{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:57Z","timestamp":1772168937305,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.164552.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000}},{"DOI":"10.12688\/f1000research.164552.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000}}],"reference-count":50,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    Background Periodontitis (PD) is a chronic infectious inflammatory disease that affects the tissues supporting teeth and results in a progressive deterioration of the alveolar bone. Rheumatoid arthritis (RA), a systemic autoimmune disease that has been associated with increased severity of periodontal disease. This study aimed to evaluate the salivary levels human leukocyte antigen-DR4 (HLA-DR4), matrix metalloproteinase-8 (MMP-8), and anti-citrullinated protein antibody (ACPA), and to assess their diagnostic potential using ROC curve analysis in periodontitis patients with and without rheumatoid arthritis. Methods The study included three groups; thirty patients with PD, thirty patients with PD and RA, and twenty healthy control participants. Clinical periodontal parameters [plaque Index (PLI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL)] were assessed. Salivary biomarkers were analyzed by enzyme-linked immunosorbent assay (ELISA), and the microbial load of\n                    <ns3:italic>Porphyromonas gingivalis<\/ns3:italic>\n                    (\n                    <ns3:italic>P. gingivalis<\/ns3:italic>\n                    ) was determined using quantitative real time polymerase chain reaction (qRT-PCR). Results Our findings showed that salivary HLA-DR4 levels were significantly lower in patient groups compared with healthy controls (P = 0.000), whereas salivary MMP-8 and ACPA levels were significantly elevated in patients (P = 0.034) and (P = 0.001) respectively, with no significant differences between the patient groups(P &gt; 0.05). On the other hand, microbial load was significantly higher in the PD with and without RA groups than that in controls (P = 0.001), with a positive correlation between microbial load and CAL in the PD-RA group.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.164552.3","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:25:07Z","timestamp":1761823507000},"page":"615","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Salivary HLA-DR4 and MMP-8 Levels Along with Porphyromonas gingivalis in Periodontitis Patients with Rheumatoid Arthritis"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3621-4094","authenticated-orcid":false,"given":"Shaymaa Abdulkareem","family":"Nori","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Batool Hassan","family":"Al-Ghurabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nik Nairan","family":"Abdullah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3892\/wasj.2024.295","article-title":"Role of salivary caspase-1 and gasdermin D in the pathophysiology of rheumatoid arthritis in relation to salivary pH and flow rate of saliva.","volume":"7","author":"W Abdullah","year":"2024 Nov 18","journal-title":"World Academy of Sciences Journal."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"9-18","DOI":"10.26477\/jbcd.v36i1.3586","article-title":"Serum levels of antimicrobial peptides (Cathelicidins and Beta Defensins-1) in patients with periodontitis.","volume":"36","author":"F Al-Daragi","year":"2024 Mar 15","journal-title":"J. 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Dent."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/14-615\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-615\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-615\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:25:36Z","timestamp":1763663136000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/14-615\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":50,"URL":"https:\/\/doi.org\/10.12688\/f1000research.164552.3","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.164552.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.164552.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.190310.r428395","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.190310.r428395","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/14-615\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.187844.r413621, Aram Mohammed Sha, University of Sulaimani, Sulaimani- Kurdistan Region, 22 Oct 2025, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/14-615\/v2#referee-response-413621","order":0,"name":"referee-response-413621","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.181080.r394190, Ali A Abdulkareem, University of Baghdad, Baghdad, Baghdad Governorate, 08 Aug 2025, version 1, 2 not approved","URL":"https:\/\/f1000research.com\/articles\/14-615\/v1#referee-response-394190","order":1,"name":"referee-response-394190","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Shaymaa Abdulkareem Nori<\/b>; \n<i>Posted: 06 Sep 2025<\/i>; We thank the reviewer for this valuable suggestions. All revisions have been made as requested by the reviewer and here are some answers for some of the reviewers questions&nbsp; 1. we agree that the term pristine gingiva is not consistent with the terminology used in the 2017 world workshop on the classification of periodontal diseases, we used this term to decrease the plagiarism percentage. This term have been changed to healthy gengiva in the updated version&nbsp; 2.&nbsp;We fully agree that including a group of RA patients with a clinically healthy periodontium would provide a stronger control against confounding factors. Unfortunately, due to the limited number of RA patients without periodontal involvement attending our clinics during the recruitment period, such a group could not be established. 3. Our selection of sites with CAL \u22654 mm was intended to ensure that participants included in the periodontitis group presented with a clear diagnosis of periodontitis, in line with standard case definitions. While we did not stratify the cases by stage, the CAL threshold provided consistency in diagnosis. We have clarified this rationale in the Methods section. 4.&nbsp;The term \u201cunrestricted gingival border\u201d was inadvertently used to describe the \u201cfree gingival margin.\u201d The text has been revised accordingly to use the correct terminology. 5. Clinical parameters were measured by the examiner. First&nbsp;the examiner was trained to apply a precise probing force. Then, periodontal parameters for five patients (not enrollment in this study) were measured for all teeth except third molar by the researcher and the specialist at the same time until an agreement was reached for all clinical periodontal parameters. 6.&nbsp;We agree that paper points are less traumatic for healthy sites. In our protocol, curettes were used in both groups to maintain uniformity in sample collection. Here is an article they support our method:&nbsp;Wang J, Geng Y, Guo J, Peng J, Xu H, Zhao B, Huang S, Qin M, Du W, Tian J. The Subgingival Microbial Composition in Health and Periodontitis with Different Probing Depths. Microorganisms. 2025 Apr 17;13(4):930. doi: 10.3390\/microorganisms13040930. PMID: 40284767; PMCID: PMC12029188. 7. the duration of RA was recorded in years. This information has been added to table 1 8.&nbsp;The relatively elevated PI in the healthy group may be attributed to variations in oral hygiene practices among the participants, the control group was not instructed to brush their teeth before the examination to avoid the bias. 9. ROC curves have been fully interpreted in the revised version.    best regards&nbsp; Shaymaa A. Nori  author","URL":"https:\/\/f1000research.com\/articles\/14-615\/v3#referee-comment-14516","order":2,"name":"referee-comment-14516","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.187844.r414214, Ghasaq Asim Abdul-Wahhab, Mustansiriyah University, Baghdad, Baghdad Governorate, 09 Oct 2025, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/14-615\/v2#referee-response-414214","order":3,"name":"referee-response-414214","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Shaymaa Abdulkareem Nori<\/b>; \n<i>Posted: 24 Oct 2025<\/i>; We appreciate the reviewer\u2019s thoughtful comments and believe these revisions have substantially strengthened our manuscript in clarity and methodological precision.","URL":"https:\/\/f1000research.com\/articles\/14-615\/v3#referee-comment-14843","order":4,"name":"referee-comment-14843","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.190310.r428395, Gaetano Isola, University of Catania, Catania, 11 Nov 2025, version 3, indexed","URL":"https:\/\/f1000research.com\/articles\/14-615\/v3#referee-response-428395","order":5,"name":"referee-response-428395","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.187844.r417608, Athraa Ali Mahmood, Department of Oral Surgery and Periodontics, College of Dentistry, Mustansiriyah University, Baghdad, Baghdad Governorate, 13 Oct 2025, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/14-615\/v2#referee-response-417608","order":6,"name":"referee-response-417608","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Shaymaa Abdulkareem Nori<\/b>; \n<i>Posted: 24 Oct 2025<\/i>; We thank the reviewer for this valuable feedback. In response, we have clarified the rationale for selecting subjects with PPD \u22654 mm, CAL \u22654 mm, and \u226530% of teeth, referencing the 2018 classification of periodontal diseases (Tonetti et al., 2018) to justify the definition of generalized periodontitis. A new paragraph titled \n<i>\u201cRationale for Methodological Choices\u201d<\/i> has been added to the \n<b>Methods<\/b> section to explain these criteria in detail. Additionally, we have expanded the \n<b>Discussion<\/b> section with an \n<i>\u201cAdditional Considerations and Limitations\u201d<\/i> paragraph to acknowledge the potential effects of inclusion criteria and measurement variability. Finally, the \n<b>Keywords<\/b> have been rearranged alphabetically and standardized according to MeSH terminology. We appreciate the reviewer\u2019s insightful comments, which have improved the clarity and rigor of our manuscript.","URL":"https:\/\/f1000research.com\/articles\/14-615\/v3#referee-comment-14838","order":7,"name":"referee-comment-14838","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":8,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}