A statistically significant association between periodontal disease (PD) and systemic diseases has been identified. Rheumatoid arthritis (RA), which is a chronic inflammatory joint disease, exhibits similar characteristics and pathogenesis to PD. The association between RA and PD has been investigated, and numerous publications on this subject exist. Approximately 20 bacterial species have been identified as periodontal pathogens, and these organisms are linked to various types of PD. The most analyzed species of periodontopathic bacteria are Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans. Antibodies and DNA from these oral pathogens have been isolated from the sera and synovial fluids of RA patients. This rapid communication describes the role of periodontal pathogens in the etiopathogenesis of RA.

The purpose of this review is to evaluate the association between rheumatoid arthritis (RA) and periodontopathic bacteria. Clinical studies of RA and periodontal disease have provided evidence for a significant association between the two disorders. Patients with long-standing active RA have a substantially increased frequency of periodontal disease compared with that among healthy subjects. High levels of oral anaerobic bacterial antibodies have been found in the serum and synovial fluid of RA patients. Porphyromonas gingivalis, Tannerella forsythensis, and Prevotella intermedia have been identified in RA synovial fluid. Ornidazole, levofloxacin, and clarithromycin are used in the treatment of infections caused by anaerobic bacteria. These antibiotics have been shown to be effective against RA. The evidence in this review indicates that oral bacteria directly associate with etiopathogenesis of RA.

Background: Pancreatic cancer is the fourth leading cause of cancer-related deaths worldwide. Chronic pancreatitis is frequently observed in patients with pancreatic cancer, and a significant relationship between orodigestive cancer-related deaths and chronic periodontitis has been detected. Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, collectively called the Red complex, are the major pathogens responsible for chronic periodontitis and secrete peptidylarginine deiminase. Anti-P. gingivalis antibodies titers are higher in pancreatic cancer patients than in healthy subjects. Summary: This review examines the association between oral bacteria and the etiology of pancreatic cancer. Key Message: High rates of tumor suppressor gene p53 mutations, particularly p53 arginine mutations, were detected in pancreatic cancer patients. K-ras arginine mutations were detected in patients with pancreatic cancer. Oral bacteria peptidylarginine deiminases might lead to the p53 and K-ras point mutations by degrading arginine. Practical Implications: Oral bacteria are likely to be responsible for the development of pancreatic cancer. If this hypothesis is true, it may reveal the real cause of pancreatic cancer, which is a fatal disease.

In patients with early active rheumatoid arthritis, treatment with clarithromycin significantly improved the signs and symptoms of rheumatoid arthritis. Clarithromycin has been shown to be effective against rheumatoid arthritis.

Ankylosing spondylitis (AS) is a human leukocyte antigen (HLA)-B27-associated chronic inflammatory disease of unknown etiology. There are few effective treatments for ankylosing spondylitis, which causes substantial morbidity. The relationship between AS and enterobacteria, especially Klebsiella pneumoniae, has been reported from several groups in several countries. We performed an open-label trial of moxifloxacin, a fluoroquinolone antibiotic, in patients with ankylosing spondylitis. Treatment with moxifloxacin resulted in significant and sustained improvement. At 12 weeks, patients treated with moxifloxacin had significantly greater improvement in primary outcome measures (P < 0.001). The moxifloxacin group also had significantly greater improvement in many of the secondary outcome measures (P < 0.001). In this twelve-week trial, moxifloxacin was safe, well tolerated, and associated with improvement in the inflammatory symptoms of AS.