No Clear Association Found Between Gingival Crevicular Fluid Cytokines and Periodontitis in Older Patients With RA

In patients with rheumatoid arthritis (RA), there was no clear association between pro- and anti-inflammatory cytokines in the gingival crevicular fluid and a diagnosis of periodontitis, according to study results published in the Journal of Periodontal Research.

Previous studies on cytokines in the gingival crevicular fluid in patients with RA were found to be inconclusive.

Researchers of the current population-based, cross-sectional study enrolled 132 dentate patients with RA who were aged 61 years and older. Interleukin (IL)-1-β, IL-4, IL-6, IL-10, IL-17A, tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), and chemokines RANTES/CCL5, eotaxin and monocyte chemoattractant protein (MCP-1) were analyzed from the gingival crevicular fluid and stratified for periodontitis, age, sex, body mass index (BMI), smoking, and anticyclic citrullinated protein (anti-CCP) status.

A total of 80 (61%) participants were diagnosed with periodontitis. Researchers did not observe any differences between the cytokine levels stratified for periodontitis in any of the cytokines or chemokines included in the study. However, associations between age and TNF-α (r_s=0.301; P =.002), MCP-1 (r_s=0.275; P =.005), IL-10 (r_s=0.222; P =.014), and RANTES (r_s=0.344; P =.000) were noted. No cytokines were found to be associated with sex, anti-CCP antibodies, and BMI.

Smoking was associated with IFN-γ (P =.006), which was between smokers and never smokers (P =.021) and previous smokers and never smokers (P =.035). The lowest levels of IFN-γ were observed in smokers. RANTES/CCL5 (P =.033), was also associated with smoking; this association was between smokers and previous smokers (P =.05), with smokers having the lowest values. Binary logistic regression analyses indicated that only RANTES was associated with periodontitis (P =.049; odds ratio, 1.001, 95% CI, 1.000-1.002).

The majority of the study population (89%) received dental care at least once a year, which may have influenced the results. The cross-sectional nature of the study did not allow for the identification of stable vs progressive periodontitis. In addition, conclusions could not be drawn regarding the effect of antirheumatic medications on periodontitis or the cytokine levels. The study was also limited by a 43% drop-out rate and no healthy control group.

Researchers concluded, “We found no clear association of pro-inflammatory or anti-inflammatory cytokines in gingival crevicular fluid in [older] patients [with] RA with periodontitis.”

Reference

Söderlin, MK, Persson GR, Renvert S, Berglund SJ. Cytokines in gingival crevicular fluid in elderly rheumatoid arthritis patients in a population‐based cross‐sectional study: RANTES was associated with periodontitis. J Periodont Res. Published online May 5, 2021. doi:10.1111/jre.12887