Local gingival crevicular fluid, synovial fluid, and circulating levels of prolactin hormone in patients with moderately active rheumatoid arthritis and stage III and IV periodontitis before and after non-surgical periodontal treatment—a controlled trial

Abstract

Objectives We aimed to investigate prolactin (PRL) levels in gingival crevicular fluid (GCF), synovial fluid, and serum in patients suffering from moderately active rheumatoid arthritis (RA) with and without periodontitis (P). Further, to evaluate the effect of non-surgical periodontal treatment on these levels compared to controls. Materials and methods Eighty subjects were divided into 4 groups: group 1: 20 patients with RA + P, group 2: 20 periodontitis patients (systemically healthy), group 3: RA patients (periodontally healthy), and group 4: healthy controls. Patients with periodontitis received scaling and root planning (SRP). PRL was measured using enzyme‐linked immunosorbent assay. Results At baseline, in GCF of RA + P group showed the highest mean PRL levels, followed by P group whereas groups 3 and 4 showed a statistically less values than the first 2 groups. Serum values showed non-significant difference between the first three groups, although higher than healthy controls. SRP reduced GCF and serum levels of PRL in both P groups as well as synovial fluid PRL in group 1. SRP caused no change in DAS scores while reduced ESR values were observed in group 1 after treatment. Conclusions Local GCF and synovial levels of PRL seem to be linked to the disease process of both periodontitis and rheumatoid arthritis than serum levels. SRP reduced these local levels. Clinical relevance In patients with RA and CP, local PRL seems to play a role in the association between the two conditions; further, periodontal treatment is essential to improve periodontal condition in RA patients. Trial registration Clinicaltrials.gov. Identifier: NCT04279691.

Menopozun sağlıklı ve periodontitisli kadınlarda kortizol, alfa-amilaz, dopamin ve prolaktin seviyeleri üzerine etkisi: kesitsel bir çalışma

“…However, the effect of menopause on serum prolactin levels is not fully understood, as a result of various age-related mechanisms (38). As in the study of el-Wakeel et al (39), a positive correlation between serum prolactin levels and clinical periodontal parameters (PI, GI, PD, and AL) was found in the present study, indicating the effect of inflammatory diseases and, thus, clinical utility as a biomarker for disease activity and prognosis (39).…”

The Effects of Periodontal Treatment on Rheumatoid Arthritis and of Anti-Rheumatic Drugs on Periodontitis: A Systematic Review

“…In the synovial fluid, RA patients undergoing NSPT present a reduction of prolactin [119]. At the salivary level, a reduction of RANKL was detected [70].…”

“…NSPT affects the levels of proinflammatory cytokines and various inflammatory mediators in serum, gingival crevicular fluid (GCF), saliva, and synovial fluid in RA-patients (Table 3). In serum, reduction of the following cytokines was observed: TNF-α, IL-6, receptor activator of nuclear factor-KB ligand (RANKL), carbamylated protein (CarP), neutrophil extracellular traps (NETs), the apoptosis inhibitor survivin, and the neuroendocrine hormone prolactin [70,[98][99][100]115,[117][118][119]. RANKL is expressed by stromal cells and osteoblasts to regulate osteoclastogenesis; its dysregulation has been correlated with osteoporosis, bone cancer, and RA [134].…”

“…In GCF, NSPT reduces the levels of TNF-α, IL-1β, IL-6, matrix metalloproteinase-8 (MMP-8), prostaglandin E2 (PGE2), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-2 (PAI-2), and prolactin [117,[119][120][121][122]. Affecting the homeostasis of extracellular matrix and cartilage degradation, the enzyme MMP-8 increases the severity of RA [140].…”

Mediators of Periodontitis complementing the development of Neural Disorders

“…More than that the endocrine role of hormones like corticosteroids, androgens, estrogens, and progesterone has also proved a key factor in the formation of gingival pocketing through multiple channels such as clampdown immunity, aggravating exudation, osseous resorption progression and enhancing the fibroblastic action, terminating into clinical attachment loss and presenting periodontal pathology. 10 Mohammed LJ et al reported a high prevalence of 21% of periodontal pathologies in women who were using oral contraceptives compared to only 9% prevalence in the controls who were not using these varieties of steroids. 11 …”