Periodontal disease and periodontal bacteria as triggers for rheumatoid arthritis

Abstract

There is an epidemiological association between periodontitis and rheumatoid arthritis (RA), which is hypothesised to lead to enhanced generation of RA-related autoantibodies that can be detected years before the onset of RA symptoms. Periodontitis is a common dysbiotic disease; tissue damage occurs because the immune system fails to limit both the resident microbial community and the associated local immune response. Certain periodontal bacteria, including Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, may contribute to RA autoantibody production through direct post-translational modification of proteins or, indirectly, by influencing neutrophil-mediated neo-epitope generation. Oral bacteria that invade the blood may also contribute to chronic inflammatory responses and generation of autoantibodies. The putative association between periodontitis and the development of RA raises the potential of finding novel predictive markers of disease and disease progression and for periodontitis treatment to be included in the future as an adjunct to conventional RA immunotherapy or as part of a preventive strategy.

No effects without causes: the Iron Dysregulation and Dormant Microbes hypothesis for chronic, inflammatory diseases

“…Since blood can appear in the oral cavity, there is nothing to stop the reverse process of microbial infection of the blood (Dhotre, Davane & Nagoba, ; Kilian et al ., ; Koren et al ., ) and periodontal origins represent another source of potential microbial translocation (Moon & Lee, ). There is considerable evidence for a significant association between periodontitis and RA (Bingham III & Moni, ; Cheng et al ., ; de Smit et al ., ; Detert et al ., ; Konig et al ., ; Koziel, Mydel & Potempa, ; Lee et al ., ; Martinez‐Martinez et al ., ; Mikuls et al ., ; Monsarrat et al ., ; Ogrendik, ; Potempa, Mydel & Koziel, ). Atherosclerosis provides another example (Chukkapalli et al ., ; Gibson III & Genco, ; Kebschull, Demmer & Papapanou, ; Łysek et al ., ; Mahalakshmi et al ., ; Rangé et al ., ; Reyes et al ., ; Rivera et al ., ; Teeuw et al ., ; Toyofuku et al ., ; Velsko et al ., ).…”

Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study

“…We know that periodontitis is a significant risk factor in cardiovascular disease (endothelial dysfunction, atherosclerotic plaque instability and dyslipidemia); diabetes (insulin resistance); rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis and others …”

“…rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis and others. 4,5 Several studies have established the relationship between periodontitis and diabetes, and it seems to be bidirectional. 6 Diabetes is an established risk factor for periodontitis, and periodontitis also influences metabolic control and the development of diabetic complications.…”

Probiotics for the Management of Rheumatoid Arthritis

“…There are over 700 species of microorganisms colonizing this cavity, yet the periodontal pockets are the most significant sites as they may contain up to 10 8 bacteria. 17 There is a relationship between RA and periodontopathic bacteria, which may allow RA-related antibodies to be identified in periodontal disease patients prior to the onset of RA symptoms. 17 RA patients also have a considerably increased comorbidity with periodontal disease and patients with periodontal disease are more likely to have RA.…”

“…17 There is a relationship between RA and periodontopathic bacteria, which may allow RA-related antibodies to be identified in periodontal disease patients prior to the onset of RA symptoms. 17 RA patients also have a considerably increased comorbidity with periodontal disease and patients with periodontal disease are more likely to have RA. An epidemiological relationship may exist between the two diseases because of their similar risk factors, mechanisms for disease progression, and the fact that treatment of periodontal disease positively impacts RA severity in patients.…”