Influence of periodontitis on levels of autoantibodies in rheumatoid arthritis patients: A systematic review

Nik Eezammuddeen, Nazurah and Vaithilingam, Rathna Devi and Mohammad Hassan, Norul Husna (2023) Influence of periodontitis on levels of autoantibodies in rheumatoid arthritis patients: A systematic review. Journal of Periodontal Research, 58 (1). pp. 29-42. ISSN 0022-3484, DOI https://doi.org/10.1111/jre.13065.

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Abstract

Background and objective Periodontitis (PD) is a dysbiotic disease of tooth-supporting structures that has been associated with various systemic diseases including rheumatoid arthritis (RA). To date, evidence demonstrated increased prevalence of RA among PD patients and postulated PD to have a role in the development of autoantibodies in RA patients. Therefore, a systematic review was conducted to assess the available evidence to ascertain the effect of PD on levels of autoantibodies in the serum, saliva and gingival crevicular fluid (GCF) of RA patients. Material and methods The systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Relevant literature was searched from PubMed, Web of Science, Scopus and Ebscohost databases from inception until 31 August 2020. The risk of bias in each study was determined based on the Newcastle-Ottawa Scale tool. Results from random-effect meta-analyses were presented as summary estimates of odds ratios (ORs) for seropositivity and standardised mean difference (SMD) of autoantibody levels with 95% confidence intervals. Sensitivity tests and meta-regression were performed to assess the robustness of the results and potential cause of heterogeneity. Results The electronic and manual searches gathered 932 articles. Following screening and full-text assessment, a total of 29 studies were included in the analysis. Twenty-eight published observational studies were included in the quantitative analysis in the form of random-effect meta-analysis which revealed that PD was associated with anti-citrullinated proteins autoantibodies (ACPAs) and Rheumatoid Factor (RF) seropositive RA patients (OR for ACPA seropositivity: 1.82; 95% CI: 1.13-2.93) (OR for RF seropositivity: 1.53; 95% CI: 1.05-2.24). Also, RA patients with PD had increased serum levels of ACPA and RF. However, high heterogeneity among studies' results, partially ascribed to the unstandardised case definition of PD and laboratory testing of autoantibodies. Apart from ACPA and RF in serum, studies which reported on other RA-related autoantibodies, as well as autoantibody levels in saliva and GCF were scarce. Conclusion RA patients with PD tend to have greater ACPA and RF levels in their serum when compared with the RA patients without PD supporting the plausible role of PD in the development of systemic autoimmunity in RA patients.

Item Type: Article
Funders: Ministry of Higher Education, Malaysia, FP017‐2017A, Universiti Malaya, DPRG/31/19
Uncontrolled Keywords: Autoantibodies; Periodontitis; Rheumatoid arthritis; Systematic review
Subjects: R Medicine > RK Dentistry
Divisions: Faculty of Dentistry
Depositing User: Ms Zaharah Ramly
Date Deposited: 27 Nov 2023 05:41
Last Modified: 27 Nov 2023 05:41
URI: http://eprints.um.edu.my/id/eprint/39356

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