Rheumatoid arthritis and periodontitis : antibody response, oral microbiome, cytokine profile and effect of periodontal treatment

• Main Author: Lopez-Oliva Santa Cruz, Isabel
• Published: University of Birmingham 2018
• Subjects: RK Dentistry
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.752950

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease that affects about 1% of the world population. This common disease is characterized by chronic inflammation of the synovium that leads to destruction of cartilage and bone in the join, and the cause of this exacerbated inflammatory reaction remains unknown. Periodontitis (PD) is also a chronic inflammatory disease characterized by destruction of bone and other connective tissue that shares notable similarities with RA. Over the last 20 years, numerous studies have found an epidemiological connection between RA and periodontitis. However the biological mechanisms that explain the interrelations between the two conditions are not known. The aim of this thesis was to investigate the role of periodontitis in RA and the effect of periodontal therapy on immunological and microbiological parameters. To do that, different biological samples were collected from two pilot studies, comparing RA and periodontitis patients to the appropriate controls and from a selected group of randomized RAPD patients before and after periodontal therapy. The antibody response and subgingival microbiome of patients with RA and periodontitis were compared to the appropriate controls (no RA no PD, RA no PD, no RA PD). The effect of periodontal therapy on these parameters and on the cytokine changes in gingival crevicular fluid was also investigated. The findings from this thesis lend further credence to the link between RA and the oral microbiome, with RA patients having a disrupted and more anaerobic microflora and an exacerbated immunological reaction against periodontal bacteria and citrullinated proteins.