Porphyromonas gingivalis in the tongue biofilm is associated with clinical outcome in rheumatoid arthritis patients

Abstract

Several studies have suggested a link between human microbiome and rheumatoid arthritis (RA) development. Porphyromonas gingivalis seems involved in RA initiation and progression, as supported by the high occurrence of periodontitis. In this case-control study, we analysed tongue P. gingivalis presence and quantification in a large healthy and RA cohort. We enrolled 143 RA patients [male/female (M/F) 32/111, mean ± standard deviation (s.d.), age 57·5 ± 19·8 years, mean ± s.d. disease duration 155·9 ± 114·7 months); 36 periodontitis patients (M/F 11/25, mean ± s.d., age 56 ± 9·9 years, mean ± s.d. disease duration 25·5 ± 20·9 months); and 57 patients (M/F 12/45, mean ± s.d., age 61·4 ± 10·9 years, mean ± s.d. disease duration 62·3 ± 66·9 months) with knee osteoarthritis or fibromyalgia. All subjects underwent a standard cytological swab to identify the rate of P. gingivalis/total bacteria by using quantitative real-time polymerase chain reaction. The prevalence of P. gingivalis resulted similarly in RA and periodontitis patients (48·9 versus 52·7%, P = not significant). Moreover, the prevalence of this pathogen was significantly higher in RA and periodontitis patients in comparison with control subjects (P = 0·01 and P = 0·003, respectively). We found a significant correlation between P. gingivalis rate in total bacteria genomes and disease activity score in 28 joints (DAS28) (erythrocyte sedimentation rate) (r = 0·4, P = 0·01). RA patients in remission showed a significantly lower prevalence of P. gingivalis in comparison with non-remission (P = 0·02). We demonstrated a significant association between the percentage of P. gingivalis on the total tongue biofilm and RA disease activity (DAS28), suggesting that the oral cavity microbiological status could play a role in the pathogenic mechanisms of inflammation, leading to more active disease.

Probiotics and Amelioration of Rheumatoid Arthritis: Significant Roles of Lactobacillus casei and Lactobacillus acidophilus

“…Periodontitis is highly correlated with RA in the clinic, and the oral bacterial population shift towards Porphyromonas gingivalis and other anaerobic bacteria such as Prevotella spp. [ 91 , 103 ] ( Table 1 ). A concomitant increase in Porphyromonas gingivalis in the oral cavity and P. copri in the intestine is observed in patients who experience RA [ 92 ] ( Figure 1 ).…”

Periodontitis and Rheumatoid Arthritis: The Same Inflammatory Mediators?

“…This enzyme contributes to RA development by catalyzing citrullination, a posttranslational modification playing a crucial role in the production of anticyclic citrullinated peptide antibodies (ACPA), widely recognized as diagnostic and prognostic biomarkers for RA patients [7, 8]. Recently, our group observed a significant association between the percentages of P. gingivalis , assessed by real-time PCR, on the total tongue biofilm and RA disease activity (evaluated as disease activity score on 28 joints—DAS28) [9]. This result suggests that the oral cavity microbiological status could play a role in the pathogenic mechanisms of inflammation, leading to more active diseases [9, 10].…”

“…Recently, our group observed a significant association between the percentages of P. gingivalis , assessed by real-time PCR, on the total tongue biofilm and RA disease activity (evaluated as disease activity score on 28 joints—DAS28) [9]. This result suggests that the oral cavity microbiological status could play a role in the pathogenic mechanisms of inflammation, leading to more active diseases [9, 10].…”

Microbiota of the Tongue and Systemic Connections: The Examination of the Tongue as an Integrated Approach in Oral Medicine

“…Prevotella, Haemophilus, and Streptococcus were dominant in the lining of the tongue in patients with colorectal cancer. Porphyromonas gingivalis was involved in the initiation and progression of rheumatoid arthritis [66][67][68][69]. Periodontal disease, caused by porphyromonas gingivalis, tannerella forsythya, and treponema denticola, was a risk factor for a variety of diseases, such as atherosclerotic vascular disease, type 2 diabetes, and nonalcoholic fatty liver disease [55][56][57].…”