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    Elevated serum TREM-1 is associated with periodontitis and disease activity in rheumatoid arthritis
    (Nature Research, 2021) İnanç, Nevsun; Mumcu, Gonca; Can, Meryem; Yay, Meral; Silbereisen, Angelika; Manoil, Daniel; Direskeneli, Haner; Bostancı, Nagihan
    The 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), Behçet´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.
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    Elevated serum trem-1 levels are associated with das28 and periodontitis in rheumatoid arthritis
    (BMJ Publishing Group, 2019) İnanç, Nevsun; Mumcu, Gonca; Can, Meryem; Direskeneli, Haner; Bostancı, Nagihan
    Background: The Triggering Receptor Expressed on Myeloid cells 1(TREM-1) along with its putative ligand peptidoglycan recognition protein1 (PGLYRP1) are involved in the propagation of the inflammatoryresponse to microbial exposure(1). Periodontal disease (PD) has beensuggested as an environmental risk factor for rheumatoid arthritis (RA),yet further studies are required to dissect the mechanisms underlying theassociation between the two(2).
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    Novel and known periodontal pathogens residing in gingival crevicular fluid are associated with rheumatoid arthritis
    (Wiley, 2021) Manoil, Daniel; Bostancı, Nagihan; Mumcu, Gonca; İnanç, Nevsun; Can, Meryem; Direskeneli, Haner; Belibasakis, Georgios N.
    Background Periodontitis is a suspected environmental risk factor for the development of rheumatoid arthritis (RA). However, correlation mechanisms between the two pathologies remain elusive. This study examined potential correlations between detached subgingival bacteria collected in gingival crevicular fluid (GCF) and RA parameters. Methods RA patients (n = 52, F:M = 40:12), patients with Behcet's disease (BD,n = 40, F:M = 29:11) as another systemic inflammatory disease were studied along with a systemically healthy control group (HC,n = 57, F:M = 40:17). All participants were non-smokers. Full mouth periodontal parameters were recorded. RA activity was assessed using the 28-joint Disease Activity Score (DAS-28). Rheumatoid factors (RFs)-IgM and -IgA were measured by ELISA. GCF samples were investigated by means of fluorescent in situ hybridization for 10 different bacterial taxa. Results The taxa TM7,Synergistetescluster B,Leptotrichia, Megasphaera,Anaeroglobus geminatus, andTannerella forsythiadisplayed significantly differential abundances between the groups. Whereas abundances ofMegasphaeraandA. geminatuswere significantly increased in the RA group, onlyPorphyromonas gingivalisdisplayed significant correlations with plaque scores, bleeding on probing, and RF-IgA. RA patients displaying RF-IgA levels >75 IU/mL exhibited five-fold more abundantP. gingivalislevels than patients below the threshold. This association with RF-IgA levels appeared even more pronounced, by six-fold moreP. gingivalis(P = 0.025), in patients with a DAS-28 score >3.2, indicative of moderate/very active RA. Conclusions Unattached GCF bacteria may mediate the association between periodontitis and RA, and monitoring the bacterial composition of GCF might inform on RA activity. The role of newly identified bacterial taxa in RA warrants further investigations.

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