Anti-cyclic Citrullinated Peptide Antibody and Rheumatoid Factor and the Relationship between Periodontitis and Rheumatoid Arthritis

Abstract

The purpose of this study is to determine the concentration of Rheumatic Factor (RF) and Anti-cyclic Citrullinated Peptide Antibody (ACPA) in serum and in Gingival Crevicular Fluid (GCF) and their dependence on the presence of periodontitis (P) and rheumatoid arthritis (RA). The study involved 81 patients divided into three groups: Group I – patients with P and without RA (with osteoarthritis) – 26 subjects; Group II – patients with P and RA – 30 subjects; Group III – patients with periodontal health (without P) and RA – 25 subjects. For all patients the levels of ACPA and RF (class IgM) have been analyzed by ELISA in serum and GCF. We found a significantly higher incidence of ACPA in the GCF positive individuals and significantly higher mean ACPA values in GCF in Group II patients compared to patients in Group I. We found a significant difference between the frequency of RF in the GCF positive patients in Group II compared to those in Group I as well as the RF in the GCF positive patients in Group II compared to those in Group III. In the study among the patients of Group II we found a significant correlation between the RF and ACPA concentrations in serum and the number of lost teeth. These results are associated with possible enhanced extraarticular synthesis of ACPA and RF in the periodontal tissues in patients with periodontitis and predisposed to RA. Evidence for the effect of RA on periodontitis is the correlation between the concentration of ACPA and RF in serum – biomarkers for RA and the number of lost teeth.