Bagavant Harini, Dunkleberger Micah L, Wolska Nina, Sroka Magdalena, Rasmussen Astrid, Adrianto Indra, Montgomery Courtney, Sivils Kathy, Guthridge Joel M, James Judith A, Merrill Joan T, Deshmukh Umesh S
Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA.
Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, USA. Current affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, USA.
Clin Exp Rheumatol. 2019 Jan-Feb;37(1):106-111. Epub 2018 Jun 25.
Microbial infections and mucosal dysbiosis influence morbidity in patients with systemic lupus erythematosus (SLE). In the oral cavity, periodontal bacteria and subgingival plaque dysbiosis provide persistent inflammatory stimuli at the mucosal surface. This study was undertaken to evaluate whether exposure to periodontal bacteria influences disease parameters in SLE patients.
Circulating antibodies to specific periodontal bacteria have been used as surrogate markers to determine an ongoing bacterial burden, or as indicators of past exposure to the bacteria. Banked serum samples from SLE patients in the Oklahoma Lupus Cohort were used to measure antibody titres against periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola) and commensals (Capnocytophaga ochracea, and Streptococcus gordonii) by ELISA. Correlations between anti-bacterial antibodies and different clinicalparameters of SLE including, autoantibodies (anti-dsDNA, anti-SmRNP, anti-SSA/Ro and anti-SSB/La), complement, and disease activity (SLEDAI and BILAG) were studied.
SLE patients had varying amounts of antibodies to different oral bacteria. The antibody titres against A. actinomycetemcomitans, P. gingivalis, T. denticola, and C. ochracea were higher in patients positive for anti-dsDNA antibodies, and they showed significant correlations with anti-dsDNA titres and reduced levels of complement. Among the periodontal pathogens, only antibodies to A. actinomycetemcomitans were associated with higher disease activity.
Our results suggest that exposure to specific pathogenic periodontal bacteria influences disease activity in SLE patients. These findings provide a rationale for assessing and improving periodontal health in SLE patients, as an adjunct to lupus therapies.
微生物感染和黏膜生态失调会影响系统性红斑狼疮（SLE）患者的发病率。在口腔中，牙周细菌和龈下菌斑生态失调会在黏膜表面提供持续的炎症刺激。本研究旨在评估接触牙周细菌是否会影响SLE患者的疾病参数。
针对特定牙周细菌的循环抗体已被用作替代标志物来确定持续的细菌负荷，或作为过去接触该细菌的指标。来自俄克拉荷马狼疮队列中SLE患者的储存血清样本通过酶联免疫吸附测定法（ELISA）来测量针对牙周病原体（伴放线聚集杆菌、牙龈卟啉单胞菌和具核梭杆菌）和共生菌（黄褐二氧化碳嗜纤维菌和戈登链球菌）的抗体滴度。研究了抗菌抗体与SLE的不同临床参数之间的相关性，这些参数包括自身抗体（抗双链DNA、抗SmRNP、抗SSA/Ro和抗SSB/La）、补体和疾病活动度（SLE疾病活动指数和不列颠狼疮评估组指数）。
SLE患者对不同口腔细菌的抗体量各不相同。抗双链DNA抗体呈阳性的患者中，针对伴放线聚集杆菌、牙龈卟啉单胞菌、具核梭杆菌和黄褐二氧化碳嗜纤维菌的抗体滴度更高，并且它们与抗双链DNA滴度和补体水平降低呈显著相关性。在牙周病原体中，只有针对伴放线聚集杆菌的抗体与更高的疾病活动度相关。
我们的结果表明，接触特定的致病性牙周细菌会影响SLE患者的疾病活动度。这些发现为评估和改善SLE患者的牙周健康提供了理论依据，作为狼疮治疗的辅助手段。
