Apical periodontitis as an aggravating factor for the severity of rheumatoid arthritis: An animal study

IF 5.4 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE International endodontic journal Pub Date : 2024-07-30 DOI:10.1111/iej.14130

Bianca Araújo Magalhães Damiani, Karem Paula Pinto, Cláudio Malizia Alves Ferreira, Estéfano Borgo Sarmento, Carolina Oliveira de Lima, Caroline Silva Cassimiro, Luciana Moura Sassone, Emmanuel João Nogueira Leal da Silva

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Abstract

Aim

The present study investigated the influence of apical periodontitis (AP) on the severity of rheumatoid arthritis (RA) using a Wistar rat model.

Methodology

Forty male Wistar rats were distributed across four groups (n = 10) based on the induction of RA and AP: Control, RA, AP, and RA + AP. RA was induced through two immunisations with type II collagen emulsified in incomplete Freund's adjuvant, followed by one immunisation with complete Freund's adjuvant. After 21 days of RA induction, AP was induced by exposing the pulp of four molars. Animals were euthanized after 28 days of pulp exposure. Through the experiment, visual and behavioural assessments tracked RA development and the knees and hind paw joints were measured. Micro-computed tomography scans of knees and hind paws, as well as mandibles and maxillae, were conducted to evaluate RA severity and the presence of AP, respectively. Serum samples were collected to analyse proinflammatory cytokines (IL-1β, IL-2, IL-17, and TNF-α). Non-parametric data were analysed using the Kruskal-Wallis test followed by Student–Newman–Keuls test, while one-way anova followed by Tukey's test was performed for parametric data. A significance level of 5% was employed.

Results

All molars submitted to access cavity developed AP. All joints subjected to arthritis induction developed the disease, with AP + RA demonstrating a higher arthritis severity when compared to the RA group (p < .05). RA + AP group displayed a significantly larger hind paw and knee circumference compared to the RA group (p < .05). Micro-CT images of RA and RA + AP groups revealed joints with erosions and bone deformities, with a significantly lower bone surface density, lower trabecular number and higher trabecular separation in the hind paw and a significantly lower percent bone volume and higher trabecular separation in the knees of RA + AP group compared to RA group (p < .05). RA + AP group exhibited a significantly higher level of TNF-α and a lower level of IL-2 compared to all other groups (p < .05). Both RA and RA + AP groups had significantly higher IL-17 levels (p < .05), while there was no significant difference in IL-1β levels among the groups (p > .05).

Conclusion

The findings from this study underscore a possible relationship between apical periodontitis and the exacerbation of rheumatoid arthritis.

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根尖牙周炎是类风湿性关节炎严重程度的加重因素：一项动物研究。

目的：本研究以Wistar大鼠为模型，研究根尖牙周炎（AP）对类风湿性关节炎（RA）严重程度的影响：根据 RA 和 AP 的诱导情况，将 40 只雄性 Wistar 大鼠分为四组（n = 10）：对照组、RA 组、AP 组和 RA + AP 组。先用不完全弗氏佐剂乳化的 II 型胶原蛋白进行两次免疫诱导 RA，再用完全弗氏佐剂进行一次免疫诱导。诱导 RA 21 天后，暴露四颗臼齿的牙髓诱导 AP。暴露牙髓 28 天后，动物被安乐死。在整个实验过程中，通过视觉和行为评估跟踪 RA 的发展，并测量膝关节和后爪关节。对膝盖和后爪以及下颌骨和上颌骨进行微型计算机断层扫描，分别评估RA的严重程度和AP的存在情况。采集血清样本分析促炎细胞因子（IL-1β、IL-2、IL-17 和 TNF-α）。非参数数据采用 Kruskal-Wallis 检验和 Student-Newman-Keuls 检验进行分析，参数数据则采用单因素分析和 Tukey's 检验进行分析。显著性水平为 5%：结果：所有进入龋洞的磨牙均出现 AP。与 RA 组相比，AP + RA 组的关节炎严重程度更高（P .05）：本研究的结论强调了根尖牙周炎与类风湿性关节炎恶化之间可能存在的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International endodontic journal 医学-牙科与口腔外科

CiteScore

10.20

自引率

28.00%

发文量

195

审稿时长

4-8 weeks

期刊介绍： The International Endodontic Journal is published monthly and strives to publish original articles of the highest quality to disseminate scientific and clinical knowledge; all manuscripts are subjected to peer review. Original scientific articles are published in the areas of biomedical science, applied materials science, bioengineering, epidemiology and social science relevant to endodontic disease and its management, and to the restoration of root-treated teeth. In addition, review articles, reports of clinical cases, book reviews, summaries and abstracts of scientific meetings and news items are accepted. The International Endodontic Journal is essential reading for general dental practitioners, specialist endodontists, research, scientists and dental teachers.