Oral ulcers with amyloidosis secondary to rheumatoid arthritis

Nawata, Takashi; Shiragami, Kosaku; Matsuura, Takafumi; Honda, N; Kubo, Makoto; Kawano, Hiroyuki; Yano, Masafumi

doi:10.1093/rheumatology/keaa706

Cited by 2 publications

(1 citation statement)

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“…Extended use of corticosteroids can also deteriorate oral mucosal health, thus elevating the risk of ulcer development ( Best et al, 2018 ). However, Nawata et al indicated that the uncontrolled nature of severe RA itself, rather than the side effects of medications, directly lead to mouth ulcers ( Nawata et al, 2021 ). Additionally, RA can contribute to oral dryness, thereby compromising the mouth’s protective mucosal layer, which increases susceptibility to trauma and infection, potentially resulting in mouth ulcers ( Aloyouny et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Exploring the causal relationships between rheumatoid arthritis and oral phenotypes: a genetic correlation and Mendelian randomization study

Shen,

Lou,

Zhang

2024

Front. Genet.

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BackgroundRheumatoid arthritis (RA) frequently presents with oral manifestations, including gingival inflammation, loose teeth, and mouth ulcers; however, the causal connections between these conditions remain unclear. This study aims to explore the genetic correlations and causal relationships between RA and prevalent oral phenotypes.MethodsUsing summary data from genome-wide association studies of European populations, a cross-trait linkage disequilibrium score regression was conducted to estimate the genetic correlations between RA and six oral phenotypes. Subsequently, a two-sample Mendelian randomization (MR) approach was employed to assess the causal relationships, corroborated by various sensitivity analyses. Heterogeneity was addressed through the RadialMR method, while potential covariates were corrected using the multivariable MR approach.ResultsA significant negative genetic correlation was detected between RA and denture usage (rg = −0.192, p = 4.88 × 10−8). Meanwhile, a heterogenous causal relationship between RA and mouth ulcers was observed (OR = 1.027 [1.005–1.05], p = 0.016, Pheterogeneity = 4.69 × 10−8), which remained robust across sensitivity analyses. After excluding outlier variants, the results demonstrated robustly consistent (OR = 1.021 [1.008–1.035], p = 1.99 × 10−3, Pheterogeneity = 0.044). However, upon adjusting for covariates such as smoking, alcohol consumption, body mass index, and obesity, the significance diminished, revealing no evidence to support independent genetic associations.ConclusionGenetically predicted RA increases the risk of mouth ulcers, and a negative genetic correlation is identified between RA and denture use. The observed heterogeneity suggests that shared immunological mechanisms and environmental factors may play significant roles. These findings highlight the importance of targeted dental management strategies for RA patients. Further clinical guidelines are required to improve oral health among vulnerable RA patients.

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Section: Discussionmentioning

confidence: 99%