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J Clin Med. 2019 May 8;8(5). pii: E630. doi: 10.3390/jcm8050630.

Periodontal Health and Oral Microbiota in Patients with Rheumatoid Arthritis.

Author information

1
Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden. Kaja.Eriksson@ki.se.
2
Center for Rheumatology, Academic Specialist Center, Stockholm Health Services, 10235 Stockholm, Sweden. guozhong.fei@sll.se.
3
Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden. anna.kats@hotmail.com.
4
Department of Dental Medicine, Division of Orofacial Diagnostics and Surgery-Image and Functional Odontology, Karolinska Institutet, Huddinge 14104, Sweden. daniel.benchimol@ki.se.
5
Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden. linkiatlee@gmail.com.
6
Science for Life Laboratory School of Biotechnology, KTH Royal Institute of Technology, 17121 Stockholm, Sweden. yue.hu@ki.se.
7
Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, 17164 Stockholm, Sweden. yue.hu@ki.se.
8
Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden. Saedis.Saevarsdottir@ki.se.
9
Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden. anca.catrina@ki.se.
10
Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden. bjorn.klinge@ki.se.
11
Department of Periodontology, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden. bjorn.klinge@ki.se.
12
Science for Life Laboratory School of Biotechnology, KTH Royal Institute of Technology, 17121 Stockholm, Sweden. anders.andersson@scilifelab.se.
13
Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden. Lars.Klareskog@ki.se.
14
Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden. Karin.Lundberg@ki.se.
15
Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden. leif.jansson@sll.se.
16
Department of Periodontology at Eastmaninstitutet, Stockholm County Council, 11382 Stockholm, Sweden. leif.jansson@sll.se.
17
Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden. Tulay.Lindberg@ki.se.

Abstract

This study aimed to investigate the periodontal health of patients with established rheumatoid arthritis (RA) in relation to oral microbiota, systemic and oral inflammatory mediators, and RA disease activity. Forty patients underwent full-mouth dental/periodontal and rheumatological examination, including collection of blood, saliva, gingival crevicular fluid (GCF) and subgingival plaque. Composition of plaque and saliva microbiota were analysed using 16S rRNA sequencing and levels of inflammatory mediators by multiplex-immunoassay. The majority of the patients (75%) had moderate or severe periodontitis and the rest had no/mild periodontitis. Anti-citrullinated protein antibody (ACPA) positivity was significantly more frequent in the moderate/severe periodontitis (86%) compared to the no/mild group (50%). No significance between groups was observed for RA disease duration or activity, or type of medication. Levels of sCD30/TNFRSF8, IFN-α2, IL-19, IL-26, MMP-1, gp130/sIL-6Rß, and sTNF-R1 were significantly higher in serum or GCF, and April/TNFSF13 was significantly higher in serum and saliva samples in moderate/severe periodontitis. The microbial composition in plaque also differed significantly between the two groups. In conclusion, the majority of RA patients had moderate/severe periodontitis and that this severe form of the disease was significantly associated with ACPA positivity, an altered subgingival microbial profile, and increased levels of systemic and oral inflammatory mediators.

KEYWORDS:

Porphyromonas gingivalis; anti-citrullinated protein autoantibodies; medication; periodontal disease; periodontitis; rheumatoid arthritis; rheumatoid factor; smoking

PMID:
31072030
DOI:
10.3390/jcm8050630
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