Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature
An association between oral disease/periodontitis and rheumatoid arthritis (RA) has been considered since the early 1820s. The early treatment was tooth eradication. Epidemiological studies suggest that the prevalence of RA and periodontitis may be similar and about 5% of the population are aged 50...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2012-02-01
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| Series: | Journal of Oral Microbiology |
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| Online Access: | http://www.journaloforalmicrobiology.net/index.php/jom/article/view/11829/19693 |
| _version_ | 1818392488944074752 |
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| author | G. Rutger Persson |
| author_facet | G. Rutger Persson |
| author_sort | G. Rutger Persson |
| collection | DOAJ |
| description | An association between oral disease/periodontitis and rheumatoid arthritis (RA) has been considered since the early 1820s. The early treatment was tooth eradication. Epidemiological studies suggest that the prevalence of RA and periodontitis may be similar and about 5% of the population are aged 50 years or older. RA is considered as an autoimmune disease whereas periodontitis has an infectious etiology with a complex inflammatory response. Both diseases are chronic and may present with bursts of disease activity. Association studies have suggested odds ratios of having RA and periodontitis varying from 1.8:1 (95% CI: 1.0–3.2, NS) to 8:1 (95% CI: 2.9–22.1, p<0.001). Genetic factors are driving the host responses in both RA and periodontitis. Tumor necrosis factor-α, a proinflammatory cytokine, regulates a cascade of inflammatory events in both RA and periodontitis. Porphyromonas gingivalis is a common pathogen in periodontal infection. P. gingivalis has also been identified in synovial fluid. The specific abilities of P. gingivalis to citrullinate host peptides by proteolytic cleavage at Arg-X peptide bonds by arginine gingipains can induce autoimmune responses in RA through development of anticyclic citrullinated peptide antibodies. In addition, P. gingivalis carries heat shock proteins (HSPs) that may also trigger autoimmune responses in subjects with RA. Data suggest that periodontal therapies combined with routine RA treatments further improve RA status. Conclusion s: Periodontal infection (P. gingivalis) carries a unique risk for development of autoimmune antibodies associated with RA. Patients with RA have either lost many teeth or usually have severe periodontitis. Additional research, both in regards to basic mechanisms as well as clinical studies, are necessary before it can be said that there are causative links between RA and periodontitis. Cross-disciplinary research in well-defined populations should be performed to further enhance knowledge and develop clinical strategies how to coordinate therapy and risk assessments of RA and periodontitis. |
| first_indexed | 2024-12-14T05:30:13Z |
| format | Article |
| id | doaj.art-fc394c0247a5436aa7e813356c64a6e6 |
| institution | Directory Open Access Journal |
| issn | 2000-2297 |
| language | English |
| last_indexed | 2024-12-14T05:30:13Z |
| publishDate | 2012-02-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Oral Microbiology |
| spelling | doaj.art-fc394c0247a5436aa7e813356c64a6e62022-12-21T23:15:21ZengTaylor & Francis GroupJournal of Oral Microbiology2000-22972012-02-014011610.3402/jom.v4i0.11829Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literatureG. Rutger PerssonAn association between oral disease/periodontitis and rheumatoid arthritis (RA) has been considered since the early 1820s. The early treatment was tooth eradication. Epidemiological studies suggest that the prevalence of RA and periodontitis may be similar and about 5% of the population are aged 50 years or older. RA is considered as an autoimmune disease whereas periodontitis has an infectious etiology with a complex inflammatory response. Both diseases are chronic and may present with bursts of disease activity. Association studies have suggested odds ratios of having RA and periodontitis varying from 1.8:1 (95% CI: 1.0–3.2, NS) to 8:1 (95% CI: 2.9–22.1, p<0.001). Genetic factors are driving the host responses in both RA and periodontitis. Tumor necrosis factor-α, a proinflammatory cytokine, regulates a cascade of inflammatory events in both RA and periodontitis. Porphyromonas gingivalis is a common pathogen in periodontal infection. P. gingivalis has also been identified in synovial fluid. The specific abilities of P. gingivalis to citrullinate host peptides by proteolytic cleavage at Arg-X peptide bonds by arginine gingipains can induce autoimmune responses in RA through development of anticyclic citrullinated peptide antibodies. In addition, P. gingivalis carries heat shock proteins (HSPs) that may also trigger autoimmune responses in subjects with RA. Data suggest that periodontal therapies combined with routine RA treatments further improve RA status. Conclusion s: Periodontal infection (P. gingivalis) carries a unique risk for development of autoimmune antibodies associated with RA. Patients with RA have either lost many teeth or usually have severe periodontitis. Additional research, both in regards to basic mechanisms as well as clinical studies, are necessary before it can be said that there are causative links between RA and periodontitis. Cross-disciplinary research in well-defined populations should be performed to further enhance knowledge and develop clinical strategies how to coordinate therapy and risk assessments of RA and periodontitis.http://www.journaloforalmicrobiology.net/index.php/jom/article/view/11829/19693rheumatoid arthritisperiodontitisbacteriainflammationPorphyromonas gingivaliscitrullinationgeneticsreview |
| spellingShingle | G. Rutger Persson Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature Journal of Oral Microbiology rheumatoid arthritis periodontitis bacteria inflammation Porphyromonas gingivalis citrullination genetics review |
| title | Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature |
| title_full | Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature |
| title_fullStr | Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature |
| title_full_unstemmed | Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature |
| title_short | Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature |
| title_sort | rheumatoid arthritis and periodontitis x2013 inflammatory and infectious connections review of the literature |
| topic | rheumatoid arthritis periodontitis bacteria inflammation Porphyromonas gingivalis citrullination genetics review |
| url | http://www.journaloforalmicrobiology.net/index.php/jom/article/view/11829/19693 |
| work_keys_str_mv | AT grutgerpersson rheumatoidarthritisandperiodontitisx2013inflammatoryandinfectiousconnectionsreviewoftheliterature |