Crosstalk between salivary citrullinated proteins and oral health status in patients with rheumatoid arthritis: A cross-sectional study.

CONTEXT: Rheumatoid arthritis (RA) is often associated with reduced salivary flow, increasing susceptibility to opportunistic oral infections. Evidence suggests shared pathogenic mechanisms between RA and periodontitis. As a non-invasive medium, saliva offers potential for evaluating associations between anti-citrullinated protein antibody, Porphyromonas gingivalis, and RA. AIMS: To measure salivary citrullinated proteins in RA patients, detect P. gingivalis and Candida species, and assess associated oral changes. SETTINGS AND DESIGN: Cross-sectional study including 21 RA patients and 21 age- and gender-matched healthy controls. MATERIALS AND METHODS: Unstimulated saliva was collected for citrullinated protein estimation using enzyme-linked immunosorbent assay and cultured on Sabouraud dextrose agar for Candida quantification. Subgingival plaque samples were analysed for P. gingivalis. Oral status was assessed using the Community Periodontal Index (CPI) and decayed, missing, and filled teeth (DMFT) index. STATISTICAL ANALYSIS USED: Mann-Whitney test, Chi-square, the Independent Student t-test, and one-way ANOVA test were used. RESULTS: Salivary citrullinated proteins showed significant positive correlation with Candida (P = 0.003), P. gingivalis (P < 0.001), and DMFT scores (P = 0.001). RA patients demonstrated significantly higher colony-forming units of Candida (5.11 ± 0.50 vs. 2.13 ± 0.16 log10; P < 0.001) and P. gingivalis (5.20 ± 0.08 vs. 2.12 ± 0.29 log10; P < 0.001). CPI scores correlated with microbial load (Candida, P = 0.04; P. gingivalis, P = 0.009). CONCLUSIONS: Although not a standalone diagnostic marker, salivary citrullinated proteins correlate with microbial load and caries, supporting saliva-based biomarkers for RA monitoring.