RESUMO
BACKGROUND: The primary aim of this study was to compare the inflammatory activity in the gingival crevicular fluid (GCF) in a group of patients with rheumatoid arthritis (RA) and a group of matched controls. Secondarily, we aimed to evaluate the effect of rheumatologic treatment on periodontal inflammation. METHODS: Seventeen individuals with RA with a mean duration of disease of 12.1 (+/- 9.9) years and the same number of systemically healthy individuals matched for age, gender, periodontal status, and tobacco use were selected. Medication data were registered, and GCF was collected by means of an intracrevicular washing method. Besides clinical registrations, periodontal inflammation was assessed by analysis of the cytokines interleukin (IL)-1beta and -18 and of elastase activity. RESULTS: Amounts of IL-1beta and total elastase were significantly lower in the patient group. IL-1beta and total elastase had a significant and strong correlation in the RA group (r(s) = 0.883). This correlation was not observed in the control group. CONCLUSION: The anti-inflammatory treatment taken by RA patients might influence the periodontal inflammation status represented by IL-1beta and elastase in the GCF.
Assuntos
Anti-Inflamatórios/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Líquido do Sulco Gengival/química , Interleucina-1beta/análise , Elastase Pancreática/análise , Acetaminofen/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite Reumatoide/enzimologia , Artrite Reumatoide/imunologia , Estudos de Casos e Controles , Estudos Transversais , Índice de Placa Dentária , Feminino , Líquido do Sulco Gengival/enzimologia , Líquido do Sulco Gengival/imunologia , Hemorragia Gengival/classificação , Humanos , Interleucina-18/análise , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/classificação , Índice Periodontal , Bolsa Periodontal/classificação , Periodontite/classificação , Prednisona/uso terapêutico , FumarRESUMO
BACKGROUND: The primary aim of this study was to compare the inflammatory activity in the gingival crevicular fluid (GCF) in a group of patients with rheumatoid arthritis (RA) and a group of matched controls. Secondarily, we aimed to evaluate the effect of rheumatologic treatment on periodontal inflammation. METHODS: Seventeen individuals with RA with a mean duration of disease of 12.1 (± 9.9) years and the same number of systemically healthy individuals matched for age, gender, periodontal status, and tobacco use were selected. Medication data were registered, and GCF was collected by means of an intracrevicular washing method. Besides clinical registrations, periodontal inflammation was assessed by analysis of the cytokines interleukin (IL)-1ß and -18 and of elastase activity. RESULTS: Amounts of IL-1ß and total elastase were significantly lower in the patient group. IL-1ß and total elastase had a significant and strong correlation in the RA group (rs = 0.883). This correlation was not observed in the control group. CONCLUSION: The anti-inflammatory treatment taken by RA patients might influence the periodontal inflammation status represented by IL-1ß and elastase in the GCF.
RESUMO
Os objetivos deste artigo foram abordar aspectos grais da osteoporose e revisar a literatura acerca do tratamento desta afecção; apresentar dados atuais sobre os efeitos biológicos do paratormônio (PTH) no metabolismo ósseo e discutir o papel do teriparatide (rPTH 1-34, forma recombinante do PTH humano) no moderno tratamento da osteoporose. O método utilizado foi à revisão, através de biblioteca virtual, dos dados atuais acerca dos efeitos osteometabólicos do PTH e revisão, a partir do Méd-line, dos artigos disponíveis envolvendo o uso clínico do rPTH em pacientes com osteoporose . O rPTH, quando usado de forma intermitente, induz formação óssea em modelos animais e em pacientes com osteoporose. Carcinogênese em murinos tratados com doses altas de PTH foi eventualmente descrita. O número de estudos clínicos controlados envolvendo o fármaco é ainda pequeno. O rPTH diminui o índice de fraturas, particularmente em ossos trabeculados. O uso combinado de bifosfonatos parece diminuir o efeito anabólico do rPTH. O rPTH, ao estimular a atividade osteoblástica, funciona como agente anabólico em pacientes com osteoporose. O alto custo e a reconhecida eficácia das drogas anti-reabsortivas limitam a indicação clínica do RPTH nestes pacientes. Entretanto, em situações específicas o fármaco pode se constituir em estratégias útil.