Document Type : Original Article

Authors

1 Assistant Professor, Firoozabadi Clinical Research Development Unit (FACRDU), Iran University of Medical Science (IUMS), Tehran, Iran

2 Professor, Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

3 Student of PhD, Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

4 Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

5 Department of Medical Biotechnology, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran

6 Medical Student, Iran University of Medical Sciences, Tehran, Iran

7 Assistant Professor, Department of Rheumatology, Rheumatology Research Center, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran

Abstract

Background: The relationship between rheumatoid arthritis and poor oral hygiene has longbeen proven. Colonization of Porphyromonas gingivalis in the oral cavity can play an important role in rheumatoid arthritis. The aim of this study was to determine whether there is a relationship between rheumatoid arthritis disease and the presence of P. gingivalis.
Methods:sixty patients with rheumatoid arthritis and 75 controls with matched age, sex and smoking and oral health status were selected. Provided samples from dental plaque were assessed for the presence of P. gingivalis by using bacterial culture and polymerase chain reaction (PCR).
Results:Results of bacterial culture and PCR showed no significant difference between rheumatoid arthritis patients and control group in terms of the presence of P. gingivalis (P = 0.9 and P = 0.1, respectively). There was also no relationship between the number of bacterial copies and the activities of rheumatoid arthritis.
Conclusion:Findings showed that there was no significant relationship between the presence of P. gingivalis in dental plaque and rheumatoid arthritis.

Keywords

  1. Bax M, van Heemst J, Huizinga TW, Toes RE. Genetics of rheumatoid arthritis: what have we learned? Immunogenetics 2011; 63(8):459-66.
  2. Firestein GS. Evolving concepts of rheumatoid arthritis. Nature 2003; 423(6937):356-61.
  3. De Pablo P, Dietrich T, McAlindon TE. Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population. J Rheumatol 2008; 35(1):70-6.
  4. Kässer UR, Gleissner C, Dehne F, Michel A, Willershausen-Zönnchen B, Bolten WW. Risk for periodontal disease in patients with longstanding rheumatoid arthritis. Arthritis Rheum 1997; 40(12):2248-51.
  5. Tolo K, Jorkjend L. Serum antibodies and loss of periodontal bone in patients with rheumatoid arthritis. J Clin Periodontol 1990; 17(5):288-91.
  6. Mercado F, Marshall RI, Klestov AC, Bartold PM. Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol 2000; 27(4):267-72.
  7. Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim) 2017; 11(2):72-80.
  8. Rutger Persson G. Rheumatoid arthritis and periodontitis-inflammatory and infectious connections. Review of the literature. J Oral Microbiol 2012; 4.
  9. Ogrendik M. Rheumatoid arthritis is linked to oral bacteria: etiological association. Modern Rheumatology 2009; 19(5):453-6.
  10. Marsh P, Lewis M, Rogers H, Williams D, Wilson M. Oral Microbiology. 6th ed. USA: Elsevier; 2009.
  11. Wegner N, Wait R, Sroka A, Eick S, Nguyen KA, Lundberg K, et al. Peptidylarginine deiminase from Porphyromonas gingivalis citrullinates human fibrinogen and α‐enolase: implications for autoimmunity in rheumatoid arthritis. Arthritis Rheum 2010; 62(9):2662-72.
  12. Kinloch A, Tatzer V, Wait R, Peston D, Lundberg K, Donatien P, et al. Identification of citrullinated alpha-enolase as a candidate autoantigen in rheumatoid arthritis. Arthritis Res Ther 2005; 7(6):R1421-9.
  13. Hitchon CA, Chandad F, Ferucci ED, Willemze A, Ioan-Facsinay A, van der Woude D, et al. Antibodies to porphyromonas gingivalis are associated with anticitrullinated protein antibodies in patients with rheumatoid arthritis and their relatives. J Rheumatol 2010; 37(6):1105-12.
  14. Kinloch AJ, Alzabin S, Brintnell W, Wilson E, Barra L, Wegner N, et al. Immunization with porphyromonas gingivalis enolase induces autoimmunity to mammalian α‐enolase and arthritis in DR4‐IE–transgenic mice. Arthritis Rheum 2011; 63(12):3818-23.
  15. Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty‐eight‐joint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995; 38(1):44-8.
  16. Clais S, Boulet G, Van Kerckhoven M, Lanckacker E, Delputte P, Maes L, et al. Comparison of viable plate count, turbidity measurement and real‐time PCR for quantification of porphyromonas gingivalis. Lett Appl Microbiol 2015; 60(1):79-84.
  17. Ceccarelli F, Orrù G, Pilloni A, Bartosiewicz I, Perricone C, Martino E, et al. Porphyromonas gingivalis in the tongue biofilm is associated with clinical outcome in rheumatoid arthritis patients. Clin Exp Immunol 2018; 194(2):244-52.
  18. Rodríguez-Lozano B, González-Febles J, Garnier-Rodríguez JL, Dadlani S, Bustabad-Reyes S, Sanz M, et al. Association between severity of periodontitis and clinical activity in rheumatoid arthritis patients: a case-control study. Arthritis Res Ther 2019; 21(1):27.
  19. de Smit M, Westra J, Vissink A, Doornbos-van der Meer B, Brouwer E, van Winkelhoff AJ. Periodontitis in established rheumatoid arthritis patients: a cross-sectional clinical, microbiological and serological study. Arthritis Res Ther 2012; 14(5):R222.
  20. Linden GJ, Linden K, Yarnell J, Evans A, Kee F, Patterson CC. All‐cause mortality and periodontitis in 60–70‐year‐old men: a prospective cohort study. J Clin Periodontol 2012; 39(10):940-6.
  21. Linden GJ, Linden K, Yarnell J, Evans A, Kee F, Patterson CC. All‐cause mortality and periodontitis in 60–70‐year‐old men: a prospective cohort study. J Clin Periodontol 2012; 39(10):940-6.
  22. Kinloch A, Tatzer V, Wait R, Peston D, Lundberg K, Donatien P, et al. Identification of citrullinated alpha-enolase as a candidate autoantigen in rheumatoid arthritis. Arthritis Res Ther 2005; 7(6):R1421-9.
  23. Bender P, Bürgin WB, Sculean A, Eick S. Serum antibody levels against Porphyromonas gingivalis in patients with and without rheumatoid arthritis - a systematic review and meta-analysis. Clin Oral Investig 2017; 21(1):33-42.
  24. Johansson L, Sherina N, Kharlamova N, Potempa B, Larsson B, Israelsson L, et al. Concentration of antibodies against porphyromonas gingivalis is increased before the onset of symptoms of rheumatoid arthritis. Arthritis Res Ther 2016; 18:201.
  25. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010; 69(9):1580-8.