People with high levels of gum disease are at risk of developing rheumatoid arthritis (RA), as a new study suggests that it could be a key initiator of autoimmunity related to RA.
The researchers explained that it is because autoimmunity in RA is characterized by an antibody response to citrullinated proteins and the oral bacterium Porphyromonas gingivalis (Pg) is the only human pathogen known to express an enzyme that can generate citrullinated proteins.
"Our results support the hypothesis that local inflammation on mucosal surfaces, such as gums, in this case, may provide the primary trigger for systemic autoimmunity observed in RA," said co-author Kulveer Mankia of Institute of Rheumatic and Musculoskeletal Medicine of Leeds.
"It has been shown that RA- badociated antibodies, such as anti-citrullinated protein antibodies, are present long before any evidence of joint disease." This suggests that they originate at a site outside the joints. " added Mankia.
RA is a chronic inflammatory disease that affects a person's joints, causing pain and disability and can also affect internal organs.
The study, presented at the Annual European Congress of Rheumatology (EULAR 2018), included 48 at-risk individuals who tested positive for anti-curd protein antibodies and had musculoskeletal symptoms, but no clinical synovitis, 26 patients with RA and 32 healthy controls.
DNA was isolated from the subgingival plaque, next to the gums, of each participant and used to measure the levels of three types of bacteria – Pg, Aggregatibacter actinomycetemcomitans (Aa) and Alocis Filifactor, the researchers said.
The results showed that there was a greater abundance of Pg and Aa in individuals at risk. However, for people at risk, only Pg increased significantly in healthy dental sites and was badociated with the general spread of gum disease.
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Published: June 17, 2018 1:35 pm