RESEARCH - Association of periodontal disease and joint destruction in RA extends link between SE and severity of bone destruction

[Guest guest]

ls of the Rheumatic Diseases 2006;65:905-909

© 2006 by BMJ Publishing Group Ltd & European League Against Rheumatism

--------------------------------------------------------------------------

EXTENDED REPORT

The association between periodontal disease and joint destruction in

rheumatoid arthritis extends the link between the HLA-DR shared epitope and

severity of bone destruction

H Marotte1, P Farge2, P Gaudin3, C andre4, B Mougin1 and P Miossec1

1 Hospices Civils de Lyon-bioMérieux Research Unit on Rheumatoid Arthritis,

Lyon, France

2 Faculty of Odontology, University Lyon I, Lyon, France

3 Grenoble Hospital, Grenoble, France

4 Saint-Etienne Hospital, Saint-Etienne, France

Correspondence to:

Professor P Miossec

Clinical Immunology Unit, Departments of Immunology and Rheumatology,

Hôpital Edouard Hérriot, 69437 Lyon Cedex 03, France; miossec@...

Objective: To evaluate a possible association between wrist and periodontal

destruction in rheumatoid arthritis, and between periodontal destruction,

dry mouth, and labial salivary gland biopsy and the contribution of genetic

factors (the shared epitope (SE) and IL1B (+3954) or TNFA (-238 or -308)

gene polymorphisms).

Methods: 147 patients with rheumatoid arthritis were enrolled. Periodontal

damage was defined according to the Hugoson and Jordan criteria on panoramic

dental x rays. Typing for the SE and cytokine polymorphisms was undertaken

by enzyme linked oligosorbent assay. Odds ratios (OR), relative risk (RR),

and 2 values were calculated to quantify associations.

Results: An association was observed between wrist and periodontal bone

destruction (2 = 11.82; p<0.001): 63 patients had both wrist and periodontal

destruction, 31 had wrist destruction alone, 20 had periodontal destruction

alone, and 33 had no destruction at either site. An association was seen

between a positive labial salivary gland biopsy and periodontal bone

destruction (RR = 2.73 (95% CI, 1.35 to 5.51), p<0.01, n = 41) or wrist bone

destruction (RR = 4.52 (1.96 to 10.45), p<0.001, n = 41). The SE was

associated with wrist bone destruction (OR = 2.5 (1.16 to 5.42), p<0.05) and

periodontal bone destruction (OR = 2.2 (1.04 to 4.84), p<0.05). No

association was found between the selected cytokine polymorphisms and bone

destruction.

Conclusions: A strong association was found between wrist and periodontal

bone destruction. The destruction risk was further increased in patients

with sicca syndrome. The SE appears to be a severity genetic marker for both

wrist and periodontal bone destruction.

http://ard.bmjjournals.com/cgi/content/abstract/65/7/905

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org