis; and some are very rare but peculiar, such as strawberry-like gingivitis in patients with granulomatosis with polyangiitis. Other oral manifestations are due to adverse reactions to disease-modifying anti-rheumatic drugs. Oral alterations in rheumatic diseases are frequently overlooked in clinical practice, but their prompt recognition not only allows the local lesions to be appropriately treated, but also makes it possible to identify an underlying systemic disease.
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Affiliation(s)
- Roberta Gualtierotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy.
| | - Angelo Valerio Marzano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Dermatology Unit, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Francesco Spadari
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milano, Italy.
| | - Massimo Cugno
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy.
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Sete MRC, Carlos JC, Lira-Junior R, Boström EA, Sztajnbok FR, Figueredo CM. Clinical, immunological and microbial gingival profile of juvenile systemic lupus erythematosus patients. Lupus 2018; 28:189-198. [PMID: 30563424 DOI: 10.1177/0961203318819134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Periodontal disease has been associated with rheumatic diseases; however, few studies have evaluated the association with systemic lupus erythematosus (SLE), and its impact on the local inflammatory and microbial profiles. Therefore, this study evaluated the levels of several cytokines in gingival crevicular fluid (GCF) and serum from juvenile SLE (jSLE) patients with gingival inflammation, compared with controls. In addition, we assessed their subgingival microbial profile. Thirty jSLE patients and 29 systemically healthy individuals were recruited. Participants were rheumatologically and periodontally examined, and GCF, serum and intrasulcular biofilm were collected. Cytokines were analysed by bead-based multiplex assays and the bacterial profile by checkerboard DNA-DNA hybridization. jSLE patients presented higher percentages of dental plaque and bleeding than controls, as well as increased mean probing depth and attachment loss. After adjustment for multiple comparisons, GCF levels of interleukin (IL)-1β, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein-1 were significantly higher, whereas the levels of granulocyte-macrophage colony-stimulating factor were significantly lower in jSLE patients. In serum, G-CSF levels tended to be higher in jSLE patients (adjusted p-value = 0.06). Intrasulcular counts of Aggregatibacter actinomycetemcomitans were significantly higher in jSLE patients as compared with controls. We conclude that patients with jSLE present a worse periodontal condition associated with altered levels of pro-inflammatory cytokines in GCF and increased counts of A. actinomycetemcomitans in the intrasulcular biofilm.
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Affiliation(s)
- M R C Sete
- 1 Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - J C Carlos
- 1 Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - R Lira-Junior
- 2 Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E A Boström
- 2 Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - F R Sztajnbok
- 3 Unit of Rheumatology, Adolescent Health Studies Center, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - C M Figueredo
- 1 Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,4 Division of Periodontology, School of Dentistry and Oral Health, Griffith University, Queensland, Australia
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Abstract
Periodontal diseases are initiated by bacteria that accumulate in a biofilm on the tooth surface and affect the adjacent periodontal tissue. Systemic diseases such as diabetes, rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) increase susceptibility to destructive periodontal diseases. In human studies and in animal models, these diseases have been shown to enhance inflammation in the periodontium and increase the risk or severity of periodontitis. All 3 systemic diseases are linked to a decrease in bacterial taxa associated with health and an increase in taxa associated with disease. Although there is controversy regarding the specific oral bacterial changes associated with each disease, it has been reported that diabetes increases the levels of Capnocytophaga, Porphyromonas, and Pseudomonas, while Prevotella and Selenomonas are increased in RA and Selenomonas, Leptotrichia, and Prevotella in SLE. In an animal model, diabetes increased the pathogenicity of the oral microbiome, as shown by increased inflammation, osteoclastogenesis, and periodontal bone loss when transferred to normal germ-free hosts. Moreover, in diabetic animals, the increased pathogenicity could be substantially reversed by inhibition of IL-17, indicating that host inflammation altered the microbial pathogenicity. Increased IL-17 has also been shown in SLE, RA, and leukocyte adhesion deficiency and may contribute to oral microbial changes in these diseases. Successful RA treatment with anti-inflammatory drugs partially reverses the oral microbial dysbiosis. Together, these data demonstrate that systemic diseases characterized by enhanced inflammation disturb the oral microbiota and point to IL-17 as key mediator in this process.
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Affiliation(s)
- D T Graves
- 1 Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J D Corrêa
- 2 Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - T A Silva
- 2 Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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D-Mannose Enhanced Immunomodulation of Periodontal Ligament Stem Cells via Inhibiting IL-6 Secretion. Stem Cells Int 2018; 2018:7168231. [PMID: 30271438 PMCID: PMC6151224 DOI: 10.1155/2018/7168231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 06/06/2018] [Indexed: 12/14/2022] Open
Abstract
Periodontal ligament stem cell- (PDLSC-) mediated periodontal tissue regeneration has recently been proposed for the new therapeutic method to regenerate lost alveolar bone and periodontal ligament. It was reported that both autogenic and allogeneic PDLSCs could reconstruct damaged periodontal tissues but the regeneration effects were not consistent. The effective methods to improve the properties of PDLSCs should be further considered. In this study, we investigated if D-mannose could affect the immunomodulatory properties of hPDLSCs. After being pretreated with D-mannose, hPDLSCs could inhibit T cell proliferation and affect T cell differentiation into Treg cells. We found that less IL-6 could be detected in D-mannose-pretreated hPDLSCs. In the D-mannose pretreatment group, induced Treg cell number would decrease if increased IL-6 levels could be detected. Our data uncovered a previously unrecognized function of D-mannose to regulate the immunomodulatory function of PDLSCs and that IL-6 might play a key role in this process. The results provided a property method to improve PDLSC-based periodontal regeneration.
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Zhao X, Liu Z, Shu D, Xiong Y, He M, Xu S, Si S, Guo B. Association of Periodontitis with Rheumatoid Arthritis and the Effect of Non-Surgical Periodontal Treatment on Disease Activity in Patients with Rheumatoid Arthritis. Med Sci Monit 2018; 24:5802-5810. [PMID: 30124222 PMCID: PMC6113853 DOI: 10.12659/msm.909117] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/13/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The association of periodontitis (PD) with the prevalence of rheumatoid arthritis (RA) remains controversial. Therefore, the aim of this study was to evaluate their correlation and investigate the effects of non-surgical periodontal treatment on RA. MATERIAL AND METHODS A total of 64 patients were enrolled in this study and divided into 4 groups: 18 PD patients (PD+RA-), 18 RA patients (PD-RA+), 18 RA with PD patients (PD+RA+), and 10 healthy controls (PD-RA-). Periodontal and rheumatologic parameters were examined at baseline and 1 month following non-surgical periodontal treatment. RESULTS Our results showed that RA patients had similar periodontal status. However, patients in the PD+RA+ group had significantly higher levels of rheumatologic parameters such as C-reactive protein (CRP), anti-cyclic citrulline peptide antibody (ACPA), erythrocyte sedimentation rate (ESR), and Disease Activity Score 28 (DAS28) than those in the PD-RA+ group. In addition, non-surgical periodontal treatment was efficacious in improving rheumatologic parameters of patients in the PD+RA+ group. CONCLUSIONS The presence of PD might contribute to the progression of RA, while RA might have little effect on accelerating the development of PD. In addition, RA patients with PD receiving non-surgical periodontal treatment resulted in noteworthy improvement in the clinical outcome for RA.
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Affiliation(s)
- Xinyuan Zhao
- Department of Dentistry, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Zhongjun Liu
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Dalong Shu
- Department of Dentistry, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
| | - Yanlin Xiong
- Department of Dentistry, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Minzhao He
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Shuaimei Xu
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Shanshan Si
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Bing Guo
- Department of Dentistry, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
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Xie WZ, Jin YH, Leng WD, Wang XH, Zeng XT. Periodontal Disease and Risk of Bladder Cancer: A Meta-Analysis of 298476 Participants. Front Physiol 2018; 9:979. [PMID: 30083109 PMCID: PMC6064739 DOI: 10.3389/fphys.2018.00979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/03/2018] [Indexed: 12/23/2022] Open
Abstract
Objective: It has been reported that the periodontal disease is linked to a number of malignant tumors such as lung cancer and pancreatic cancer. In this study, we aimed to investigate the association of periodontal disease with risk of bladder cancer by a meta-analysis. Methods: PubMed, Scopus, ScienceDirect, and Chinese National Knowledge Infrastructure (CNKI) were searched for eligible publications up to December 15, 2017. Cohort and nested case-control studies on the association between periodontal disease and risk of bladder cancer were included. After study selection and data extraction, pooled hazard ratios (HRs) and their 95% confidence intervals (95%CIs) were calculated using a fixed-effect inverse-variance model. All analyses were performed using the RevMan 5.3 software. Results: Finally, five cohort studies were identified and included in this meta-analysis, involving 1,104 bladder cancer cases of 298,476 participants. Summary estimates based on adjusted data showed that periodontal disease was not significantly associated with the risk of bladder cancer (HR = 1.09, 95% CI = 0.95–1.25, I2 = 0%). A similar result was also observed after cumulative, subgroup and sensitivity analyses. Conclusions: Current evidence from cohort studies suggests that patients with periodontal disease may not be at an increased risk of developing bladder cancer.
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Affiliation(s)
- Wen-Zhong Xie
- Department of Stomatology, Kaifeng Stomatological Hospital, Kaifeng Central Hospital, Kaifeng, China
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei-Dong Leng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Xing-Huan Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xian-Tao Zeng
- Department of Stomatology, Kaifeng Stomatological Hospital, Kaifeng Central Hospital, Kaifeng, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Yang S, Zhao LS, Cai C, Shi Q, Wen N, Xu J. Association between periodontitis and peripheral artery disease: a systematic review and meta-analysis. BMC Cardiovasc Disord 2018; 18:141. [PMID: 29980169 PMCID: PMC6035462 DOI: 10.1186/s12872-018-0879-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/02/2018] [Indexed: 12/26/2022] Open
Abstract
Background Inflammation is a common feature of both peripheral arterial disease (PAD) and periodontitis. Some studies have evaluated the association between PAD and periodontitis. However, there is still no specialized meta-analysis that has quantitatively assessed the strength of the association. Thus, we conducted this meta-analysis to critically assess the strength of the association between PAD and periodontitis. Methods PubMed, Embase, and the Cochrane Library were searched for observational studies of the association between periodontitis and PAD in February 2018. Risk ratios (RRs) and their 95% confidence intervals (CIs) from included studies were pooled to evaluate the strength of the association between periodontitis and PAD. Weighted mean differences (WMDs) and their 95% CIs were pooled to compare the difference in periodontal-related parameters between PAD and non-PAD patients. Results Seven studies including a total of 4307 participants were included in the meta-analysis. The pooled analysis showed that there was a significant difference in the risk of periodontitis between PAD patients and non-PAD participants (RR = 1.70, 95% CI = 1.25–2.29, P = 0.01). There was also a significant difference in number of missing teeth between PAD patients and non-PAD participants (WMD = 3.75, 95% CI = 1.31–6.19, P = 0.003). No significant difference was found in clinical attachment loss between PAD patients and non-PAD participants (WMD = − 0.05, 95% CI = − 0.03–0.19, P = 0.686). Conclusion In conclusion, the results of this meta-analysis revealed a significant relationship between periodontitis and PAD. Moreover, our study indicated that PAD patients had more missing teeth than control subjects did. Further high-quality and well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusions of this study. Electronic supplementary material The online version of this article (10.1186/s12872-018-0879-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shuo Yang
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Li Sheng Zhao
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Chuan Cai
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Quan Shi
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ning Wen
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Juan Xu
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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Oral Manifestations of Systemic Lupus Erythematosus Patients in Qatar: A Pilot Study. Int J Rheumatol 2018; 2018:6052326. [PMID: 29849650 PMCID: PMC5914093 DOI: 10.1155/2018/6052326] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/11/2018] [Accepted: 03/11/2018] [Indexed: 12/16/2022] Open
Abstract
Objective The purpose of this pilot study was to assess the prevalence of oral manifestations among systemic lupus erythematosus (SLE) patients in Qatar, in order to warrant future studies that would investigate each one of these manifestations with detail and further scrutiny. Methods Study procedures took place between November 2014 and April 2016. All patients visiting the outpatient rheumatology clinics at Hamad General Hospital, Doha, Qatar, were asked to join. The American College of Rheumatology (ACR) 1997 criteria of SLE were used. The patients were examined initially by a rheumatologist and were later scheduled for an appointment with a dentist at the same institution. A total of 77 patients were recruited for the study. Results Prevalence rates for the different oral manifestations ranged from 2.4% for soft palate ulcers, cheilitis, and oral candida to 88.1% for the presence of cavitation. Gingivitis, periodontal disease, cavities, and missing teeth were observed in more than 50% of the sample. The prevalence of periodontal disease and missing teeth was higher among those with an SLE duration > 8 years. On the contrary, the prevalence of gingivitis and cavities was higher among those with an SLE duration ≤ 8 years. Conclusion This study found high rates of gingivitis, periodontal disease, cavities, and missing teeth among SLE patients in Qatar. It is recommended that healthcare providers of such patients monitor the presence of any oral manifestations in order to arrange for early treatment and prevention efforts. Future prospective longitudinal studies with adequate sample size and power are needed in order to ascertain any causation factors or common etiology pathways.
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