The association of multiple sclerosis with systemic inflammatory biomarkers: A case-control study exploring links with periodontal disease

Multiple sclerosis is a chronic autoimmune disease that results in nerve demyelination. It has been theorized to be associated with other diseases, such as periodontal diseases, which comprise gingivitis and periodontitis. The current study investigates the effects of these two conditions on the inflammatory biomarkers MMP-1, MMP-2, MMP-9, TIMP-1, and RgpA in the serum of individuals with periodontal diseases and multiple sclerosis. Revealing the bidirectional link between said conditions is key, as treatment must shift to a whole-body approach—managing periodontitis may help control neuroinflammation in MS. The case-control study consisted of four groups: the first group consisted of 32 patients with MS and periodontal diseases, the second group encompassed 22 patients with MS and healthy periodontium, the third group included 20 patients with periodontal diseases, but they were systemically healthy, while the fourth group consisted of 15 subjects with healthy periodontium and systemically healthy. Serum was then collected from all participants, and ELISA kits were used to measure the inflammatory biomarkers. Multiple linear regression analyses were conducted to evaluate the independent effects of MS and periodontal disease on biomarker levels. Regression analysis revealed that MS was significantly associated with elevated MMP-9, RgpA, and MMP-1. While PDs appear to be less associated with MMP-9 and RgpA. MS has a significantly greater independent effect on systemic levels of MMP-9, RgpA, and MMP-1 than periodontal disease. The association between MS, elevated RgpA, and worse periodontal parameters suggests a potential role for periodontal pathogens in the MS inflammatory milieu.