Role of periodontal disease in the development of autoimmune inflammatory entities clinical: implications and therapeutic challenges

8 páginasDuring the last decade the knowledge related to the pathogenesis of odontogenic infections and their possible association with systemic diseases has been of great interest. Periodontal pathogens that enter to bloodstream are involved in systemic pathological effects. The Focal Infection Theory is based on the pathophysiology correlation between chronic periodontitis and the development of certain autoimmune diseases. Rheumatoid arthritis as inflammatory disease is characterized by persistent synovitis and destruction of cartilage and bone. The etiology is uncertain, but some microorganisms may play important role in the lack of self- tolerance and the consequent development of autoimmunity. P. gingivalis may be involved in amplifying the immune response and induction of the disease in individuals with genetic susceptibility. Therefore, the concept of periodontal medicine as a discipline to integrate these associations has emerged.Durante la última década el área de conocimiento relacionada con la patogénesis de infecciones odontogénicas y su posible asociación con enfermedades sistémicas ha sido de gran interés. Patógenos periodontales que ingresan al torrente sanguíneo se encuentran implicados en efectos patológicos sistémicos y esto ha llevado al desarrollo de la Teoría de Infección Focal, que se basa en la correlación fisiopatológica entre periodontitis crónica y ciertas enfermedades autoinmunes. La artritis reumatoide, como enfermedad inflamatoria, se caracteriza por sinovitis persistente, destrucción del cartílago y del hueso. Su etiología es incierta, pero ciertos microorganismos pueden jugar un papel importante en la pérdida de autotolerancia y desarrollo de autoinmunidad. P. gingivalis puede estar comprometida en la amplificación de la respuesta inmune en individuos susceptibles genéticamente. Surge, entonces, el concepto de medicina periodontal como una disciplina que integra dichas asociaciones

Comparison of body mass index, anti-citrullinated peptides antibodies status and periodontal condition in first degree relatives individuals to rheumatoid arthritis

Association studies in rheumatoid arthritis (RA) have been focused in the pre-clinical phases of the disease in asymptomatic individuals with higher risk to develop RA such as first-degree relatives (FDR). Previous data has shown that obesity, the anti-citrullinated peptides antibodies (ACPA) status and the periodontal condition may modulate the severity and the clinical presentation of RA. The objective of this study were to investigate the body mass index (BMI), ACPA status, the frequency and severity of periodontal disease and the level of antibodies IgG-1, IGG-2 against P. gingivalis in healthy FDR individuals of RA-patients and compare these variables with a control group of healthy individuals from general population

Role of periodontal disease in the development of autoimmune inflammatory entities clinical: implications and therapeutic challenges

Durante la última década el área de conocimiento relacionada con la patogénesis de infecciones odontogénicas y su posible asociación con enfermedades sistémicas ha sido de gran interés. Patógenos periodontales que ingresan al torrente sanguíneo se encuentran implicados en efectos patológicos sistémicos y esto ha llevado al desarrollo de la Teoría de Infección Focal, que se basa en la correlación fisiopatológica entre periodontitis crónica y ciertas enfermedades autoinmunes. La artritis reumatoide, como enfermedad inflamatoria, se caracteriza por sinovitis persistente, destrucción del cartílago y del hueso. Su etiología es incierta, pero ciertos microorganismos pueden jugar un papel importante en la pérdida de autotolerancia y desarrollo de autoinmunidad. P. gingivalis puede estar comprometida en la amplificación de la respuesta inmune en individuos susceptibles genéticamente. Surge, entonces, el concepto de medicina periodontal como una disciplina que integra dichas asociaciones.During the last decade the knowledge related to the pathogenesis of odontogenic infections and their possible association with systemic diseases has been of great interest. Periodontal pathogens that enter to bloodstream are involved in systemic pathological effects. The Focal Infection Theory is based on the pathophysiology correlation between chronic periodontitis and the development of certain autoimmune diseases. Rheumatoid arthritis as inflammatory disease is characterized by persistent synovitis and destruction of cartilage and bone. The etiology is uncertain, but some microorganisms may play important role in the lack of self- tolerance and the consequent development of autoimmunity. P. gingivalis may be involved in amplifying the immune response and induction of the disease in individuals with genetic susceptibility. Therefore, the concept of periodontal medicine as a discipline to integrate these associations has emerged

Periodontal disease in individuals with a genetic risk of developing arthritis and early rheumatoid arthritis: A cross-sectional study

Recent consensus emphasizes the importance of studying individuals at risk for rheumatoid arthritis (pre‐RA) and those with early RA (eRA). Periodontal tissues have been recently evaluated, but these studies are limited. To evaluate the periodontal condition, immunoglobulin (Ig)G subclasses against Porphyromonas gingivalis in individuals with pre‐RA and eRA were compared with controls to establish an association between periodontal infection markers and rheumatic activity. Rheumatologic and periodontal condition was evaluated in 119 individuals with pre‐RA, 48 patients with eRA, and matched controls. P. gingivalis IgG1 and IgG2 were analyzed. C‐reactive protein, erythrocyte sedimentation rate (ESR), rheumatoid factor, anticitrullinated protein antibodies (ACPAs), and RA activity were measured. The groups were compared with McNemar test and paired t‐test. Conditional logistic regression was performed for pre‐RA confounders, and χ2 test was used to evaluate periodontal variables and RA activity indices. Pre‐RA individuals showed significantly higher levels of plaque index (P = 0.01) and bleeding on probing (P = 0.03) and higher severity of periodontal disease (P = 0.02). Periodontitis was associated with pre‐RA (odds ratio, 3.39; 95% confidence interval, 1.64 to 7.01) but not with eRA. In pre‐RA, P. gingivalis–specific IgG2 was associated with ACPAs (P = 0.049) and disease severity visual analog scale (P = 0.03). In eRA, IgG2 against P. gingivalis was associated with ESR (P = 0.046) and ACPAs (P = 0.04). P. gingivalis was associated with ACPAs (P = 0.04). This study shows that individuals with pre‐RA have significant inflammatory periodontal involvement. There was a significant association between IgG against P. gingivalis and ACPAs in pre‐RA and markers of RA activity in individuals with eRA