Periodontitis and rheumatoid arthritis: a review.
Periodontitis and rheumatoid arthritis (RA) appear to share many pathologic features. In this review, the common pathologic mechanisms of these two common chronic conditions are explored. Emerging evidence now suggests a strong relationship between the extent and severity of periodontal disease and RA. While this relationship is unlikely to be causal, it is clear that individuals with advanced RA are more likely to experience more significant periodontal problems compared to their non-RA counterparts, and vice versa. A case is made that these two diseases could be very closely related through common underlying dysfunction of fundamental inflammatory mechanisms. The nature of such dysfunction is still unknown. Nonetheless, there is accruing evidence to support the notion that both conditions manifest as a result of an imbalance between proinflammatory and anti-inflammatory cytokines. As a result, new treatment strategies are expected to emerge for both diseases that may target the inhibition of proinflammatory cytokines and destructive proteases. The clinical implications of the current data dictate that patients with RA should be carefully screened for their periodontal status.
Bartold
P M
PM
Department of Dentistry, University of Adelaide, Adelaide, South Australia, Australia. mark.bartold@adelaide.edu.au
Marshall
R I
RI
Haynes
D R
DR
D000818:Animals; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000276:immunology*; D002352:Carrier Proteins / Q000096:biosynthesis; D016207:Cytokines / Q000378:metabolism; D020022:Genetic Predisposition to Disease; D006023:Glycoproteins / Q000096:biosynthesis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000378:metabolism; D008562:Membrane Glycoproteins / Q000096:biosynthesis; D010010:Osteoclasts / Q000378:metabolism; D053244:Osteoprotegerin; D010518:Periodontitis / Q000150:complications* / Q000276:immunology*; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D018160:Receptors, Cytoplasmic and Nuclear / Q000096:biosynthesis; D018124:Receptors, Tumor Necrosis Factor / Q000096:biosynthesis
D018501:Antirheumatic Agents; D002352:Carrier Proteins; D016207:Cytokines; D006023:Glycoproteins; D007166:Immunosuppressive Agents; D018836:Inflammation Mediators; D008562:Membrane Glycoproteins; D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C505686:TNFRSF11A protein, human; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human