Abstract
BackgroundPeriodontal disease could be a risk factor for rheumatoid arthritis (RA). It is assumed that the bacterial strain Porphyromonas gingivalis mediates citrullination of host peptides and thereby the generation of RA-associated autoantibodies in genetically predisposed individuals. For that reason non-RA individuals who suffered from generalized aggressive (GAgP, N = 51) and generalized chronic periodontitis (GChP, N = 50) were investigated regarding the occurrence of antibodies against citrullinated cyclic peptides (anti-CCP) and citrullinated α-enolase peptide-1 (anti-CEP-1) in comparison to non-RA non-periodontitis controls (N = 89). Furthermore, putative associations between infections with five periodontopathic bacteria or expression of certain human leucocyte antigens (HLA) to these autoantibodies were investigated.MethodsThe presence of anti-CCP and anti-CEP-1 in plasma samples was conducted with enzyme linked immunosorbent assay. Subgingival plaque specimens were taken from the deepest pocket of each quadrant and pooled. For detection of DNA of five periodontopathic bacteria PCR with sequence specific oligonucleotides was carried out. Low resolution HLA typing was carried out with PCR with sequence specific primers. Differences between patients and controls were assessed using Chi square test with Yates correction or Fisher`s exact test if the expected number n in one group was <5.ResultsTwo patients with GAgP (3.9 %), no patient with GChP and two controls (2.2 %, pFisher = 0.662) were positive for anti-CEP-1 whereas no study participant was anti-CCP positive. Individuals with P. gingivalis were slightly more often anti-CEP-1 positive in comparison to individuals without P. gingivalis (3.2 vs. 1.1 %, pFisher = 0.366). Carrier of HLA-DQB1*06 or the HLA combination DRB1*13; DRB3*; DQB1*06 were slightly more anti-CEP-1 positive (6.1 and 4.3 %) than no carriers (0.7 and 0 %, pFisher 0.053).ConclusionsGAgP and GChP and the presence of periodontopathic bacteria are not associated with an increased risk for occurrence of anti-CCP and anti-CEP-1 autoantibodies. The putative relationship between periodontitis and RA should be investigated in further studies.
Highlights
Periodontal disease could be a risk factor for rheumatoid arthritis (RA)
Apart from T. forsythia in patients with GAgP all investigated periodontal bacteria were more often found in patients with GAgP and generalized ChP (GChP) in comparison to controls (Table 1)
DNA of periodontopathic bacteria was detected in synovial fluid and the detection frequency of P. gingivalis was higher in patients with RA than in controls [37,38,39]
Summary
It is assumed that the bacterial strain Porphyromonas gingivalis mediates citrullination of host peptides and thereby the generation of RA-associated autoantibodies in genetically predisposed individuals. It is assumed that an environmental agent triggers an autoimmune reaction in a genetically predisposed individual [4] with subsequent synovial inflammation and cartilage bone destruction [5]. This hypothesis is supported by the discovery of citrulline-specific autoimmunity with generation of anti-citrullinated peptide/ protein antibodies (ACPA) in patients with RA [6, 7]. Tests for the detection of antibodies against mutated citrullinated vimentin (MCV) or cyclic citrullinated peptides (CCP) are valuable tools especially for the early diagnosis of RA [9]
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