Periodontitis is associated with disease severity and anti-double stranded DNA antibody and interferon-gamma levels in patients with systemic lupus erythematosus

Objectives: To analyse the correlation between periodontitis severity and disease activity, anti-double stranded DNA (anti-dsDNA) antibody, and interferongamma (IFN-gamma) levels in patients with systemic lupus erythematous (SLE). Methods: We selected 61 patients with SLE (age 18-55 years) selected from a hospital in Malang, Indonesia. Clinical examination and laboratory tests were performed to assess disease activity. The severity of SLE was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), while periodontitis severity was measured according to the Periodontal Index (PI) criteria. Levels of anti-dsDNA and IFN-gamma were determined using an enzyme-linked immunosorbent assay. Optical density at 450 nm was measured using an automated plate reader. Results: The mean age of the subjects with SLE was 29 years, and mean disease duration was 2.8 years. Fifty-four of 61 (88.53%) subjects with SLE had periodontitis according to the PI. SLE subjects exhibited other clinical manifestations such as lupus nephritis, vasculitis, arthritis, mucocutaneous manifestation, fatigue, fever, and/or leukopenia. SLE severity was assessed according to the average SLEDAI score (17.70 +/- 12.70), and average anti-dsDNA (122.6 +/- 81.01 U/mL), and IFN-gamma (14.64 +/- 11.17 pg/mL) levels. There was a significantly positive correlation between periodontitis score and SLEDAI score (r = 0.927; p <= 0.0001), anti-dsDNA antibody (r = 0.948; p <= 0.0001), and IFN-gamma (r = 0.951; p <= 0.0001) levels. Conclusion: Results of the present study demonstrated that periodontitis was associated with SLE disease activity, and was a biomarker of immune aging. Furthermore, this biomarker could be a reliable predictor of periodontal condition and prognosis of periodontitis and can also help in selecting the most appropriate treatment strategy for periodontitis in patients with SLE.