Periodontal and serum protein profiles in patients with rheumatoid arthritis treated with tumor necrosis factor inhibitor adalimumab

J Periodontol. 2014 Nov;85(11):1480-8. doi: 10.1902/jop.2014.140194. Epub 2014 May 26.

Abstract

Background: Tumor necrosis factor (TNF)-α inhibitor has been shown to affect the periodontal condition of patients with rheumatoid arthritis (RA). The aim of the present study is to assess the effect of a fully humanized anti-TNF-α monoclonal antibody, adalimumab (ADA), on the periodontal condition of patients with RA and to compare serum protein profiles before and after ADA therapy.

Methods: The study participants consisted of 20 patients with RA treated with ADA. Clinical periodontal and rheumatologic parameters and serum cytokine levels were evaluated at baseline and 3 months later. Serum protein spot volume was examined with two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis. Proteins with significant difference in abundance before and after ADA therapy were found and identified using mass spectrometry and protein databases.

Results: The patients showed a significant decrease in gingival index (P = 0.002), bleeding on probing (P = 0.003), probing depth (P = 0.002), disease activity score including 28 joints using C-reactive protein (P <0.001), and serum levels of TNF-α (P <0.001) and interleukin-6 (P <0.001) after ADA medication, although plaque levels were comparable. Among a total of 495 protein spots obtained, nine spots were significantly decreased in abundance at reassessment, corresponding to complement factor H, phospholipase D, serum amyloid A, complement component 4, and α-1-acid glycoprotein (P <0.01).

Conclusion: These results suggest a beneficial effect of ADA therapy on the periodontal condition of patients with RA, which might be related to differences in serum protein profiles before and after ADA therapy.

Keywords: Arthritis; immunotherapy; periodontitis; proteomics; rheumatoid; serum; tumor necrosis factor-alpha.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adalimumab / therapeutic use*
  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / drug therapy*
  • Blood Proteins / analysis
  • Blood Proteins / drug effects*
  • C-Reactive Protein / drug effects
  • Complement C4 / analysis
  • Complement C4 / drug effects
  • Complement Factor H / analysis
  • Complement Factor H / drug effects
  • Cytokines / blood
  • Dental Plaque Index
  • Female
  • Follow-Up Studies
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Orosomucoid / analysis
  • Orosomucoid / drug effects
  • Periodontal Attachment Loss / prevention & control
  • Periodontal Index
  • Periodontal Pocket / prevention & control
  • Periodontitis / blood
  • Periodontitis / prevention & control*
  • Phospholipase D / blood
  • Phospholipase D / drug effects
  • Serum Amyloid A Protein / analysis
  • Serum Amyloid A Protein / drug effects
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Antirheumatic Agents
  • Blood Proteins
  • CFH protein, human
  • Complement C4
  • Cytokines
  • IL6 protein, human
  • Interleukin-6
  • Orosomucoid
  • Serum Amyloid A Protein
  • Tumor Necrosis Factor-alpha
  • Complement Factor H
  • C-Reactive Protein
  • Phospholipase D
  • Adalimumab