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 COHR: Center for Oral Health Research | Projects | COBRE for Oral Health - Projects - Holly Mitchell


The overall objective of this study is to determine if there is an association between the severity of periodontal disease and lupus disease activity and damage in Gullah African Americans with lupus. 


Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by severe multi-system involvement and systemic inflammation. African Americans (AAs) suffer from a 3-fold increased prevalence of SLE, earlier age of disease onset, and increased disease morbidity and mortality when compared to Caucasians. Factors leading to these differences are unknown, although genetic, environmental and socioeconomic factors are all believed to contribute.

AAs also have an increased incidence of periodontal disease when compared to Caucasians. Periodontal disease is associated with a higher risk of inflammatory and autoimmune conditions including coronary artery disease, chronic kidney disease, and rheumatoid arthritis. Both SLE and periodontal disease are increased in AAs, and, while there are associations between SLE and periodontal disease, the extent due to a common genetic link and the extent due to chronic mucosal inflammation, a treatable process, triggering and exacerbating SLE is unknown.

In this pilot study, we will explore if there is a positive association between periodontal disease and SLE disease activity among AA patients with SLE. We will recruit patients with SLE from the large well-characterized database of participants in the MUSC SLE in Gullah Health (SLEIGH) study. If an association is identified, interventional studies will be implemented to test the effectiveness of decreasing periodontal disease in preventing disease damage and flares. This preventive measure will reduce dependence on potentially toxic and expensive immunosuppressants and may incentivize patients and providers of health care coverage to improve and maintain dental health in patients with SLE.

Selected Publications

  1. Mitchell HC, Thomas JW.  VH gene structure predicts a large potential anti-insulin repertoire.  Molecular Immunology 1995;32:311-321.
  2. Mitchell HC, Bolster MB, Coppage L, Schabel SI, Sutherland SE, Strange C, Silver RM.  High-resolution computed tomography (HRCT) as a means of assessing interstitial lung disease in patients with systemic sclerosis. ACR 60th National Scientific Meeting, Orlando, FL; October 18-22, 1996.
  3. Mitchell H, Bolster MB, Silver, RM.  Scleroderma and related conditions. Med Clin NA 1997;81:129-149.
  4. Brown AN, Michel YG, Mitchell HM, Bolster MB. An Epidemiological study of scleroderma patients in South Carolina.   Arthritis and Rheum 2000; 44:9 (5).
  5. Mitchell HC, Nietert PJ, Bolster MB, Silver RM. Racial Variation in Clinical, Serologic, and immunologic manifestations of systemic sclerosis (SSc) arthritis. Rheum (48) S562, 2003. ACR National Scientific Meeting, Orlando, FL; October 23-28, 2003.
  6. Nietert PJ, Silver RM, Bolster MB, Mitchell HC, Tilley BC, Shaftman SR. The influence of renal disease and race on in-hospital mortality among patients with systemic sclerosis. Arthritis.  Rheum 50:S421, 2004.
  7. Beall, A. Nietert P. Taylor M. Mitchell HC. Shaftman S. Silver, R. Smith E. Bolster B.  Ethnic Disparities Among Patients With Pulmonary Hypertension Associated with Systemic Sclerosis . Journal of Rheumatology. 34 (6): 1277-82, 2007 May.
  8. Farrar, E. Mitchell HC. Osteoarthritis and Exercise: A Review of the Literature. The Journal of the South Carolina Medical Association. Vol. 105:8-11, 2009 Feb.