Kobayashi Tetsuo, Bartold Peter Mark
General Dentistry and Clinical Education Unit, Faculty of Dentistry & Medical and Dental Hospital, Niigata University, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
Jpn Dent Sci Rev. 2023 Dec;59:263-272. doi: 10.1016/j.jdsr.2023.08.002. Epub 2023 Aug 26.
Rheumatoid arthritis (RA) is characterized by chronic inflammatory destruction of joint tissue and is caused by an abnormal autoimmune response triggered by interactions between genetics, environmental factors, and epigenetic and posttranslational modifications. RA has been suggested to be interrelated with periodontitis, a serious form or stage of chronic inflammatory periodontal disease associated with periodontopathic bacterial infections, genetic predisposition, environmental factors, and epigenetic influences. Over the last decade, a number of animal and clinical studies have been conducted to assess whether or not periodontitis and associated periodontopathic bacteria constitute risk factors for RA. The present review introduces recent accumulating evidence to support the associations of periodontitis and periodontopathic bacteria with the risk of RA or the outcome of RA pharmacological treatment with disease-modifying antirheumatic drugs. In addition, the results from intervention studies have suggested an improvement in RA clinical parameters after nonsurgical periodontal treatment. Furthermore, the potential causal mechanisms underlying the link between periodontitis and periodontopathic bacteria and RA are summarized.
类风湿性关节炎（RA）的特征是关节组织的慢性炎症性破坏，它是由遗传、环境因素以及表观遗传和翻译后修饰之间的相互作用引发的异常自身免疫反应所导致。有研究表明，RA与牙周炎相关，牙周炎是慢性炎症性牙周疾病的一种严重形式或阶段，与牙周病原菌感染、遗传易感性、环境因素以及表观遗传影响有关。在过去十年中，已经开展了多项动物和临床研究，以评估牙周炎及相关牙周病原菌是否构成RA的风险因素。本综述介绍了最近积累的证据，以支持牙周炎和牙周病原菌与RA风险或RA使用改善病情抗风湿药物治疗结果之间的关联。此外，干预研究的结果表明，非手术牙周治疗后RA的临床参数有所改善。此外，还总结了牙周炎和牙周病原菌与RA之间联系的潜在因果机制。
