Serum Immunoglobulin G Levels to Porphyromonas gingivalis Peptidylarginine Deiminase Affect Clinical Response to Biological Disease-Modifying Antirheumatic Drug in Rheumatoid ArthritisReportar como inadecuado




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Objectives

To determine whether serum immunity to Porphyromonas gingivalis peptidylarginine deiminase PPAD affects the clinical response to biological disease-modifying antirheumatic drug bDMARD in patients with rheumatoid arthritis RA.

Methods

In a retrospective study, rheumatologic and periodontal conditions of 60 patients with RA who had been treated with conventional synthetic DMARD were evaluated before baseline and after 3 and 6 months of bDMARD therapy. After serum levels of anti-PPAD immunoglobulin G IgG were determined at baseline, the patients were respectively divided into two groups for high and low anti-PPAD IgG titers according to the median measurements. Genotypes at 8 functional single nucleotide polymorphisms SNPs related to RA were also determined.

Results

After 3 and 6 months of therapy, patients with low anti-PPAD IgG titers showed a significantly greater decrease in changes in the Disease Activity Score including 28 joints using C-reactive protein DAS28-CRP P = 0.04 for both and anti-cyclic citrullinated peptide CCP IgG levels P = 0.03 and P = 0.04 than patients with high anti-PPAD IgG titers, although these parameter values were comparable at baseline. The anti-PPAD IgG titers were significantly positively correlated with changes in the DAS28-CRP P = 0.01 for both and the anti-CCP IgG levels P = 0.02 for both from baseline to 3 and 6 months later. A multiple regression analysis revealed a significantly positive association between the anti-PPAD IgG titers and changes in the DAS28-CRP after 6 months of bDMARD therapy P = 0.006, after adjusting for age, gender, smoking, periodontal condition, and RA-related SNPs.

Conclusion

The serum IgG levels to PPAD affect the clinical response to bDMARD in patients with RA.



Autor: Tetsuo Kobayashi , Satoshi Ito, Daisuke Kobayashi, Atsushi Shimada, Ichiei Narita, Akira Murasawa, Kiyoshi Nakazono, Hiromasa Yos

Fuente: http://plos.srce.hr/



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