Yu Xia, Mankia Kulveer, Do Thuy, Meade Josephine
Division of Oral Biology, School of Dentistry, University of Leeds, Leeds, UK.
Leeds Biomedical Centre-NIHR, Leeds, UK.
Adv Exp Med Biol. 2025;1472:185-199. doi: 10.1007/978-3-031-79146-8_12.
Rheumatoid arthritis and periodontal diseases, both characterized by chronic inflammation, share many common risk factors, sparking interest in understanding their established association. Emerging research has shed light on the link between these two diseases potentially occurring through the intricate interactions within the oral microbiome. The enrichment of pathogenic strains and species in this microbial community disrupts the delicate balance of both ecological and immunological homeostasis with the host. Particular attention has been paid to the role of key pathogens, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, known for their immunomodulatory abilities. The generation of an autoimmune response against proteins modified by citrullination is known to be a key step in the pathogenesis of RA. Importantly, the bidirectional citrullination mediated by both host innate immune cells and oral bacteria generates citrullinated peptide neoepitopes, which may serve as potential triggers for the loss of tolerance and subsequent autoimmunity in susceptible individuals. This review highlights the importance of understanding the mechanisms through which oral microbiome dysbiosis and citrullination contribute to the onset and progression of RA. Insights into these mechanisms not only advance pathobiological understanding but also offer potential therapeutic targets. Furthermore, we discuss the potential impact of nonsurgical periodontal treatment in modifying disease progression or mitigating RA, underscoring the critical role of periodontal health in managing systemic inflammatory conditions.
类风湿性关节炎和牙周疾病均以慢性炎症为特征，它们有许多共同的风险因素，这引发了人们对了解它们既存关联的兴趣。新出现的研究揭示了这两种疾病之间可能通过口腔微生物群内复杂的相互作用而产生的联系。这个微生物群落中致病菌株和物种的富集破坏了与宿主之间生态和免疫稳态的微妙平衡。人们特别关注了关键病原体的作用，如具核梭杆菌牙龈卟啉单胞菌和伴放线聚集杆菌，它们以其免疫调节能力而闻名。已知针对瓜氨酸化修饰蛋白产生自身免疫反应是类风湿性关节炎发病机制中的关键步骤。重要的是，由宿主固有免疫细胞和口腔细菌介导的双向瓜氨酸化产生了瓜氨酸化肽新表位，这可能是易感个体中耐受性丧失和随后自身免疫的潜在触发因素。这篇综述强调了了解口腔微生物群失调和瓜氨酸化导致类风湿性关节炎发病和进展的机制的重要性。对这些机制的深入了解不仅能推进病理生物学认识，还能提供潜在的治疗靶点。此外，我们讨论了非手术牙周治疗在改变疾病进展或减轻类风湿性关节炎方面的潜在影响，强调了牙周健康在管理全身性炎症性疾病中的关键作用。
