The study of tempromandibular joint disorders and anti-cyclic citrullinated peptide antibodies in serum and saliva of patients with rheumatoid arthritis

Abstract

Background: Rheumatoid arthritis is an autoimmune disease that affects mainly the synovial membranes and articular structures and is characterized by chronic, systemic inflammation involving multiple joints.Being a synovial joint, the Temporomandibular Joint is subject to the same disorders affecting other synovial joints, including RA.Beside it was considered as a specific serological marker for diagnosing RA disease ,antibodies to cyclic citrullinated peptide have proven to be associated with joints destruction, though; it may play a potential role in the prediction of the disease severity. Materials and Methods: Sixty nine individuals (69) were enrolled in this study, forty nine (49) were patients diagnosed with Rheumatoid Arthritis, and twenty (20) were healthy control subjects. Blood and saliva samples were taken from each subject for immunological analysis of Anti-Cyclic Citrullinated Peptides antibodies by ELISA. Each patient with Rheumatoid Arthritis disease was examined by means of Research Diagnostic Criteria for Temromandibular Disorders for the assessment of tempromandibularjoint involvement. Results: Frequency of positive serum Anti-CCP antibodies was higher in rheumatoid arthritis patients compared to healthy controls (p=0.000).Tempromandibular joint clinical findings were bilaterally involved except joint sounds, sometimes; it was unilateral. Chronic rheumatoid arthritis patients associated with higher prevalence of tempromandibular joint disorders than newly diagnosed RA, except limited mouth opening which were prevalent in newly diagnosed RA patients, (p=0.012) was significant.Positive serum Anti-CCP rheumatoid arthritis patients were associated with higher frequency of tempromandibular joint disorderscompared with RA patients with negative serum Anti-CCP, a non-significant difference was found. Conclusions:Anti-Cyclic Citrullinated Peptide antibodies are considered as a biomarker of inflammation and disease activity. Tempromandibular joint disorders are frequently involved in rheumatoid arthritis patients. Rheumatoid arthritis patients with positive serum Anti-Cyclic Citrullinated Peptides antibodies associated with higher frequency of tempromandibular joint disorders.