Immunological Traits of Patients with Coexistent Inflammatory Bowel Disease and Periodontal Disease: A Systematic Review.

This systematic review assessed studies that evaluated the immunological traits of patients with both inflammatory bowel disease (IBD) and periodontal disease. An electronic search for literature was conducted on PubMed, Embase, Scopus, Cochrane and Web of Science. Studies that evaluated the immunological response in patients with IBD and periodontal disease were considered eligible for inclusion. A total of 6 cross-sectional studies of 275 patients were included. Immunological analyses were performed in gingival crevicular fluid, saliva, serum, intestinal and gingival biopsies. Four studies identified that the presence of IBD and periodontal disease was associated with higher levels of prostaglandin E2, aMMP8, IL-18 and S100A12, respectively, when compared to patients without the coexistence of both diseases. Furthermore, another study identified higher aMMP-8 levels with increasing severity of periodontitis in Crohn's disease patients. The quality of overall evidence ranged from high to low due to the observational nature of contributing studies. The coexistence of IBD and periodontal disease seems to be associated with a more responsive inflammatory reaction compared with individuals having one or the other. More randomized controlled studies evaluating the coexistence of IBD and periodontitis are required to better explore the immunological interplay between them.

Oral potentially malignant disorders: clinical-pathological study of 684 cases diagnosed in a Brazilian population

BACKGROUND: The frequency and distribution of oral potentially malignant disorders (OPMD) may vary among dif-ferent populations. The aim of the present study was to evaluate the clinical-pathological characteristics of OPMD diagnosed in a Brazilian oral pathology laboratory over a period of 11 years. MATERIAL AND METHODS: All cases diagnosed as leukoplakia, speckled leukoplakia, erythroplakia, and actinic chei-litis from 2005 to 2015 were analyzed. Clinical information was obtained from laboratory forms and histological information was obtained from histological slides stained with hematoxylin and eosin. RESULTS: the final sample was comprised of 684 cases, of which 292 were males and 392 were females. The mean age was 58 years. The anatomical site most often involved was the lateral border of the tongue (23%), followed by the lower lip (20%), and by the buccal mucosa/vestibule (18%). Leukoplakia accounted for 82% of the sample (564 cases). The mean size of the leukoplakia and speckled leukoplakia lesions was 13 mm (ranging from 1 to 100 mm) and 15 mm (ranging from 5 to 30 mm), respectively (p = 0.460). Males reported smoking and drinking alcohol more frequently than females (p = 0.001 and p < 0.0001, respectively). In half of the cases, dysplasia was not histo-logically detected, while slight dysplasia was detected in 28% of the cases. The lesions from patients aged from 41 to 80 years presented moderate and severe dysplasia more often than lesions from patients in other age groups. CONCLUSIONS: OPMD were more common in females in their sixties. Females were more frequently affected in all anatomical sites, except for the lips. Leukoplakia lesions were the most common OPMD, followed by actinic cheili-tis. The lateral border of the tongue was the most affected anatomical site. OPMD located in the floor of the mouth/sublingual mucosa and lesions from older patients presented severe epithelial dysplasia with greater frequency

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Associação entre artrite reumatoide e citrulinização proteica por porphyromonas gingivalis: revisão de literatura / Association between Rheumatoid Arthritis and protein citrulinization by Porphyromonas gingivalis: Literature Review

A presença de peptidil-arginina deaminase (PADs), enzimas de Porphyromonas gingivalis (P. gingivalis), encontradas em pacientes com periodontite, são capazes de quebrar a tolerância imune, mediante citrulinização proteica, culminando, em um paciente suscetível, ao desenvolvimento da artrite reumatoide (AR). O objetivo desta revisão de literatura é avaliar uma possível correlação entre a periodontite e AR por meio da citrulinização proteica realizada por P. gingivalis. Para o desenvolvimento desta revisão de literatura, foi realizada uma busca na base de dados eletrônicas PUBMED, no período de maio a agosto de 2017. Foi utilizada uma estratégia de busca otimizada com as seguintes palavraschave: rheumatoid arthritis, periodontal disease e P. gingivalis. Assim, foram encontrados um total de 83 artigos, sendo selecionados inicialmente por título e resumo por um revisor e, posteriormente, por outro revisor, selecionando pelos critérios de inclusão: artigos completos escritos em língua portuguesa, espanhola ou inglesa; ter 10 anos ou menos de publicação. Ao final da seleção foram obtidos 22 artigos; destes, 15 incluídos por serem estudos clínicos em animais ou humanos. De acordo com este estudo, foi possível correlacionar positivamente a periodontite e a AR por meio da citrulinização proteica realizada pela bactéria P. gingivalis. Contudo, a mediação por PADs não é a única e exclusiva forma de correlação entre essas doenças, sendo necessários mais estudos para estabelecer outras possíveis correlações. (AU)

The presence of peptidyl arginine deaminase (PADs), an enzyme associated to Porphyromonas gingivalis (P. gingivalis), found in patients with periodontitis, can lead to the breakdown of immune tolerance by means of protein citrulinization, leading to a development of rheumatoid arthritis (RA) in susceptible patients. The objective of this literature review is to evaluate a possible correlation between periodontitis and RA through protein citrulinization performed by P. gingivalis. For the development of this literature review, a search was performed on the electronic database PUBMED from May to August 2017. An optimized search strategy was used with the following keywords: rheumatoid arthritis, periodontal disease and P. gingivalis. A total of 83 articles were found, being initially selected by title and abstract by one reviewer and later by another reviewer selecting by inclusion criteria: Complete articles written in Portuguese, Spanish or English; have 10 years or less of publication. At the end of the selection, 22 articles were obtained; of these, 15 included by being clinical studies in animals or humans. According to this study, it is possible to positively correlate periodontitis and RA with protein citrulinization performed by P. gingivalis. However, mediation by PADs is not the only and exclusive form of correlation between these diseases, and further studies are needed to establish other possible correlations. (AU)