Correlation of anti-TNF-a biological therapy with periodontal conditions and osteonecrosis in autoimmune patients: A systematic review

Majdi Abunemer, Rana; Saifuddin Shaheen, Rakan; Abudullah Alghamdi, Renad

doi:10.1016/j.sdentj.2023.07.006

Cited by 4 publications

(2 citation statements)

References 38 publications

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“…TNF-α is a proinflammatory and pleiotropic cytokine, whose main function lies in: 1)promotion of myeloid cells, 2)induction of osteoclastic activity; by RANKL-independent paracrine/autocrine signaling or by up-regulation of RANKL, 3)inhibition of osteoblastic activity; by inhibition of the wnt pathway to down-regulate osteoblast function and increase their apoptosis and 4) secretion of other cytokines/chemokines and MMPs (MMP-8, MMP-9 and MMP-13) perpetuating the proinflammatory and destructive state in the periodontium [ 60 , 61 ]. Numerous studies have shown differences in TNF-α levels in saliva, serum, tissue biopsies, PICF and GCF of subjects with periodontal disease [ 62 – 66 ].…”

Section: Discussionmentioning

confidence: 99%

IL-23/IL-17 axis levels in gingival crevicular fluid of subjects with periodontal disease: a systematic review

Alarcón-Sánchez,

Guerrero-Velázquez,

Becerra-Ruiz

et al. 2024

BMC Oral Health

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Background The IL-23/IL-17 axis plays an important role in the immunopathogenesis of periodontal disease. A systematic review was conducted to synthesize all research reporting on the levels of the IL-23/IL-17 axis in gingival crevicular fluid (GCF) from subjects with gingivits, and periodontitis, compared to healthy controls. Methods The protocol followed the PRISMA, and Cochrane guidelines, and was registered with the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/7495V. A search was conducted in the electronic databases PubMed/MEDLINE, Scopus, Google Schoolar, and Cochrane from November 15th, 2005, to May 10th, 2023. The quality of the studies was assessed using the JBI tool for cross-sectional studies. Results The search strategy provided a total of 2,098 articles, of which 12 investigations met the inclusion criteria. The total number of patients studied was 537, of which 337 represented the case group (subjects with gingivitis, and chronic periodontitis), and 200 represented the control group (periodontally healthy subjects). The ages of the patients ranged from 20 to 50 years, with a mean (SD) of 36,6 ± 4,2, of which 47% were men, and 53% were women. 75% of the investigations collected GCF samples with absorbent paper strips, and analyzed cytokine IL-17 levels individually. In addition, qualitative analysis revealed that there are differences between IL-23/IL-17 axis levels in subjects with chronic periodontitis, gingivitis and healthy controls. Conclusions Thus, IL-23/IL-17 axis levels could be used in the future as a diagnostic tool to distinguish between periodontal diseases.

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Section: Discussionmentioning

confidence: 99%

IL-23/IL-17 axis levels in gingival crevicular fluid of subjects with periodontal disease: a systematic review

Alarcón-Sánchez,

Guerrero-Velázquez,

Becerra-Ruiz

et al. 2024

BMC Oral Health

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“…In addition, opiate use is linked to tolerance and dependency. Infection risks increase while using disease-modifying antirheumatic medications (DMARDs) such as Methotrexate (MTX), which targets IL-1 and TNF-α protein fusion in TNF-α has severely restricted the utilization of etanercept, a drug used to treat autoimmune diseases, including RA [3].…”

Section: Introductionmentioning

confidence: 99%

Mechanistic evaluation of anti-arthritic effects of campesterol through downregulation of TNF-α, IL-1β, IL-6, NF-κB, MMP 3, COX I, and COX II

Nazir,

Mobashar,

Anjum

et al. 2023

Preprint

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Aims This research aimed to use a rat model of CFA-induced arthritis to evaluate the antiarthritic effects of Campesterol, a phytosterol with therapeutic promise for inflammatory ailments. Methodology : A total of 30 Sprague-Dawley rats, with weight range 250–350 g, were randomly split into five groups (n = 6). Injection of CFA on Day 0 induced arthritis, and therapy began on Day 8 and continued until Day 28. The severity of paw edema and arthritic symptoms were measured on Days 7th, 14th, 21st, and 28th. Blood was drawn after the sacrifice, and further tests included, X ray interpretation, haematological parameters, biochemical paramters, histopathological parameter, and inflammatory biomarkers were evaluated that found to be significantly reduced. Moreover mRNA expression levels of TNF-α, IL-1β, IL-6, NF-κB, MMP 3, COX I, COX II, and IL-4 were assesed by real time polymerase chain reaction and PGE2 level was also evaluated by enzyme-linked immunosorbent assay. Results The use of Campesterol significantly inhibited the progression of paw edema, culminating in a notable decrease in arthritic scor. Notably, campesterol treatment improved histopathological indicators overall. The mRNA expression levels of pro-inflammatory biomarkers such as TNF-α, NF-kB, IL-6, COX II, and IL-1β were decreased while IL-4 level was increased in treated groups as compared to arthritic control group. Moreover, treatment with campesterol and piroxicam significantly reduced PGE2 level. Haemoglobin, Red blood cells, white blood cells, and platelet counts were almost restored in the treated groups. Other indicators such as total bilirubin, creatinine, urea, alanine aminotransferase, alkaline phosphatase, and rheumatoid factor were found statistically insignificant. Conclusion Campesterol significantly possess significant antiarthritic and immunomodulatory properties by downregulating the mRNA expression levels of pro-inflammatory biomarkers such as TNF-α, NF-kB, IL-6, COX II, and IL-1β and upregulating the IL-4 level.

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Mandibular fracture in medication‐associated osteonecrosis following infliximab therapy: A case report

Kolodziejwski,

Rosa,

Guimarães

et al. 2024

Special Care in Dentistry

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IntroductionMedication‐associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti‐resorptive and anti‐angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area.ObjectiveThe aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab.Case reportA 53‐year‐old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti‐angiogenic or anti‐resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction.Final considerationsPathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.

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Correlation of anti-TNF-a biological therapy with periodontal conditions and osteonecrosis in autoimmune patients: A systematic review

Cited by 4 publications

References 38 publications

IL-23/IL-17 axis levels in gingival crevicular fluid of subjects with periodontal disease: a systematic review

IL-23/IL-17 axis levels in gingival crevicular fluid of subjects with periodontal disease: a systematic review

Mechanistic evaluation of anti-arthritic effects of campesterol through downregulation of TNF-α, IL-1β, IL-6, NF-κB, MMP 3, COX I, and COX II

Mandibular fracture in medication‐associated osteonecrosis following infliximab therapy: A case report

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