Abstract

Background:In recent literature, a strong association between periodontal disease (PD) and rheumatoid arthritis (RA) has been reported. PD is a common, progressive inflammatory disease, initiated by a bacterial infection that engages the supporting structures of the teeth and leads to tooth loss. A number of common features have been identified between PD and RA.One of the most important associations is the process of citrullination, which is caused by the production of PG specific enzyme so called Porphyromonas Gingivalis Peptydil Deminase (PPAD)Objectives:The aim of the study was to show the incidence of PG in RA patients, and to compare it with patients with osteoarthritis (OA) and healthy controls (HC) and to evaluate the possible correlation between the presence of PG in patients with RA and the positivity of anti CCP and anti MCV antibodies in RA patients.Methods:The study included 30 patients with RA which fulfilled RA classification criteria from 2010, 26 patients with osteoarthritis (OA) and 24 healthy controls. All participants were genetically analyzed for the presence of PG by Chelex®100 method and polymerase chain reaction (PCR), by isolating amplified sequences of DNA in a sub gingival biofilm taken from the deep periodontal pockets. The presence of anti CCP and anti MCV autoantibodies was detected in the sera of RA patients with ELISA test.Results:The average ages of the patients in the 3 groups were as follows -51 years for RA, 52 for OA and 58 years for HC. Seventy two percent of RA patients were females.Significantly higher levels of PG were found in the periodontal pockets of.RA patients.Eighty percent of RA patients (80% or 24 RA patients) were PG positive in comparison with 35% of OA patients and 2% healthy controls.Of the PG-positive RA patients, 83% had positive and 17% had anti-CCP negative test, while of the PG-negative patients, a positive anti-CCP test was present in 33% and a negative anti-CCP test was present in 67%.Accordingly, in PG-positive RA patients positive anti-MCV test was present in 79% and negative anti-MCV test was present in 21%, and in PG-negative RA patients anti-MCV test was positive in 17% and negative in 83% patients.Table 1.Patient’s groupsRAOAHCSignificancePorphyromonas gingivalis positive24 (80%)9 (35%)7 (29%)RA→OA(p < 0.0001)RA→HC(p < 0.0001)OA→HC(p0,65)Porphyromonas gingivalis negative6 (24%)17 (65%)17(71%)Total302624Conclusion:The results of our study indicate that PG is found more frequently in periodontal pockets of patients with rheumatoid arthritis, which implies the important role of oral microbioma in RA pathogenesis, treatment and prevention.

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