Periodontal Disease and Autoimmunity: What We Have Learned from Microbiome Studies in Rheumatology

Abstract

The oral cavity is home to vast populations of commensal microbial organisms which constitute the 'healthy oral microbiome.' Periodontitis is a destructive, infectious, inflammatory condition affecting the gums. Initially, a biofilm structure develops, causing localized inflammation. This biofilm is then colonized by certain anaerobic bacteria, including the 'red complex' organisms. There is an increasing interest in the communication between these organisms and host immune surveillance, a dialog which may plays an important role in the development of autoimmune diseases. Studies have shown an association between periodontitis and other inflammatory conditions including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and systemic lupus. The advent of accessible 16S ribosomal sequencing has led to exciting developments in the characterization of the human microbiome and the ability to study this interaction in more detail. The transmucosal communication between periodontitis and host immunity may provide avenues of discovery regarding the etiology and progression of rheumatic diseases.

Oral Manifestation on Systemic Lupus Erythematosus Patients

“…On other hand, study found non significant findings that periodontitis is more prevalent in SLE patients. The lack of statistical significance may be due to small sample size, use of immunosuppressants, age, patient condition and systemic disease disease (Rutter-Locher et al, 2017).…”

“…Specific autoantibodies in LES and the first ones appear are anti dsDNA. Anti-dsDNA autoantibodies bind to nucleosomes, laminin, type IV collagen, and heparan sulfate forms immune complexes and is deposited in various tissues, one of which is periodontail (Rutter-Locher, 2017). These autoantibodies will be directly deposited in tissues causing chronic inflammation, inflammation in periodontal tissues increases RANKL and stimulates osteoclasts.…”

“…Bacteria could ruin periodontal tissue resulting inflammation of periodontal tissues and periodontal breakdown (Vernino et al, 2007). Nowdays, instead of infection, host immune response may also plays multiple roles on periodontal damaged, associated with autoimmune disease (Rutter-Locher et al, 2017).…”

Role of Lymphocytes CD4/CD8 Ratio and Immunoglobulin G Cytomegalovirus as Potential Markers for Systemic Lupus Erythematosus Patients with Periodontal Disease

“…3 Worldwide, periodontitis in SLE is higher compared with healthy subjects in several studies. 4,5 Preliminary study in Indonesia concludes that periodontitis is associated with SLE. Early periodontitis is characterized by inflammation of gums, without attachment loss.…”

Periodontal Tissue Condition on Systemic Lupus Erythematosus Patients: A Clinical Study

“…The manifestation of SLE in the oral cavity can be ulcerated lesions on the mucosa, cavities, and damage to periodontal tissue, periodontitis. Xerostomia is found 75%, ulcerated lesions 15-40%, cavities (33-60%) and periodontitis (60-93%) [5]. Whereas in Indonesia, there has never been a research that shows periodontal tissue conditions in SLE patients.…”