Effect of MMP-13 levels on Disease Modifying Antirheumatic Drugs(DMARDS) and Corticosteroids on Rheumatoid Arthritis Patients with Chronic Periodontitis - A Biochemical Analysis

Abstract

ABSTRACT: To investigate the effect of anti-rheumatic DMARD and anti-inflammatory steroids in rheumatoid arthritis patients with chronic Periodontitis and also to estimate the levels of inflammatory biomarker MMP-13 in rheumatoid arthritis patients with chronic Periodontitis. A total of 90 subjects participated in the study. They were divided into three groups, Group I- 30 RA patients with CP who are consuming DMARD medications, Group II- 30 RA patients with CP who are consuming steroids and Group III- 30 population controls.The medications used by the rheumatoid arthritis patients were confirmed by a rheumatologist from the patients clinical records, based on the duration of the diseases, use of DMARDs, use of steroids , serological markers of RA, ACPA (anti-citrullinated peptide antibody), RF(rheumatoid factor) and no of swollen tender joints were determined. The Disease activity score (DAS 28) was calculated from the no of tender and swollen joints (28 joint count).Subsequent analysis for mmp-13 was done by enzyme linked immunosorbent assay (ELISA).The serum MMP -13 levels in the serum of the healthy control group had significantly lower mean and standard deviation when compared to group I and II. The MMP-13 levels were higher in patients taking DMARDs when compared with the patients on steroid medications, which were statistically significant (P <0.001). In our study, MMP-13 levels are raised in DMARD group and decreased in the corticosteroid group with an increase in the periodontal parameters such as pocket depth and CAL. The possibility of periodontal destruction would have happened much before and the treatment on steroids would have lead to remission, thereby reduction in the MMP 13 levels was noted.