title: Rheumatoid arthritis and salivary biomarkers of periodontal disease.
abstract: OBJECTIVE
  To test the hypothesis that rheumatoid arthritis (RA) influenced levels of salivary biomarkers of periodontal disease.
  
  
  METHODS
  Medical assessments, periodontal examinations and pain ratings were obtained from 35 RA, 35 chronic periodontitis and 35 age- and gender-matched healthy controls in a cross-sectional, case-controlled study. Unstimulated whole saliva samples were analysed for interleukin-1β (IL-1β), matrix metalloproteinase-8 (MMP-8) and tumour necrosis factor-α (TNF-α) concentrations.
  
  
  RESULTS
  The arthritis and healthy groups had significantly less oral disease than the periodontitis group (P<0.0001), with the arthritis group having significantly more sites bleeding on probing (BOP) than matched controls (P=0.012). Salivary levels of MMP-8 and IL-1β were significantly elevated in the periodontal disease group (P<0.002), and IL-1β was the only biomarker with significantly higher levels in the arthritis group compared with controls (P=0.002). Arthritis patients receiving anti-TNF-α antibody therapy had significantly lower IL-1β and TNF-α levels compared with arthritis patients not on anti-TNF-α therapy (P=0.016, 0.024) and healthy controls (P<0.001, P=0.011), respectively.
  
  
  CONCLUSIONS
  RA patients have higher levels of periodontal inflammation than healthy controls, i.e., an increased BOP. Systemic inflammation appears to influence levels of select salivary biomarkers of periodontal disease, and anti-TNF-α antibody-based disease-modifying therapy significantly lowers salivary IL-1β and TNF-α levels in RA.
authors.affiliation: Department of Oral Health Practice, Center for Oral Health Research, University of Kentucky, Lexington, KY, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Mirrielees
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Crofford
authors.forename: Yushun
authors.initials: Y
authors.lastname: Lin
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kryscio
authors.forename: Dolphus R
authors.initials: DR
authors.lastname: Dawson
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Ebersole
authors.forename: Craig S
authors.initials: CS
authors.lastname: Miller
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000378:metabolism; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D005260:Female; D005884:Gingival Hemorrhage / Q000378:metabolism; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis / Q000187:drug effects; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000032:analysis / Q000187:drug effects; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000378:metabolism; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000378:metabolism; D016300:Radiography, Bitewing; D012463:Saliva / Q000737:chemistry*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D015415:Biomarkers; D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8