UNLABELLED: THE PURPOSE OF REVIEW: Rheumatoid arthritis (RA) is a prevalent autoimmune-mediated, chronic inflammatory disorder that has been found in multiple epidemiologic studies to be associated with periodontal disease (PD). Despite the extensive epidemiologic evidence, the biologic basis of this association remains unclear. This article focuses on new insights into the potential mechanisms underlying the association between PD and RA. RECENT FINDINGS: Chronic periodontal and synovial inflammation share many common pathologic, cellular, and molecular features. In particular, the mechanisms involved in the destruction of the adjacent connective tissues are quite similar. Recent studies have shown anti-citrullinated protein antibodies (ACPA) that are highly specific for RA are detectable years before disease development. Emerging evidence suggests the oral pathogen porphymonas gingivalis may serve to break immune tolerance or amplify autoimmune responses to citrullinated antigens and, in turn, ultimately initiate RA in genetically susceptible persons. SUMMARY: Recognition of the association between RA and PD on both a clinical and biologic level may provide new opportunities for intervention that will modify the course of both of these prevalent chronic inflammatory disorders. Furthermore, an enhanced understanding of the early events that initiate RA may result in strategies that prevent disease-onset.
UNLABELLED: THE PURPOSE OF REVIEW: Rheumatoid arthritis (RA) is a prevalent autoimmune-mediated, chronic inflammatory disorder that has been found in multiple epidemiologic studies to be associated with periodontal disease (PD). Despite the extensive epidemiologic evidence, the biologic basis of this association remains unclear. This article focuses on new insights into the potential mechanisms underlying the association between PD and RA. RECENT FINDINGS: Chronic periodontal and synovial inflammation share many common pathologic, cellular, and molecular features. In particular, the mechanisms involved in the destruction of the adjacent connective tissues are quite similar. Recent studies have shown anti-citrullinated protein antibodies (ACPA) that are highly specific for RA are detectable years before disease development. Emerging evidence suggests the oral pathogen porphymonas gingivalis may serve to break immune tolerance or amplify autoimmune responses to citrullinated antigens and, in turn, ultimately initiate RA in genetically susceptible persons. SUMMARY: Recognition of the association between RA and PD on both a clinical and biologic level may provide new opportunities for intervention that will modify the course of both of these prevalent chronic inflammatory disorders. Furthermore, an enhanced understanding of the early events that initiate RA may result in strategies that prevent disease-onset.
Authors: Kevin D Deane; M Kristen Demoruelle; Lindsay B Kelmenson; Kristine A Kuhn; Jill M Norris; V Michael Holers Journal: Best Pract Res Clin Rheumatol Date: 2017-09-18 Impact factor: 4.098
Authors: Andrea Katryn Blanchard; Xikui Wang; Hani El-Gabalawy; Qier Tan; Pam Orr; Brenda Elias; Patricia Rawsthorne; Donna Hart; Shirley Chubey; Charles N Bernstein Journal: Int J Circumpolar Health Date: 2012-03-19 Impact factor: 1.228