Background/Purpose: We evaluated the periodontal involvement of rheumatoid arthritis (RA) patients, and we correlated with various laboratory biomarkers including lipids, autoantibodies, serum vitamin D levels, markers of bone metabolism in relation with the periodontal condition and cariological indices; and also correlated them with salivary citrulline and anti citrullinated protein autoantibody levels with the above mentioned clinical and blood test findings.

Methods: Twenty-three RA patients were recruited for the study. Saliva samples were taken following whole scale periodontal and cariological examination. Protein concentration, peptidyl-citrulline and anti-cyclic citrullinated protein (anti-CCP) levels were measured from saliva samples. Blood test results were provided by rheumatologists. Citrullinated enolase protein-1 (CEP-1) level from serum was also measured.

Results: Periodontal diagnoses (scores) seem to have a positive dependency on LDL (R=0.722, p=0.008), PTH1 (R=0.586, p=0.022), D₃ vitamin level (R=0.586, 0.022), the sum of D3/D2 (R=0.634, p=0.011) respectively, in these patients. Anti-CEP-1 positive patients had significantly higher periodontal scores (2.71±0.11 vs 2.50±0.09, p<0.05) compared to anti-CEP-1 negative subjects. Interestingly, anti-CEP-1 positive patients had significantly higher triglyceride levels compared to seronegative ones (1.81±0.17 vs 1.42±0.05 mmol/l; p<0.05). Salivary citrulline and salivary anti-CCP, (p=0.007, R: 0.583) level has a correlation with the maximum of clinical probing depth.

Conclusion: Our results may add further pieces to the mosaic of RA-periodontitis connection. The possible role of antimicrobial immunity, as well as the possible role of lipids and bone metabolism have also been delineated. Future therapies should aim the disruption of this framework.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/rheumatoid-arthritis-and-periodontal-disease-salivary-acpa-levels-and-clinical-presentation/