| Summary: | 碩士 === 國立臺灣大學 === 臨床牙醫學研究所 === 102 === Introduction: Chronic periodontitis and rheumatoid arthritis are the most common chronic inflammatory disease. They share a common immunoinflammatory profile, and demonstrate remarkably similar patterns of soft and hard tissue destruction. The pathogenesis of rheumatoid arthritis is complex, and there is a combination of genetic, environmental, hormonal, and infectious co-factors. It has been reported that serum anti-cyclic citrullinated peptide antibody(ACPA) titers and rheumatoid factor antibodies(RF) are significantly higher in the RA patients. P. gingivalis, a major periodontopathic bacteria, expresses peptidylarginine deimiase(PPAD) that mediates post-translational conversion of arginine to citrulline. We hypothesize that P. gingivalis infection might induce autoimmunity and is associated with elevated anti-CCP antibody titers in susceptible individuals. The aim of this study was to evaluate the effect of non-surgical periodontal treatment on serum inflammatory marker levels and autoimmune antibody titers.
Materials and Methods: 31 Taiwanese adults with chronic periodontitis were recruited from the dental clinic of National Taiwan University Hospital. Clinical periodontal examinations including probing depth (PD), clinical attachment level (CAL) and tooth number were performed. All subjects received full-mouth scaling and root planing within one month. Serum samples were collected before and 6-8 weeks after periodontal treatment. ACPA, RF, TNF-α, CRP, IL-1β, IL-6, MMP-3 and periodontopathic bacteria antibodies, including A. actinomycetemcomitans, P. intermedia, T. denticola, T. forsythia and F. nucleatum, were measured by ELISA method. Wilcoxon signed-rank test and Spearman’s rank correlation coefficient were used for statistics.
Results: After non-surgical periodontal treatment, patients showed significant reduction in percentage of PD, serum anti-F. nucleatum antibody titers, ACPA titers, and TNF-α levels, especially in moderate to severe periodontitis group. Besides, the number of extracted teeth was positively correlated with decreasing of ACPA and IL-1β serum levels separately. In smokers, the periodontal therapy improved the periodontal health, but had a limitation effect on inflammatory markers and autoimmune antibodies.
Conclusions: Periodontitis may affect systemic inflammation and autoimmune conditions. The periodontal therapy might improve the ACPA titers in rheumatoid arthritis patients. Therefore, the rheumatoid arthritis susceptible patients should pay more attention to oral hygiene and periodontal health in order to control disease activity.
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