The association between rheumatoid arthritis and periodontitis

Leech, Michelle; Bartold, P. Mark

doi:10.1016/j.berh.2015.03.001

Cited by 89 publications

(87 citation statements)

References 66 publications

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“…9 Its virulence combined with an intense host immune response is thought to contribute to the severity of the disease. 9 People with RA are almost twice as likely to have PD than those without. 52 RA patients with severe PD have significantly higher DAS-28 scores than those with moderate or no periodontitis, and PD is associated with increased radiographic joint damage.…”

Section: Periodontal Diseasementioning

confidence: 99%

“…18 Persistent joint inflammation (synovitis) results in bone and cartilage destruction which can ultimately lead to deformity, chronic pain and a loss of function. 9 Patients can experience stiffness upon waking or after prolonged periods of rest. 18,19 Systemic inflammation in RA can affect the brain (fatigue, reduced cognitive function and cerebrovascular events), liver (elevated acute-phase response and anaemia), heart (myocardial infarction and cardiac failure), lungs (inflammatory and fibrotic diseases), exocrine glands (secondary Sjögren's syndrome), bone (osteoporosis) and muscles (sarcopenia).…”

Section: Managing Patients With Rheumatoid Arthritismentioning

confidence: 99%

“…51 PD is caused by the presence of pathogenic gram-negative anaerobic bacteria within the biofilm attached to the sub-gingival tooth surface. 9 Porphyromonas gingivalis (Pg) is the main pathogen in PD. 9 Its virulence combined with an intense host immune response is thought to contribute to the severity of the disease.…”

Section: Periodontal Diseasementioning

confidence: 99%

“…9 Porphyromonas gingivalis (Pg) is the main pathogen in PD. 9 Its virulence combined with an intense host immune response is thought to contribute to the severity of the disease. 9 People with RA are almost twice as likely to have PD than those without.…”

Section: Periodontal Diseasementioning

confidence: 99%

“…5 The most recognised environmental trigger is smoking, which increases levels of the peptidyl arginine deiminase (PAD) enzyme responsible for protein citrullination (the conversion of arginine to citrulline). 9 A recent study identified a clear dose-response relationship between smoking and the risk of developing RA. 10 The periodontal pathogen Porphyromonas gingivalis has been implicated in the aetiology of RA as has, most recently, the gut microbiome.…”

Section: Introductionmentioning

confidence: 99%

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Managing patients with rheumatoid arthritis

2017

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Section: Periodontal Diseasementioning

confidence: 99%

Section: Managing Patients With Rheumatoid Arthritismentioning

confidence: 99%

Section: Periodontal Diseasementioning

confidence: 99%

Section: Periodontal Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Managing patients with rheumatoid arthritis

2017

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Salivary ammonia levels and Tannerella forsythia are associated with rheumatoid arthritis: A cross sectional study

Martínez-Rivera

Xibillé-Friedmann

González-Christen

et al. 2017

Clinical & Exp Dental Res

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The aim of this paper is to evaluate the relationship of salivary ammonium levels and the presence of bacteria with rheumatoid arthritis (RA) clinical disease activity in a cross‐sectional study of Mexican patients. From a periodontal and disease activity standpoint, 132 consecutive RA patients fulfilling clinical criteria were evaluated. Ammonia levels (including peptidyl arginine deiminase activity) were evaluated by colorimetric assay and the presence of Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia was evaluated by polymerase chain reaction (PCR) technique. After a multivariate analysis, adjusting for clinical and serological parameters, a significant association was only observed between severe periodontitis and probing depth with high RA disease activity. Additionally, in contrast to P. gingivalis, the presence of T. forsythia was significantly associated with high disease RA activity even after multivariable adjustment analysis. There was also a significant increase in ammonium levels in the high RA activity group and a significant correlation between salivary ammonia and RA disease activity but not with autoantibody titers. Similarly, we observed a significant increase in the ammonium levels derived from the cultures of P. gingivalis and T. forsythia, with respect to P. intermedia and S. gordonii cultures, or even healthy donors. These results suggest that RA activity is associated with severe periodontitis, high salivary ammonium levels and the presence of T. forsythia.

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Model answers: Rational application of murine models in arthritis research

et al. 2017

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Advances in targeted immune therapeutics have profoundly improved clinical outcomes for patients with inflammatory arthropathies particularly rheumatoid arthritis. The landscape of disease that is observed and the treatment outcomes desired for the future have also progressed. As such there is an increasing move away from traditional models of end‐stage, chronic disease with recognition of the need to consider the earliest phases of pathogenesis as a target for treatment leading to resolution and/or cure. In order to continue the discovery process and enhance our understanding of disease and treatment, we therefore need to continuously revisit the animal models we employ and assess their relevance and utility in the light of contemporary therapeutic goals. In this review, we highlight the areas where we consider new developments in animal models and their application are most required. Thus, we have contextualised the relevant mouse models and their use within the current concepts of human inflammatory arthritis pathogenesis and highlight areas of need.

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The association between rheumatoid arthritis and periodontitis

Cited by 89 publications

References 66 publications

Managing patients with rheumatoid arthritis

Managing patients with rheumatoid arthritis

Salivary ammonia levels and Tannerella forsythia are associated with rheumatoid arthritis: A cross sectional study

Model answers: Rational application of murine models in arthritis research

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