ACPA IN SALIVA AND THEIR ASSOCIATION WITH PERIODONTITIS AND RHEUMATOID ARTHRITIS

Abstract

Anti-cyclic citrullinated peptide antibodies (ACPA) are formed by the action of host-generated antigens and are part of the etiology of rheumatoid arthritis (RA). They are a sensitive and highly specific indicator of RA.

MATERIALS AND METHODS

In the study involved 105 subjects aged 32 to 85 years (Mean age 50,6 ±13,07), divided into four groups: Group I – with periodontitis (P) and without RA, with diagnosed osteoarthritis – 26 patients; Group II – with P and RA – 28 patients; Group III – without P and with RA – 26 patients; Group IV – without P and without RA – 25 individuals. All patients underwent clinical and laboratory tests for the diagnosis of RA and osteoarthritis, a clinical periodontal examination, and unstimulated whole saliva was collected.

RESULTS

We found significantly higher salivary ACPA levels in RA patients compared to healthy subjects (p <0.0001). In P patients we found significantly higher levels of ACPA in saliva than in healthy subjects (p <0.0001). Among P patients, we found a significant correlation between ACPA concentration in saliva and the following indicators: PISA; PD; BOP, respectively (p<0.001), (p =0.003), (p =0.007). Among RA patients, our results showed a significant correlation of ACPA concentration in saliva with the following indicators: serum ACPA concentration (p <0.0001); serum RF concentration (p <0.0001); DAS-28 (CRP) (p=0.009).

CONCLUSION

Based on the established correlation between salivary ACPA levels and RA indicators, a high concentration of ACPA in saliva may be suggested as an easily accessible indicator of RA, but further studies are needed to ascertain this possibility. The established association between periodontal parameters and salivary ACPA levels confirms the effect of periodontal inflammation on salivary ACPA concentration and justifies the treatment of P as a way of preventing and controlling RA.