Discussion
periodontitis, cancer, inflammation, infection, systemic lupus, RA, active disease process
PERIODONTITIS, CANCER, INFLAMMATION, INFECTION, PSORIATIC ARTHRITIS, PERIODONTAL INFLAMMATION, MULTIPLE SCLEROSIS, LEAKAGE, PATHOLOGY, DISEASES
The present study reports, for the first time, gingival crevicular fluid, synovial fluid, and serum levels of prolactin hormone in RA patients with and without periodontitis and the effect of non-surgical periodontal therapy on these levels. We included a well distinguished group of RA patients with moderate severity, not consuming biological DMARDs and those with periodontitis had equal affection between stages III and IV. The RA + P patients had significantly worsened periodontal condition at baseline compared to periodontitis group patients and healthy controls. This is consistent with previous data that reported the same findings [In this work, RA patients treated with the biologic DMARDs were excluded to avoid its possible effect on the inflammatory status and hence, PRL expression. Earlier studies reported that biologic DMARDs ameliorate periodontal inflammation in patients with RA and increase patient’s susceptibility to infection [The non-surgical periodontal therapy caused significant reduction in periodontal parameters in this study, supporting earlier data that reported improvement of the periodontal condition after treatment in both RA + P and P groups [The concept of the locally produced PRL at sites of tissue pathosis via activating its receptor on target cells has emerged as a new mechanism in various pathologic contexts, including inflammation and cancer [The high GCF expression of PRL in periodontitis patients with and without RA and its reduction after SRP agrees with earlier reports in which the local expression of prolactin increases with active disease process and reduced significantly after treatment; this further supports the value of this hormone in the inflammatory process associated with periodontitis [The pronounced synovial PRL expression in our RA patient agrees with Tang et al. findings; they attributed this to possible partial vascular leakage of the pituitary originated hormone into synovial tissue and from peripheral monocytes capable of PRL production, PRL and its receptors were suggested to be linked to RA pathology by local crosstalk (either by autocrine or paracrine ways), between the immune and endocrine systems [High PRL serum levels in patients with immune-inflammatory conditions like RA, psoriatic arthritis, multiple sclerosis, and systemic lupus were reported, highlighting the relation between PRL and these diseases [