ABSTRACT
This work was carried out on 30 patients with active rheumatoid arthritis to study the immunological and histopathological changes in the gingiva following administration of the chelating agent D- penicillamine [250 mg-750 mg/day orally] and the immunosuppressive drug Methotrexate [7.5-15 mg/week]. The study confirmed the beneficial effects of both MTX and D-PA. The response to MTX occurred earlier [2-6 weeks]. The initial immunofluorescent examination of gingival tissue showed large amounts of granular and /or lump deposits of Igs K [G, M and A] as well as complement C3. After treatment, these deposits decreased, but this decrease was statistically insignificant. Histopathological changes were in the form of absent horny layer, parakeratotic areas and the presence of vacuolated cells in the prickle cell layer. The lamina propria showed large number of infiltrating mononuclear cells with disturbed architecture of collagen fibers. At the end of 24 weeks, these changes showed significant improvement. It was evident that gingival specimen can be taken instead of synovial membrane to follow up tissue response to drugs in RA. It is an easier and safer tool