89 research outputs found
Elevated serum TREM-1 is associated with periodontitis and disease activity in rheumatoid arthritis
No full textThe triggering receptor expressed on myeloid cells 1 (TREM-1) and peptidoglycan recognition protein 1 (PGLYRP1) are involved in the propagation of inflammatory responses. This study investigated whether serum levels of TREM-1 and PGLYRP1 correlate with periodontitis in rheumatoid arthritis (RA) patients. A total of 154 non-smoking participants with RA (n=55, F/M: 41/14), Behcet ' s disease (BD, n=41, F/M: 30/11) and healthy controls (HC, n=58, F/M: 40/18) were recruited. Serum and saliva were collected, the 28-joint disease activity score (DAS-28) was calculated and dental/periodontal measurements were recorded. Serum TREM-1 and PGLYRP1 levels were measured by ELISA and salivary bacterial DNA counts by quantitative polymerase chain reaction. TREM-1 and PGLYRP1 levels were higher in RA (166.3 +/- 94.3; 155.5 +/- 226.9 pg/ml) than BD (102.3 +/- 42.8; 52.5 +/- 26.3 pg/ml) and HCs (89.8 +/- 55.7; 67.4 +/- 37.3 pg/ml) (p<0.05). In RA, periodontitis was associated with increased TREM-1 and PGLYRP1 levels (p<0.05), yet in patients under methotrexate TREM-1 levels were lower. TREM-1 correlated with C-reactive protein (CRP) levels, DAS-28 and erythrocyte sedimentation rate, whereas PGLYRP1 positively correlated with CRP. RA patients displayed 3.5-fold higher salivary bacterial DNA counts than HCs. Increased serum TREM-1 levels correlated with PGLYRP1, CRP and DAS-28-ESR in RA patients with periodontitis
Effects of azithromycin on intracellular cytokine responses and mucocutaneous manifestations in Behcet's disease
No full textObjectiveThe aim of this study was to investigate the effects of azithromycin on mucocutaneous manifestations and ex vivo intracellular cytokine responses in patients with Behcet's disease (BD). MethodsTen BD patients with active manifestations and nine healthy controls (HCs) were included in the study. Patients were treated with azithromycin (1500mg/week) for fourweeks. Clinical and immunological responses were evaluated in the pre- and post-azithromycin treatment periods. Peripheral blood mononuclear cells (PBMCs) of patients and controls were stimulated by Streptococcus sanguinis, lipopolysaccharide (LPS), lipoteichoic acid (LTA), and heat shock protein-60 (HSP-60) for three hours. Ex vivo intracellular interferon- (IFN-) and tumor necrosis factor- (TNF-) levels were measured. ResultsFollicular lesions and genital ulcers completely healed, and the number of oral ulcers decreased after treatment (P=0.000). The stimulated intracellular IFN- response to S.sanguinis was higher in BD patients (5.75%) than in HCs (3.9%) before treatment (P=0.05). Likewise, the pretreatment IFN- response was significantly higher than the post-treatment response (1.95%). In BD patients, pretreatment stimulated intracellular IFN- responses to LTA (5.8%) were also higher than post-treatment responses (3.15%), but the difference did not reach statistical significance (P=0.07). ConclusionsAzithromycin treatment decreased the mucocutaneous manifestations in BD patients and suppressed the intracellular IFN- responses of PBMCs to S.sanguinis ex vivo, which suggests this treatment has an immunomodulatory effect
Are Salivary Gland Ultrasonography Scores Associated with Salivary Flow Rates and Oral Health-related Quality of Life in Sjogren Syndrome?
No full textObjective. Major salivary gland ultrasonography (SGUS) is a widely used imaging technique to evaluate salivary gland involvement in primary Sjogren syndrome (pSS). The aim of this study was to evaluate the relationship between SGUS, salivary flow rate (SFR) as an objective measure of the gland function, and oral health-related quality of life (OHRQOL) as a patient-reported outcome measure (PROM) in a pSS cohort. Methods. Sixty-six patients with pSS were examined by SGUS according to Hocevar and Milic scoring systems. Patients with inhomogeneity/hypoechoic areas with scores >= 2 in parotid and submandibular glands were classified separately as severe glandular involvement. Further, oral health, SFR, and Oral Health Impact Profile-14 (OHIP-14) for OHRQOL were assessed. Results. Both total Hocevar and Milic scores were higher in 21 pSS patients with low unstimulated whole salivary flow rate (U-WSFR) than 45 pSS patients without low U-WSFR (P = 0.001 and P < 0.0001, respectively). Increased scores of homogeneity, hypoechoic areas and glandular border visibility were observed in patients with low U-WSFR (P < 0.05). Among these variables, homogeneity score was found to be an independent risk factor for low U-WSFR in pSS according to logistic regression analysis (OR 1.586, P = 0.001). Moreover, a higher OHIP-14 score was observed in severe parotid involvement compared to nonsevere cases (23.26 +/- 21.19 vs 8.32 +/- 13.82, P = 0.004). Conclusion. High Milic and Hocevar SGUS scores are associated with reduced SFR and poor OHRQOL as a PROM. The inhomogeneity component of the SGUS score is associated with low U-WSFR and is an indicator of severely affected gland function
Does illness perception associate with disease symptoms in Behcet's disease?
No full textThis study aims to assess the relationship between illness perception and disease course and symptoms in Behcet disease (BD). One hundred ten consecutive BD patients (F/M 50/60, mean age 38.5 +/- 9.88years) and 57 patients with Psoriasis as a disease control group (F/M 28/29, mean age 48.12 +/- 15.52) are included in this cross-sectional study. Illness perception is evaluated using a revised version of the Illness Perception Questionnaire (IPQ-R). In IPQ-R, the identity score reflecting the number of symptoms is higher in BD patients with musculoskeletal involvement than the others (6.77 +/- 2.91 vs. 5.08 +/- 3.3, respectively, p=0.007). The consequences score for musculoskeletal involvement (19.52 +/- 7.03) and timeline (acute/chronic) score for eye involvement (26.67 +/- 4.32) are also higher compared to patients without them (16.37 +/- 5.82 and 22.09 +/- 8.68) (p=0.011 and p=0.038), reflecting negative beliefs about the illness. The score of psychological attribution is higher in patients with psoriasis than BD (p=0.039), whereas the other subgroup scores are lower in patients with psoriasis compared to those of BD (p<0.05). This study provides a patient's perspective in the disease management process of BD using the IPQ-R questionnaire. A patient's own personal beliefs and emotional responses to their symptoms might affect the outcome measures, especially with musculoskeletal symptoms and eye involvement in BD. However, psychological attribution is found to be a prominent issue in psoriasis
Salivary levels of HNP 1-3 are related to oral ulcer activity in Behcet's disease
No full textBackground Saliva contains antimicrobial peptides derived from oral epithelium as well as neutrophils in the innate immune response. The aim of this study was to examine the association between salivary human neutrophil peptide (HNP) 1-3 levels originating from neutrophils and oral ulcers in patients with Behcet's disease (BD). Methods Ninety-five patients with BD (F/M: 39/56; mean age: 38.711.9years) and 53 healthy controls (HC; F/M: 23/30; mean age: 35.210.1years) were included in the study. The disease control group (F/M: 20/33; mean age: 33.7 +/- 10.7years) was comprised of patients with oral infection regarding endodontic infection (n=32) and pericoronitis (n=21). Salivary HNP 1-3 levels of groups were measured in unstimulated samples by ELISA (Hycult, the Netherlands). Results A statistically significant increase was found in salivary HNP 1-3 levels of patients with BD (2268.28 +/- 1216.38g/ml) compared with HC (1836.49 +/- 857.76g/ml), patients with endodontic infection (849.9 +/- 376.1g/ml), and patients with pericoronitis (824.3 +/- 284.02g/ml; P=0.024, 0.000 and 0.000, respectively). The ratio of active oral ulcer (100%, n=14) was higher in low HNP 1-3 levels (1000g/ml) than the others (66.7%, n=54) in active patients with BD (P=0.008). Moreover, salivary HNP 1-3 levels were significantly lower in patients with endodontic infection and patients with pericoronitis compared with those in the HC group and patients with BD (P=0.000). Conclusion A decrease in salivary HNP 1-3 levels might be a biological factor for predisposition to oral ulcers in patients with BD and oral infection in healthy patients
Oral ulcer activity in Behcet's disease: Poor medication adherence is an underestimated risk factor
No full textObjective: The aim of this study was to evaluate the relationship between oral ulcer activity and medication adherence according to gender in Behcet's disease (BD) patients. Material and Methods: The study group included 330 BD patients (F/M: 167/163, mean age: 38.5 +/- 10.5 years). Oral ulcer activity and medication adherence were evaluated in the previous month. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8) having a score range of 0 to 8 with high scores indicating better adherence. Low adherence was defined as < 6 points on MMAS-8. Results: Over half of the group had active oral ulcers (n= 219, 66.4%) within the month preceding the visit. The number of oral ulcers was significantly higher in female patients with low medication adherence (2.39 +/- 3.24) than in the rest of the female group (1.28 +/- 2.05; p= 0.023). Although a similar trend was also observed in male patients (2.14 +/- 3.3 vs. 1.81 +/- 2.31), a significant relationship was not observed (p= 0.89). The frequency of medication intake per day was lower in patients with high medication adherence than in the rest of the study group (p= 0.04). Conclusion: Low medication adherence is a hidden risk factor in the management of BD. Poor adherence was associated with oral ulcer activity in female BD patients
Salivary levels of antimicrobial peptides Hnp 1-3, Ll-37 and S100 in Behcet's disease
No full textBackground: Oral ulcer is the cardinal clinical sign and increased neutrophilic activity is a part of the pathogenesis in Behcet's disease (BD). Saliva, as a part of the innate immune response, contains antimicrobial peptides (AMPs) that are derived from both oral epithelial cells and neutrophils. The aim of this study was to investigate the associations between salivary levels of AMPs HNP 1-3, LL-37 and S100 and disease course in patients with Behcet's disease (BD). Methods: Fifty-three patients with BD and 44 healthy controls (HC) were included in the study. Disease severity score reflecting organ involvement was calculated. Salivary HNP 1-3, LL-37 and S100 levels were measured in unstimulated saliva samples by ELISA. Results: Salivary HNP 1-3 and S100 levels in BD patients (2715.2 +/- 1333.4 mu g/ml and 430.6 +/- 203.9 mu g/ml) were significantly higher compared to HC (1780.6 +/- 933.2 mu g/ml and 365.3 +/- 84.7 mu g/ml) (p = 0.000 and p = 0.004, respectively). Although LL-37 levels were also higher in BD than HC (190.9 +/- 189.1 vs 143.1 +/- 128.9 ng/ml), no significant difference was observed (p = 0.53). Salivary HNP 1-3 and LL-37 levels were associated with the severity of BD (mild disease: 1975.1 +/- 1174.2 mu g/ml and 115.9 +/- 109.4 ng/ml vs severe disease: 2955.7 +/- 1305.6 mu g/ml and 215.3 +/- 203.8 ng/ml, p = 0.020 and p = 0.031, respectively). Salivary LL-37 levels also correlated with the number of monthly oral ulcers (r = 0.5 p = 0.000). Conclusion: An increase in salivary HNP 1-3 and S100 levels might be associated with enhanced local and systemic innate responses in BD. (C) 2011 Elsevier Ltd. All rights reserved
The assessment of contributing factors to oral ulcer presence in Behcet's disease: Dietary and non-dietary factors
No full textObjective: The aim of this study was to assess the contributing factors for oral ulcer activity in Behcet's disease (BD). Methods: Ninety-two patients with BD (F/M: 42/50, mean age: 38.7 +/- 10.02 years) participated in this cross-sectional study. Data regarding disease-related factors, smoking patterns, and self-reported dietary/non-dietary triggering factors for oral ulcer activity were collected by a questionnaire. Treatment protocol was categorized as mild and intensive groups associated with organ involvements. Results: A mild treatment protocol was more common in females (52.4% vs 20%) than in males (p=0.002). During the last three months, the number of oral ulcers in female patients was higher in the mild treatment group (6.4 +/- 6.5) than in the intensive treatment group (3.3 +/- 4.9) (p=0.045). In patients with active oral ulcers (n=63), rate of being a non-smoker was also higher in females (86.7% vs 63.6%) than in males. Daily frequency of tooth brushing was 1.2 +/- 0.8 in patients with BD, and was higher in females (1.5 +/- 0.9 vs 0.9 +/- 0.6) (p=0.001). Stress and fatigue (78.3%) were reported as the most frequent triggering factors for oral ulcer presence in patients with BD. A total of 148 different dietary factors associated with oral ulcer presence were reported in the study. Conclusion: A mild treatment protocol and being a non-smoker were found to be the contributing factors associated with oral ulcer activity in patients with BD. Being motivated for oral hygiene and being non-smokers were positive health behaviors observed in females. Irrespective of gender, stress and fatigue were defined as the most common self-reported triggering factors for oral ulcer presence in BD. In addition, the roles of some dietary factors were also reported
Oral health is a mediator for disease severity in patients with Behcet's disease: A multiple mediation analysis study
No full textObjectivesThe aim of the study was to examine whether oral health as an infection focus could mediate disease course in patients with Behcet's disease (BD). MethodsIn the study, oral health of 194 BD patients was examined at baseline and follow-up periods. The reasons for last dental visits were recorded as tooth extraction or regular control visits/planned treatments at the end of follow-up period. The Behcet's disease severity score was calculated with higher scores indicating a more severe course. Mediation analysis was carried out to assess the effects of oral health on disease severity score at follow-up period in the study. ResultsDental and periodontal indices were found to be higher at follow-up visit compared to those of baseline (P<0.05). Disease severity score was found to be higher in males (5.32.4) compared to females (4.4 +/- 2.5) in the whole group (P=0.005). Moreover, patients having tooth extraction at their last dental visit and patients with dental caries had a more severe disease course (5.4 +/- 2.4; 5.5 +/- 2.5) compared to others (4.2 +/- 2.3; 4.4 +/- 2.4; P<0.0001). In multiple mediation analysis, disease severity score was a dependent variable and was directly mediated by male gender (B=-0.8822, P=0.0145) and indirectly mediated through the presence of dental caries (B=0.9509 P=0.0110) and need of tooth extraction (B=0.8758, P=0.0128). ConclusionBoth presence of dental caries and need of tooth extraction were observed to be effective mediators for a more severe disease course in BD. Therefore, better oral health should be aimed to eliminate microbial factors, which are a part of pathogenic processes
ELEVATED SERUM TREM-1 LEVELS ARE ASSOCIATED WITH DAS28 AND PERIODONTITIS IN RHEUMATOID ARTHRITIS
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