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Periodontitis and Rheumatoid Arthritis: What Do We Know?
Menke J de Smit1, Johanna Westra2, Elisabeth Brouwer2
1Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Journal of Periodontology
|May 14, 2015
Summary
Periodontitis, an oral inflammatory condition, is linked to rheumatoid arthritis (RA). Research suggests a potential causal role for periodontitis in RA development, though the specific bacterium Porphyromonas gingivalis
Area of Science:
- Periodontology
- Rheumatology
- Immunology
Background:
- Focus on the potential link between periodontitis and rheumatoid arthritis (RA).
- Investigating the role of Porphyromonas gingivalis (Pg), a bacterium with a unique citrullinating enzyme.
- Highlighting the specificity of anti-citrullinated protein antibodies for RA.
Purpose of the Study:
- To assess the causality of the association between periodontitis and RA using the Bradford Hill criteria.
- To interpret the existing literature in the absence of longitudinal cohort studies.
Main Methods:
- Systematic review and application of Bradford Hill criteria.
- Analysis of existing epidemiological and experimental data.
Main Results:
- RA patients exhibit a higher incidence of periodontal disease.
- A dose-response relationship exists between periodontitis severity and RA activity.
- Evidence suggests periodontitis may precede RA, but Pg's direct role is unproven.
Conclusions:
- Periodontitis is biologically plausible as an infectious cause of RA.
- The specific mechanism of Pg's citrullination in RA pathogenesis requires further investigation.
- Animal models demonstrate Pg's role in arthritis development and exacerbation.
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