Autopathogenic correlation of periodontitis and rheumatoid arthritis

Abstract

Recently, a number of studies have pointed to a potential relationship between periodontitis (PO) and RA and vice versa. Both diseases are characterized by chronic inflammation, osseous destruction, damage of the supporting soft tissues, similar cellular immune responses and common immunogenetic findings. Although a definite, methodological report associating these diseases is missing from the literature, it is possible that both diseases share a common aetiopathogenic background. This background includes the post-translation modification citrullination, which guides the conversion of the amino acid arginine to citrulline in certain self-proteins, generating neo-epitope structures. This results in reduced self-tolerance, development of autoimmunity and the production of ACPAs. The current hypothesis suggests that certain oral bacteria induce the citrullination of proteins under the action of the enzyme peptidyl arginine deiminase (PAD), which exists in both Porphyromonas gingivalis and inflammatory cells. Antibodies against citrullinated proteins and peptides constitute a common serological finding in both RA and PO. The aim of this review is to map the immunological and serological profiles of PO, and to unveil the parameters that connect PO with the appearance of RA at clinical, prognostic and pathogenetic levels. Until now, there have been no reports sufficiently mapping the immunological profile of PO and defining its aetiopathogenic connection with RA, although a similarity between the immunological profile of PO and RA is highly expected.

Periodontal disease and rheumatoid arthritis

“…Rheumatoid arthritis and periodontal disease share a number of pathobiologic processes that have been previously reviewed [21,38 ■■ ,39,40 ■ ,41–43, 44 ■ ]. These include similar cellular participation at the inflammatory focus, microenvironmental and serum cytokine, matrix metalloproteinase and other mediator profiles, and osteoclast-mediated bone destruction.…”

Association between a history of periodontitis and the risk of rheumatoid arthritis: a nationwide, population-based, case–control study

“…Periodontitis is caused by chronic bacterial infections of the gingiva with subsequent destruction of the periodontal attachment and alveolar bone 19. The relationship between RA and periodontitis is supported by pathological and immunological data 20 21 . Porphyromonas gingivalis (P gingivalis) , a major pathogenic bacterium of periodontitis, is the sole micro-organism known to express peptidyl arginine deiminase,22 which leads to citrullination, an irreversible, post-translational conversion of arginine to citrulline 15 23.…”

Highly Specific Protease-Based Approach for Detection of Porphyromonas gingivalis in Diagnosis of Periodontitis

“…In addition to being a major cause of tooth loss, periodontal disease has also been associated with several systemic diseases. Animal-and population-based studies have demonstrated associations between periodontal disease and diabetes, cardiovascular disease, rheumatoid arthritis, stroke, and adverse pregnancy outcomes (4,8,38). Although the mechanisms that cause these associations are far from being completely understood, more reliable detection of early stage periodontal disease could have widespread health benefits, even beyond the prevention of tooth loss.…”