Chronic periodontitis and rheumatoid arthritis: Interrelationship of etiopathogenesis

In chronic periodontitis, the main etiological factors are microorganisms that are found in plaque scrapings, where they are organized into a biofilm. Gram-negative periodontopathogens, such as P. gingivalis, A. actinomycetemcomitans, T. denticola, P. intermedia, and T. forsythensis, have endotoxins in their cell walls, which can cross-react with antigens of joint cartilage and cause inflammation in the joint. Pro-inflammatory cytokines: Interleukin-1β, Interleukin-6, Tumor Necrosis Factor alpha, found in periodontal pockets, play a key role in the pathogenesis of rheumatoid arthritis by inducing cellular infiltration of the synovium and an erosive process. To determine the etiological significance of obligate anaerobes, which play a key role in the development of chronic periodontitis and rheumatoid arthritis, molecular genetic methods, specifically real-time PCR with the use of the "parodonto- screen" test system, were employed. Cytokine content in gingival fluid was examined using an enzyme-linked immunosorbent assay (ELISA) with test systems from Vector-Best. PCR analysis showed that the pathological microbial colonization of the periodontium differs from the normal condition. In group 1, where chronic periodontitis and rheumatoid arthritis are present, the frequency of occurrence of pathogens was: P. gingivalis (78%), A. actinomycetemcomitans (58%), P. intermedia (60%), T. forsythensis (100%), T. denticola (75%), Candida albicans (34%). The levels of pro-inflammatory cytokines in group 1 (with periodontitis and rheumatoid arthritis) were as follows: Interleukin-1β – 8.23 pg/ml, Interleukin-6 – 2.7 pg/ml, Tumor Necrosis Factor alpha – 4.43 pg/ml, Interleukin-6 in serum – 6 pg/ml; while in group 2 (control group), the levels were: Interleukin-1β – 1.8 pg/ml, Interleukin- 6 – 0.71 pg/ml, Tumor Necrosis Factor alpha – 1.1 pg/ml, Interleukin-6 in serum – 3 pg/ml. Detection of periodontopathogens and five types of pro-inflammatory cytokines in gingival fluid using real-time polymerase chain reaction Polymerase Chain Reaction and enzyme-linked immunosorbent assay (ELISA) allows for accurate diagnosis of chronic periodontitis and rheumatoid arthritis, which are etiopathogenetically interconnected