Symptoms of periodontitis and antibody responses to Porphyromonas gingivalis in juvenile idiopathic arthritis

Abstract

BackgroundThe association between rheumatoid arthritis (RA) and periodontitis is well established. Some children with juvenile idiopathic arthritis (JIA) phenotypically resemble adults with RA, characterized by the presence of anti-cyclic citrullinated peptide (CCP) antibodies. We sought to investigate an association between CCP-positive JIA and symptoms of periodontitis and antibodies to oral microbiota.MethodsAntibodies to oral pathogens Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum were measured using ELISA in 71 children with CCP-positive JIA and 74 children with CCP-negative JIA. Oral health history was collected from 37 children with CCP-positive JIA and 121 children with CCP-negative JIA. T-tests, Chi-square tests, Mann–Whitney U tests, and multivariable regression were used to compare the groups.ResultsCompared to those with CCP-negative JIA, children with CCP-positive JIA were more likely to be female, older and non-Caucasian. Anti-P. gingivalis (p <0.003) and anti-P. intermedia (p <0.008) IgG antibody titers were higher in the CCP-positive cohort. Differences in P. gingivalis antibody titers remained significant after adjusting for age (p = 0.007). Children with CCP-positive JIA more likely reported tender/bleeding gums (43 % vs. 24 %, p < 0.02) compared to children with CCP-negative JIA. After controlling for age at collection, the odds of having tender/bleeding gums were 2.2 times higher in the CCP-positive group compared (95 % CI 0.98 – 4.83; p = 0.056).ConclusionsChildren with CCP-positive JIA have higher antibody titers to P. gingivalis and more symptoms of poor oral health, supporting a possible role for periodontitis in the etiology of CCP-positive JIA.

The microbiome in autoimmune diseases

“…This result is due to a decrease in the abundance of segmented filamentous bacteria, a commensal that influences the adaptive immunity and the innate immune system through an increase of IgA secretion and a development of Th17 lymphocytes, respectively [59,60]. Recently, other studies have demonstrated that the gut microbiome of a newonset RA was characterized by an increase of P. copri and lower numbers of Bifidobacteria, the Bacteroides-Porphyromonas group, the B. fragilis subgroup and Eubacterium rectal-Clostridium coccoides [52,53,61]. Interestingly, Moreno et al [62] suggested that P. copri might play a key role in the pathogenesis of RA in patients with a lower level of genetic susceptibility, where environmental factors are critical for the development of the disease.…”

The Oral Microbiome of Children: Development, Disease, and Implications Beyond Oral Health

“…For instance children with juvenile idiopathic arthritis (13 years old in average), who typically resemble adults with rheumatoid arthritis, have increased antibody response to Porphyromonas gingivalis, one of the main taxon involved in periodontal disease [108, 109], and higher incidence of symptoms related to periodontal disease [110]. Likewise, children with celiac disease (1.4 years old in average) under gluten free diets show a less diverse salivary microbiome compared to healthy controls, and increased abundance of oral caries-related taxa (e.g.…”

Immunization with alkyl hydroperoxide reductase subunit C reduces Fusobacterium nucleatum load in the intestinal tract

“…Faecal Fn infection has been identified as an important diagnostic marker for CRC 6 , 7 . Previously, Fn was considered a key aetiological agent in human periodontal disease 8 – 10 that plays important roles in different infectious processes, including juvenile idiopathic arthritis, rheumatoid arthritis and Alzheimer’s disease 11 – 13 . Recently, accumulating evidence has shown a high correlation between Fn infection and gastrointestinal tumours, and novel strategies on cancer prevention and treatment by targeting Fn have been proposed 2 , 14 .…”