Epigenética na artrite reumatoide, relação com a doença periodontal e benefícios da medicina hiperbárica

Abstract

Over the past 20 years, a highly significant interrelationship has been identified between rheumatoid arthritis and periodontal disease. The secretion of inflammatory mediators contributes to the destruction of periodontal and synovial tissues, respectively. These diseases share common risk factors and pathogenic pathways that lead to loss of function and disability. Parameters of RA (rheumatoid arthritis) severity, elevated erythrocyte sedimentation rate and protein C levels, as well as multiple inflamed joints, are associated with periodontal bone loss. The presence of citrullinated proteins, as well as genetic predisposition, is associated with the development of arthritis and periodontal disease (PD). Through epigenetics, we can understand how environmental and genetic factors may predispose individuals to the development of RA. There is growing evidence that epigenetic modifications play an important role in regulating the pathogenesis of RA. Treatment with HBOT (hyperbaric oxygen therapy) reduces the degree of cartilage destruction and the release of keratan sulfate during the first weeks after injury, suggesting an interruption of acute joint damage. HBOT has also been shown to decrease the expression of inducible nitric oxide synthase (iNOS), acting primarily on the immune and inflammatory response. HBOT has been shown to have an overall immunomodulatory effect, resulting in a positive effect by slowing autoimmune deterioration, as well as in cancer and vascular injuries, improving clinical markers by significantly reducing inflammation.