Gingival crevicular fluid, serum levels of receptor activator of nuclear factor-kappa B ligand, osteoprotegerin, interleukin-17 in rheumatoid arthritis and osteoporosis patients with periodontal disease

Background: This study was performed to evaluate gingival crevicular fluid (GCF) and serum levels of soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), interleukin (IL)-17A, IL-17E, IL-17F, IL-17A/F and osteoprotegerin (OPG) in rheumatoid arthritis (RA), osteoporosis (OPR) and systemically healthy (SH) women all with periodontal disease. Methods: Gingival crevicular fluid (GCF) and serum samples were obtained before any periodontal intervention from 17 RA, 19 OPR patients and 13 SH women with periodontitis. Full-mouth clinical periodontal measurements were recorded. sRANKL, OPG, IL-17 levels were determined by Enzyme-linked Immunosorbent Assay. Results: Clinical periodontal measurements were similar in the three study groups. Although the total amounts of GCF albumin, OPG, IL-17A and IL-17A/F, were similar in the study groups, there were statistically significant differences in GCF concentrations of sRANKL, OPG, IL-17A, IL-17E, IL-17F and IL-17A/F. The sRANKL/OPG ratio were significantly higher in the RA group than in the OPR and SH groups (p<0.05). Serum sRANKL, sRANKL/OPG and IL-17A/IL-17E ratios were significantly higher, while OPG concentrations were significantly lower in the RA group compared with other groups (p<0.05). Serum IL-17A concentrations were significantly higher in the RA and OPR groups than in the SH group (p<0.05). Conclusion: Increased inflammatory mediator levels in RA patients despite the long-term usage of various anti-inflammatory drugs suggest that these patients may have a propensity to overproduce these inflammatory mediators