Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, AP-HP, Université Paris-Sud, and INSERM U1012, Le Kremlin Bicêtre, France.
EA 1254, Université de Rennes 1, and Université Européenne de Bretagne, Rennes, France.
Arthritis Rheumatol. 2015 Jul;67(7):1729-37. doi: 10.1002/art.39118.
To investigate the possible link between Porphyromonas gingivalis infection and rheumatoid arthritis (RA), according to antibody profile, genetic and environmental factors, and RA severity.
For assessing P gingivalis infection, serum levels of antibodies directed against P gingivalis lipopolysaccharide were measured in 694 patients with early RA who were not exposed to steroids or disease-modifying antirheumatic drugs. Anti-P gingivalis antibody titers were compared between patients with early RA and various control groups, and according to various patient characteristics.
Anti-P gingivalis antibody titers did not significantly differ between patients with RA and controls and did not significantly differ with anti-citrullinated protein antibody (ACPA), rheumatoid factor (RF), or HLA shared epitope status. Anti-P gingivalis antibody titers were significantly higher among patients who had never smoked compared to patients who had ever smoked (P = 0.0049). Among nonsmokers, high anti-P gingivalis antibody levels were associated with a higher prevalence of erosive change (47.5% versus 33.3% with modified Sharp/van der Heijde score erosion subscale ≥1; P = 0.0135).
In this large early RA cohort, we did not detect any association of anti-P gingivalis antibodies with RA or with ACPA status. These results suggest that the association of periodontitis and RA could be linked to bacterial species other than P gingivalis or to a mechanism other than citrullination. Nevertheless, we found higher anti-P gingivalis antibody titers in nonsmokers. In addition, in this population of nonsmokers, high anti-P gingivalis antibody titers were associated with more severe disease. We hypothesize that the role of tobacco in RA pathogenesis is so high that the effect of P gingivalis could be revealed only in a population not exposed to tobacco.
根据抗体谱、遗传和环境因素以及类风湿关节炎（RA）严重程度，研究牙龈卟啉单胞菌感染与类风湿关节炎之间可能存在的联系。
为了评估牙龈卟啉单胞菌感染，在 694 名未接触过类固醇或改善病情的抗风湿药物的早期 RA 患者中，测量了针对牙龈卟啉单胞菌脂多糖的血清抗体水平。比较了早期 RA 患者与各种对照组以及根据患者不同特征的抗牙龈卟啉单胞菌抗体滴度。
RA 患者与对照组的抗牙龈卟啉单胞菌抗体滴度无显著差异，与抗瓜氨酸蛋白抗体（ACPA）、类风湿因子（RF）或 HLA 共享表位状态也无显著差异。与曾吸烟的患者相比，从不吸烟的患者抗牙龈卟啉单胞菌抗体滴度显著更高（P=0.0049）。在不吸烟者中，高抗牙龈卟啉单胞菌抗体水平与侵蚀性改变的患病率更高相关（改良 Sharp/van der Heijde 侵蚀评分亚量表≥1 的患者中，分别为 47.5%和 33.3%；P=0.0135）。
在这个大型早期 RA 队列中，我们未发现抗牙龈卟啉单胞菌抗体与 RA 或 ACPA 状态之间存在任何关联。这些结果表明，牙周炎与 RA 的关联可能与牙龈卟啉单胞菌以外的细菌种类或瓜氨酸化以外的机制有关。尽管如此，我们发现不吸烟者的抗牙龈卟啉单胞菌抗体滴度更高。此外，在这群不吸烟者中，高抗牙龈卟啉单胞菌抗体滴度与更严重的疾病相关。我们假设烟草在 RA 发病机制中的作用如此之大，以至于只有在未接触烟草的人群中才能发现牙龈卟啉单胞菌的作用。
