Host Modulation in Rheumatoid Arthritis Patients with TNF Blockers Significantly Decreases Biochemical Parameters in Periodontitis

Abstract

The aim of this study was to evaluate the effects of host modulation therapy on periodontal and biochemical parameters. Sixteen rheumatoid arthritis patients newly scheduled for anti-tumour necrosis factor (TNF) therapy were screened for 30 days. Periodontal parameters (clinical attachment level, probing pocket depth, bleeding on probing, plaque index and gingival index) as well as salivary and gingival crevicular fluid (GCF), interleukin (IL)-1β, IL-8 and monocyte chemoattractant protein-1 (MCP-1) levels of the patients were evaluated at baseline and on the 30th day of therapy. GCF volume, IL-1β and IL-8 levels (p = 0.007, p = 0.017 and p = 0.009, respectively) of the periodontitis patients significantly decreased. Although there was a decrease in all these parameters in healthy patients, it was below statistical significance. Salivary IL-8 and MCP-1 levels significantly decreased in periodontitis patients (p = 0.028 and p = 0.013, respectively), but IL-1β levels remained unchanged. These results suggest that TNF blockers may significantly modify host response in terms of biochemical parameters of the periodontium and may mask significant associations such as those reported between periodontitis and rheumatoid arthritis.

Periodontal and Serum Protein Profiles in Patients With Rheumatoid Arthritis Treated With Tumor Necrosis Factor Inhibitor Adalimumab

“…The results of periodontal assessments demonstrated a significant improvement of periodontal condition, as determined by GI, BOP, and PD, in patients with RA after ADA therapy. These results are consistent with the findings of other studies, 13‐17 suggesting a therapeutic efficacy of TNF inhibition on periodontal condition. The data also showed comparable levels of supragingival plaque and the same status of smoking and RA medication between baseline and reassessment.…”

“…Recently, TNF inhibitors have been evaluated for their efficacy on periodontal condition in patients with RA 13‐17 . It has been shown that treatment with infliximab (IFX), a chimeric mouse/human anti‐TNF‐α monoclonal antibody, proved beneficial in suppressing periodontal disease in patients with RA 13,14,16 .…”

“…It has been shown that treatment with infliximab (IFX), a chimeric mouse/human anti‐TNF‐α monoclonal antibody, proved beneficial in suppressing periodontal disease in patients with RA 13,14,16 . Other studies also demonstrated an improvement of clinical periodontal condition in patients who were treated with IFX; etanercept (ETN), a recombinant fusion protein linked to human type II TNF receptor‐Fc portion; or adalimumab (ADA), a fully humanized anti‐TNF‐α monoclonal antibody 15,17 . However, there has been no study that evaluated the effect of ADA therapy alone on periodontal condition.…”

Dietary arginine silicate inositol complex inhibits periodontal tissue loss in rats with ligature-induced periodontitis

“…The main etiologic factor of periodontitis is an interaction between periodontal pathogenic bacteria and host tissue response 2–4. Since discovering the importance of host immune response in the pathogenesis of periodontal diseases, scientists have investigated host modulation therapy, which alters host tissue response to reduce destructive factors and increase preventive mediators 5,6. Various host modulatory agents have been investigated, such as growth factors, tetracycline, antiosteoclastic drugs, antioxidants, enamel matrix proteins, anti-inflammatory drugs, and bone morphogenetic proteins 5,7–10.…”

Análise clínica e de citocinas no fluido gengival de pacientes com periodontite agressiva - estudo longitudinal

“…A MCP-1 foi correlacionada com a gravidade da periodontite em diversos estudos (Longo et al, 2014;Gupta et al 2013;Üstün et al, 2013). Novamente após o no tratamento de um ano houve aumento nos níveis de MCP-1, o que não ocorreu no soro de indivíduos com PA no estudo de Shaddox et al (2013).…”