No Obvious Role for Suspicious Oral Pathogens in Arthritis Development

Abstract

A particular role for Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) has been suggested in periodontitis and rheumatoid arthritis (RA), as these bacteria could initiate the formation of rheumatoid factor (RF) and anticitrullinated protein autoantibodies (ACPA). We assessed whether serum antibodies against Pg and Aa in RA patients and non-RA controls reflect the subgingival presence of Pg and Aa, and evaluated the relationship of these antibodies to the severity of periodontal inflammation and RA-specific serum autoantibodies. In 70 Indonesian RA patients and 70 non-RA controls, the subgingival presence of Pg and Aa was assessed by bacterial 16S rRNA gene sequencing, and serum IgG levels specific for Pg and Aa were determined. In parallel, serum levels of ACPA (ACPA:IgG,IgA) and RF (RF:IgM,IgA) were measured. The extent of periodontal inflammation was assessed by the periodontal inflamed surface area. In both RA patients and the controls, the presence of subgingival Pg and Aa was comparable, anti-Pg and anti-Aa antibody levels were associated with the subgingival presence of Pg and Aa, and anti-Pg did not correlate with ACPA or RF levels. The subgingival Pg and Aa were not related to RA. No noteworthy correlation was detected between the antibodies against Pg and Aa, and RA-specific autoantibodies.

The Relationship Between Porphyromonas Gingivalis and Rheumatoid Arthritis: A Meta-Analysis

“…Another study by Schmickler and others showed that patients with RA had worse oral health than healthy controls because of the absolute number of missing teeth and periodontal conditions ( Rahajoe et al., 2021 ). The prevalence of all bacteria investigated in RA and HC groups is similar ( Arévalo-Caro et al., 2022 ).…”

Influence of Oral Microbiota on the Presence of IgA Anti-Citrullinated Protein Antibodies in Gingival Crevicular Fluid

“…Previously, antibodies to periodontal pathogens have been investigated and related to RA autoantibodies, but often weak, or no correlations of anti- Porphyromonas gingivalis antibodies with ACPA or RF were found [ 20 , 36 ]. In a large population of non-RA persons of 60 years and older tested for antibodies against 19 periodontal species, no association with RF seropositivity was found [ 37 ].…”

“…Full mouth periodontal measures (pocket probing depth, bleeding on probing, and periodontal attachment loss) were used to calculate the periodontal inflamed surface area (PISA) [ 19 , 20 ]. Periodontal examination and subgingival microbial sampling were done in the same visit and were supervised by the same examiner (PSR) who was calibrated by a periodontist (MJdS) that was trained in performing PISA and subgingival sampling.…”

“…Subgingival microbial sampling, DNA isolation, purification, quantification, and preparation for Illumina MiSeq were described by Rahajoe et al [ 20 ]. In short, subgingival microbial samples with sterile paper points were based on pocket probing depth measurements and bleeding on probing.…”

Is periodontitis linked to low grade inflammation and development of rheumatoid arthritis?

“…Full mouth periodontal measures (pocket probing depth, bleeding on probing, and periodontal attachment loss) were used to calculate the periodontal inflamed surface area (PISA) Rahajoe et al, 2021). Periodontal examination and subgingival microbial sampling were done in the same visit and were supervised by the same examiner (PSR) who was calibrated by a periodontist (MJdS) that was trained in performing PISA and subgingival sampling.…”