Scher Jose U, Ubeda Carles, Equinda Michele, Khanin Raya, Buischi Yvonne, Viale Agnes, Lipuma Lauren, Attur Mukundan, Pillinger Michael H, Weissmann Gerald, Littman Dan R, Pamer Eric G, Bretz Walter A, Abramson Steven B
Division of Rheumatology, New York University and New York University Hospital for Joint Diseases, New York, New York 10003, USA.
Arthritis Rheum. 2012 Oct;64(10):3083-94. doi: 10.1002/art.34539.
To profile the abundance and diversity of subgingival oral microbiota in patients with never-treated, new-onset rheumatoid arthritis (RA).
Periodontal disease (PD) status, clinical activity, and sociodemographic factors were determined in patients with new-onset RA, patients with chronic RA, and healthy subjects. Multiplexed-454 pyrosequencing was used to compare the composition of subgingival microbiota and establish correlations between the presence/abundance of bacteria and disease phenotypes. Anti-Porphyromonas gingivalis antibody testing was performed to assess prior exposure to the bacterial pathogen P gingivalis.
The more advanced forms of periodontitis were already present at disease onset in patients with new-onset RA. The subgingival microbiota observed in patients with new-onset RA was distinct from that found in healthy controls. In most cases, however, these microbial differences could be attributed to the severity of PD and were not inherent to RA. The presence and abundance of P gingivalis were also directly associated with the severity of PD and were not unique to RA. The presence of P gingivalis was not correlated with anti-citrullinated protein antibody (ACPA) titers. Overall exposure to P gingivalis was similar between patients with new-onset RA and controls, observed in 78% of patients and 83% of controls. The presence and abundance of Anaeroglobus geminatus correlated with the presence of ACPAs/rheumatoid factor. Prevotella and Leptotrichia species were the only characteristic taxa observed in patients with new-onset RA irrespective of PD status.
Patients with new-onset RA exhibited a high prevalence of PD at disease onset, despite their young age and paucity of smoking history. The subgingival microbiota profile in patients with new-onset RA was similar to that in patients with chronic RA and healthy subjects whose PD was of comparable severity. Although colonization with P gingivalis correlated with the severity of PD, overall exposure to P gingivalis was similar among the groups. The role of A geminatus and Prevotella/Leptotrichia species in this process merits further study.
分析未经治疗的新发类风湿关节炎（RA）患者龈下口腔微生物群的丰度和多样性。
对新发RA患者、慢性RA患者和健康受试者的牙周疾病（PD）状况、临床活动度及社会人口学因素进行评估。采用多重454焦磷酸测序技术比较龈下微生物群的组成，并确定细菌的存在/丰度与疾病表型之间的相关性。进行抗牙龈卟啉单胞菌抗体检测，以评估既往是否接触过牙龈卟啉单胞菌这种细菌病原体。
新发RA患者在疾病发作时就已存在较严重形式的牙周炎。新发RA患者的龈下微生物群与健康对照者不同。然而，在大多数情况下，这些微生物差异可归因于PD的严重程度，并非RA所固有。牙龈卟啉单胞菌的存在和丰度也与PD的严重程度直接相关，并非RA所特有。牙龈卟啉单胞菌的存在与抗瓜氨酸化蛋白抗体（ACPA）滴度无关。新发RA患者和对照者中牙龈卟啉单胞菌的总体暴露情况相似，分别在78%的患者和83%的对照者中观察到。双珠厌氧球菌的存在和丰度与ACPA/类风湿因子的存在相关。无论PD状况如何，普氏菌属和纤毛菌属是新发RA患者中唯一观察到的特征性分类群。
新发RA患者尽管年轻且吸烟史较少，但在疾病发作时PD患病率较高。新发RA患者的龈下微生物群谱与慢性RA患者以及PD严重程度相当的健康受试者相似。虽然牙龈卟啉单胞菌的定植与PD的严重程度相关，但各组之间牙龈卟啉单胞菌的总体暴露情况相似。双珠厌氧球菌以及普氏菌属/纤毛菌属在这一过程中的作用值得进一步研究。
