Bacteremia, antibodies link periodontal disease to RA development & activity. MedTwitter Rheumatology RheumTwitter
Lorraine L. Janeczko, MPHBacterial proteins in the bleeding gums of patients with periodontal disease and rheumatoid arthritis enter the bloodstream and trigger immune responses that may contribute to RA pathogenesis and disease flares, aThe results suggest that PD involves repeated oral mucosa breakdowns with the release of citrullinated oral bacteria into the bloodstream and that these bacteria activate inflammatory monocytes in the inflamed RA synovium and in the blood of patients with RA.
PD is more common in people with RA who have detectable ACPAs, and that link implicates oral mucosal inflammation in RA pathogenesis.At Rockefeller University, Orange and her colleagues followed five female patients with RA who were seropositive for CCP over the course of 1–4 years. Two had severe PD, and three showed no signs of PD.
The researchers found that the patients with PD also had repeated flare-ups of oral bacteria in the blood, mainly from the Streptococcaceae family, suggesting that the oral mucosa repeatedly broke down and introduced bacteria into the bloodstream. In the blood, inflammatory immune cells targeted the bacteria and released ACPAs, which have been linked with RA.
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