Zekeridou Alkisti, Gilbert Benoit, Finckh Axel, Giannopoulou Catherine
Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Division of Rheumatology, Geneva University Hospitals (HUG), Geneva, Switzerland.
Front Oral Health. 2022 May 6;3:895753. doi: 10.3389/froh.2022.895753. eCollection 2022.
Periodontal disease (PD) and rheumatoid arthritis (RA) are chronic inflammatory diseases with a bi-directional relationship. Both share common genetic and environmental risk factors and result in the progressive destruction of bone and connective tissue. First degree relatives of patients with RA (FDR-RA) are one of the at-risk populations for RA. The etiopathogenic mechanisms of their susceptibility are currently being explored, focusing mostly on the role of anti-cyclic citrullinated protein/ peptide antibodies (ACPA) in triggering RA. Oral microbiota and their relation with oral health has been suggested as a factor influencing the risk of the FDR-RA developing RA. In particular, compromised periodontal status often correlates with ACPA seropositivity in FDR-RA. The presence of periodontal pathogens such as , in oral microbiota has been proposed to increase the risk of developing RA through its uniquely expressed peptidyl arginine deiminase (PPAD), capable of citrullinating both host and bacterial peptides. and its leukotoxin A (LtxA), also induces hypercitrullination in host neutrophils. Common risk factors of periodontitis and RA such as genetic predisposition, smoking, higher local and systemic inflammatory burden, are discussed in the literature. Based on those mechanisms periodontal disease seems to be presented as one of the factors triggering RA in FDR-RA. Larger studies evaluating all the potential mechanisms linking RA and periodontitis are needed in FDR-RA to confirm that periodontal disease should be considered in the screening of FDR-RA.
牙周病（PD）和类风湿性关节炎（RA）是具有双向关系的慢性炎症性疾病。两者具有共同的遗传和环境风险因素，并导致骨骼和结缔组织的进行性破坏。类风湿性关节炎患者的一级亲属（FDR-RA）是类风湿性关节炎的高危人群之一。目前正在探索其易感性的发病机制，主要关注抗环瓜氨酸化蛋白/肽抗体（ACPA）在引发类风湿性关节炎中的作用。口腔微生物群及其与口腔健康的关系被认为是影响FDR-RA患类风湿性关节炎风险的一个因素。特别是，牙周状况受损通常与FDR-RA中的ACPA血清阳性相关。口腔微生物群中存在如 等牙周病原体，已被提出通过其独特表达的肽基精氨酸脱氨酶（PPAD）增加患类风湿性关节炎的风险，该酶能够使宿主和细菌肽瓜氨酸化。 及其白细胞毒素A（LtxA）也会诱导宿主中性粒细胞的过度瓜氨酸化。牙周炎和类风湿性关节炎的常见风险因素，如遗传易感性、吸烟、更高的局部和全身炎症负担，在文献中已有讨论。基于这些机制，牙周病似乎是引发FDR-RA患类风湿性关节炎的因素之一。需要在FDR-RA中进行更大规模的研究来评估所有连接类风湿性关节炎和牙周炎的潜在机制，以确认在FDR-RA的筛查中应考虑牙周病。
