Periodontal Assessment in RA Study (PARAS)

RA 研究中的牙周评估 (PARAS)

• 批准号: 7033758
• 负责人: CLIFTON O BINGHAM
• 金额: $ 8.18万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7033758
• 关键词: antibody; arthritis; bacteria; bone; clinical research; cytokine; emotions; health; joints; lead; measurement; motivation; periodontitis; rheumatoid arthritis; university

DESCRIPTION (provided by applicant): The pathogenic mechanisms of rheumatoid arthritis (RA) and periodontal disease (PD) are remarkably similar, with similar cellular events in the inflammatory focus, common profiles of cytokines, proteases, and inflammatory markers, and bone and collagen degradation. An increased prevalence of PD has been described in patients with longstanding RA, yet further exploration of this association has been limited. Many have argued that RA predisposed to the development of PD with hypothesized interactions of decreased salivary pool, poor oral hygiene from hand disability, or medication effects. The growing appreciation of Anti-CCP antibodies as diagnostic and prognostic markers for RA is significant, given that certain strains of bacteria associated with progressive periodontal disease represent a source of an enzyme producing citrullinated peptides, potentially serving to trigger the attendant antibody response seen in RA. Thus, it is possible that PD serves as a precipitant for some cases of RA or is a modifying factor of the disease. The recognition of an influence of PD on other systemic illnesses, notably diabetes and atherosclerotic disease, in which shared pathogenic mechanisms are less clear, provide additional rationale to evaluate relationships between PD and RA, diseases in which the mechanisms of disease have many similarities. It is our hypothesis that the prevalence of periodontal disease in RA patients at the onset of their arthritic disease is increased compared to matched controls without RA and that the presence and severity of PD will correlate with RA disease activity. Specific Aim 1 is to evaluate a cohort of subjects with newly diagnosed RA for periodontal health compared to control subjects without arthritis. The primary outcome measurement will be the presence of periodontal disease in RA compared to non-arthritic controls. Specific Aim 2 is to explore relationships between RA disease activity with periodontal severity. These studies represent the first comprehensive evaluation of periodontal disease in early RA and will provide important preliminary data and biological samples for further studies of disease progression, response to therapy, and to elucidate common mechanisms of pathogenesis. This study represents a collaborative effort between Rheumatology at Johns Hopkins, the Univ. Of Maryland College of Dental Surgery, and NYU College of Dentistry. The relationships developed for this study constitute a unique multi-centered interdisciplinary group of investigators and will facilitate the preparation and implementation of much broader research proposals to more clearly define the overall oral health of patients with RA.

描述（由申请人提供）：类风湿关节炎（RA）和牙周病（PD）的致病机制非常相似，炎症灶中有相似的细胞事件，细胞因子、蛋白酶和炎症标志物的共同特征，以及骨和胶原降解。长期类风湿关节炎患者PD患病率增加，但对这种关联的进一步探索受到限制。许多人认为，类风湿性关节炎易患帕金森病，与假设的唾液池减少、手部残疾导致的口腔卫生不良或药物作用相互作用。鉴于某些与进进性牙周病相关的细菌菌株是产生瓜氨酸化肽的酶的来源，可能有助于引发RA中所见的伴随抗体反应，抗ccp抗体作为RA的诊断和预后标记物的价值日益增加。因此，PD可能是某些RA病例的诱发因素，或者是该疾病的修饰因素。认识到帕金森病对其他全身性疾病的影响，特别是糖尿病和动脉粥样硬化性疾病，其中共同的致病机制尚不清楚，为评估帕金森病和RA之间的关系提供了额外的依据，这些疾病的发病机制有许多相似之处。