Salivary interleukin 6, interleukin 8, interleukin 17A, and tumour necrosis factor α levels in patients with periodontitis and rheumatoid arthritis

Introduction: Rheumatoid arthritis (RA) and periodontitis share risk factors and inflammatory pathways that could be related to cytokines, such as interleukin IL-6, IL-8, IL-17A, and tumour necrosis factor-alpha (TNE-alpha ). The aim of this study was to compare periodontal status and salivary levels of selected cytokines between patients diagnosed with RA and periodontitis. RA patients were assessed for the potential influence of anti-rheumatic therapy.Material and methods: One hundred and six patients were enrolled in a cross-sectional study. Medical assessment and periodontal examination were performed in 35 patients with chronic periodontitis, in 35 patients with RA and chronic periodontitis, and in 36 controls. Unstimulated whole saliva samples were analysed for IL-6, IL-8, IL-17A, and TNF-alpha.Results: Significant differences in biomarkers and periodontal parameters were found among groups. Study groups exhibited higher mean pocket depth (PD), number of PD > 4 nun, and mean clinical attachment loss, when compared with controls. The RA group had lower bleeding on probing index and PD, but higher values of plaque indices than the periodontitis group. Concentration of evaluated cytokines were higher in the RA and periodontitis groups, compared with controls. The periodontitis group showed also higher levels of IL-6, IL-17A, and TNF-alpha in comparison to RA. RA patients were treated with disease-modifying anti-rheumatic drugs (DMARDs) and glucocorticosteroids.Conclusions: Salivary levels of IL-6, IL-8, IL-17A, and TNF-alpha can be affected by periodontitis, RA, and presumably DMARDs. DMARD therapy appears to reduce destructive and inflammatory processes in periodontal tissues because lower values of PD, BOP, and salivary levels of IL-6, IL-17A, and TNF-a were found in RA.

引言：类风湿关节炎（RA）和牙周炎具有共同的风险因素以及可能与细胞因子相关的炎症通路，例如白细胞介素IL - 6、IL - 8、IL - 17A和肿瘤坏死因子 - α（TNF - α）。本研究的目的是比较被诊断为类风湿关节炎和牙周炎的患者的牙周状况以及所选细胞因子的唾液水平。对类风湿关节炎患者评估了抗风湿治疗的潜在影响。 材料和方法：106名患者参与了一项横断面研究。对35名慢性牙周炎患者、35名类风湿关节炎合并慢性牙周炎患者以及36名对照者进行了医学评估和牙周检查。对未刺激的全唾液样本进行了IL - 6、IL - 8、IL - 17A和TNF - α分析。 结果：各组之间在生物标志物和牙周参数方面存在显著差异。与对照组相比，研究组表现出更高的平均牙周袋深度（PD）、牙周袋深度＞4毫米的数量以及平均临床附着丧失。类风湿关节炎组的探诊出血指数和牙周袋深度较低，但菌斑指数值高于牙周炎组。与对照组相比，类风湿关节炎组和牙周炎组中所评估的细胞因子浓度较高。与类风湿关节炎组相比，牙周炎组还显示出更高水平的IL - 6、IL - 17A和TNF - α。类风湿关节炎患者接受了改善病情的抗风湿药（DMARDs）和糖皮质激素治疗。 结论：IL - 6、IL - 8、IL - 17A和TNF - α的唾液水平会受到牙周炎、类风湿关节炎以及可能是改善病情的抗风湿药的影响。改善病情的抗风湿药治疗似乎可减少牙周组织中的破坏性和炎症过程，因为在类风湿关节炎患者中发现牙周袋深度、探诊出血以及IL - 6、IL - 17A和TNF - α的唾液水平较低。