Anti-cyclic citrullinated peptide antibodies (ACPA) are formed by the action of host-generated antigens and are part of the etiology of rheumatoid arthritis (RA). They are a sensitive and highly specific indicator of RA. MATERIALS AND METHODS In the study involved 105 subjects aged 32 to 85 years (Mean age 50,6 ±13,07), divided into four groups: Group I – with periodontitis (P) and without RA, with diagnosed osteoarthritis – 26 patients; Group II – with P and RA – 28 patients; Group III – without P and with RA – 26 patients; Group IV – without P and without RA – 25 individuals. All patients underwent clinical and laboratory tests for the diagnosis of RA and osteoarthritis, a clinical periodontal examination, and unstimulated whole saliva was collected. RESULTS We found significantly higher salivary ACPA levels in RA patients compared to healthy subjects (p <0.0001). In P patients we found significantly higher levels of ACPA in saliva than in healthy subjects (p <0.0001). Among P patients, we found a significant correlation between ACPA concentration in saliva and the following indicators: PISA; PD; BOP, respectively (p<0.001), (p =0.003), (p =0.007). Among RA patients, our results showed a significant correlation of ACPA concentration in saliva with the following indicators: serum ACPA concentration (p <0.0001); serum RF concentration (p <0.0001); DAS-28 (CRP) (p=0.009). CONCLUSION Based on the established correlation between salivary ACPA levels and RA indicators, a high concentration of ACPA in saliva may be suggested as an easily accessible indicator of RA, but further studies are needed to ascertain this possibility. The established association between periodontal parameters and salivary ACPA levels confirms the effect of periodontal inflammation on salivary ACPA concentration and justifies the treatment of P as a way of preventing and controlling RA.

Introduction: Bacterial challenge in periodontal diseases activates both local and systemic immune responses of a macroorganism by increasing multiple proinflammatory factors that can be discovered in gingival crevicular fluid (GCF) and in saliva. We tested the hypothesis that IL-1&beta; concentration in GCF and saliva correlates with periodontal health and diseases.&nbsp; Materials and methods: The study included 62 people (mean age 36&plusmn;14 yrs), divided into three groups &ndash; patients with periodontitis (24 people), patients with gingivitis (19 people) and periodontally healthy people (19 people). Saliva and GCF samples were taken from all participants and the levels of IL-1&beta; in all samples were determined by ELISA. Results: IL-1&beta; concentrations in GCF of healthy individuals were significantly lower than the IL-1&beta; concentration in GCF of patients with gingivitis (p=0.009) and with periodontitis (p<0.0001). The IL-1&beta; concentrations in the saliva of healthy individuals were significantly lower than the IL-1&beta; concentrations in the saliva of pa-tients with gingivitis (p=0.002) and patients with periodontitis (p=0.025). Conclusions: Based on the obtained results, IL-1&beta; concentrations in GCF and saliva may be proposed as additional diagnostic criteria of inflammation in periodontal tissues, both at initial diagnosis and at diagnosis of recurrence of periodontitis, but further studies are needed to verify them as markers of periodontal diseases.

Antibodies against cyclic citrullinated peptides (ACPA) have significant prognostic value for the onset or progression of rheumatoid arthritis (RA). Extraarticular citrullination and the production of ACPA as an immune response have been well documented in a number of tissues, including inflamed gingiva associated with periodontal disease. The aim of this study was to analyze the relative value of serum ACPA, determined by anti-CCP test, in the periodontitis (P) associated with RA severity`s assessment. The study included 60 patients with a mean age of 58 ± 10 (34 to 74 years), of whom 44 were women and 16 were men with concomitant P and RA. All patients underwent clinical and laboratory tests for the diagnosis of RA and clinical periodontal examination for the diagnosis of P, after signed informed consent. In the studied cohort we found that the average number of lost teeth was 8 ± 5 (0-18), and the average depth of periodontal pockets in mm was 4.4 ± 1.1. In 50% of patients there was a loss of attachment> 5 mm, and in 43% we found furcation lesions. Fifty-eight patients (96.7%) had a 100% prevalence of probing bleeding (BoP), and 47 patients (78.3%) had PISA ≥ 934.71mm². The mean value of PISA in the studied patients was 1727.04 ± 873.64 (214.37 - 4324.00). We did not find a statistically significant difference in serum ACPA levels depending on the severity of periodontal parameters PD (p = 0.357), CAL (p = 0.589) and PISA (p = 0.788). We found that the ROC-based cutoff values ​​for ACPA were high (123.85 IU / ml) and had low sensitivity and specificity in distinguishing between severe and moderate / mild forms of periodontal disease.

The purpose of this study is to determine the concentration of Rheumatic Factor (RF) and Anti-cyclic Citrullinated Peptide Antibody (ACPA) in serum and in Gingival Crevicular Fluid (GCF) and their dependence on the presence of periodontitis (P) and rheumatoid arthritis (RA). The study involved 81 patients divided into three groups: Group I – patients with P and without RA (with osteoarthritis) – 26 subjects; Group II – patients with P and RA – 30 subjects; Group III – patients with periodontal health (without P) and RA – 25 subjects. For all patients the levels of ACPA and RF (class IgM) have been analyzed by ELISA in serum and GCF. We found a significantly higher incidence of ACPA in the GCF positive individuals and significantly higher mean ACPA values in GCF in Group II patients compared to patients in Group I. We found a significant difference between the frequency of RF in the GCF positive patients in Group II compared to those in Group I as well as the RF in the GCF positive patients in Group II compared to those in Group III. In the study among the patients of Group II we found a significant correlation between the RF and ACPA concentrations in serum and the number of lost teeth. These results are associated with possible enhanced extraarticular synthesis of ACPA and RF in the periodontal tissues in patients with periodontitis and predisposed to RA. Evidence for the effect of RA on periodontitis is the correlation between the concentration of ACPA and RF in serum – biomarkers for RA and the number of lost teeth.