Abstract
BackgroundThe oral microbiota has been connected to the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. The objective of this study was to characterize the salivary oral microbiome associated with juvenile idiopathic arthritis (JIA), and correlate it with the disease activity including gingival inflammation.MethodsFifty-nine patients with JIA (mean age, 12.6 ± 2.7 years) and 34 healthy controls (HC; mean age 12.3 ± 3.0 years) were consecutively recruited in this Norwegian cross-sectional study. Information about demographics, disease activity, medication history, frequency of tooth brushing and a modified version of the gingival bleeding index (GBI) and the simplified oral hygiene index (OHI-S) was obtained. Microbiome profiling of saliva samples was performed by sequencing of the V1-V3 region of the 16S rRNA gene, coupled with a species-level taxonomy assignment algorithm; QIIME, LEfSe and R-package for Spearman correlation matrix were used for downstream analysis.ResultsThere were no significant differences between JIA and HC in alpha- and beta-diversity. However, differential abundance analysis revealed several taxa to be associated with JIA: TM7-G1, Solobacterium and Mogibacterium at the genus level; and Leptotrichia oral taxon 417, TM7-G1 oral taxon 352 and Capnocytophaga oral taxon 864 among others, at the species level. Haemophilus species, Leptotrichia oral taxon 223, and Bacillus subtilis, were associated with healthy controls. Gemella morbillorum, Leptotrichia sp. oral taxon 498 and Alloprevotella oral taxon 914 correlated positively with the composite juvenile arthritis 10-joint disease activity score (JADAS10), while Campylobacter oral taxon 44 among others, correlated with the number of active joints. Of all microbial markers identified, only Bacillus subtilis and Campylobacter oral taxon 44 maintained false discovery rate (FDR) < 0.1.ConclusionsIn this exploratory study of salivary oral microbiome we found similar alpha- and beta-diversity among children with JIA and healthy. Several taxa associated with chronic inflammation were found to be associated with JIA and disease activity, which warrants further investigation.
Highlights
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, with an annual incidence of 1 to 2 per 1000 children (Moe and Rygg, 1998; Berntson et al, 2003)
The present cross-sectional study is a project within NorJIA (Norwegian JIA Study – Imaging, oral health and quality of life in children with juvenile idiopathic arthritis (JIA)), a larger Norwegian prospective multicenter cohort study on JIA registered in Clinical Trials.gov (NCT03904459)
There was a female predominance in both groups, and rheumatoid factor (RF) negative polyarthritis was the most common category among children with JIA (25%)
Summary
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, with an annual incidence of 1 to 2 per 1000 children (Moe and Rygg, 1998; Berntson et al, 2003). In all studies on the gut microbiome in JIA, no single species has been identified and different studies show changes in different taxa (Stoll et al, 2014; Di Paola et al, 2016; Stoll et al, 2016; Tejesvi et al, 2016; Aggarwal et al, 2017; Stoll et al, 2018; Dong et al, 2019; Van Dijkhuizen et al, 2019) These studies suggest that dysbiosis in the microbiota with overabundance in pathogenic microbes, may result in dysregulation of the immune system through disruption of the integrity of mucosal barrier and altered interaction with gut immune cells (Majumder and Aggarwal, 2020). The objective of this study was to characterize the salivary oral microbiome associated with juvenile idiopathic arthritis (JIA), and correlate it with the disease activity including gingival inflammation
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