Periodontitis and Rheumatoid Arthritis

Year : 2024 | Volume :01 | Issue : 01 | Page : 31-39
By

Abhishek S Krishna

Ahalya U

Shaiju S Dharan

Amal A

Abstract

This comprehensive review delves into the complex interplay between Periodontitis and Rheumatoid Arthritis, aiming to unravel the underlying mechanisms and shared inflammatory pathways that connect these seemingly distinct conditions. The review examines a wealth of current research, exploring how chronic periodontal inflammation may contribute to the development and progression of RA and vice versa. Furthermore, the review critically evaluates the clinical implications of this interrelation, emphasizing the need for interdisciplinary collaboration between rheumatologists and periodontal specialists. Insights from this synthesis of evidence could inform targeted therapeutic strategies and preventive measures for individuals at risk of concurrent periodontitis and rheumatoid arthritis. In summary, the review not only elucidates the complex interplay between periodontitis and rheumatoid arthritis but also underscores the importance of integrated approaches in both research and clinical management to address the multifaceted nature of these interconnected health conditions. While further studies are needed to elucidate specific mechanisms and establish causation, the existing evidence highlights the significance of collaboration between dental and rheumatological professionals for improved patient outcomes. Integrating oral health management into the holistic care of individuals with rheumatoid arthritis could pave the way for more effective preventive strategies and enhanced overall well-being.

Keywords: Periodontitis, rheumatoid arthritis, inflammatory pathways, porphyromonas gingivalis, citrullination

[This article belongs to International Journal of Tropical Medicines(ijtm)]

How to cite this article: Abhishek S Krishna, Ahalya U, Shaiju S Dharan, Amal A. Periodontitis and Rheumatoid Arthritis. International Journal of Tropical Medicines. 2024; 01(01):31-39.
How to cite this URL: Abhishek S Krishna, Ahalya U, Shaiju S Dharan, Amal A. Periodontitis and Rheumatoid Arthritis. International Journal of Tropical Medicines. 2024; 01(01):31-39. Available from: https://journals.stmjournals.com/ijtm/article=2024/view=144889

References

  1. Genco RJ, Williams RC. Periodontal disease and overall health: a clinician’s guide. Yardley (PA): Professional Audience Communications Inc; 2010
  2. Nguyen VB, Nguyen TT, Huynh NC, Le TA, Hoang HT. Relationship between periodontitis and rheumatoid arthritis in Vietnamese patients. Acta Odontologica Scandinavica. 2020 Oct 2;78(7):522-8.
  3. Dissick A, Redman RS, Jones M, Rangan BV, Reimold A, Griffiths GR, Mikuls TR, Amdur RL, Richards JS, Kerr GS (2010) Association of periodontitis with rheumatoid arthritis: a pilot study. J Periodontal 81 (2):223-230.
  4. Punceviciene E, Rovas A, Puriene A, Stuopelyte K, Vitkus D, Jarmalaite S, Butrimiene I. Investigating the relationship between the severity of periodontitis and rheumatoid arthritis: a cross-sectional study. Clinical Rheumatology. 2021 Aug;40:3153-60.
  5. Lima V., Bezerra M. M., Leitao R. F. C., Brito G. A. C., Rocha F. A. C., Ribeiro R. Principais mediadores inflamatorios envolvidos na fisiopatologia da periodontite- papel dos moduladores farmacologicos. R Periodontia. 2008;18(3):7-19.
  6. Nakashima T., Kobayashi Y., Yamasaki S., et al. Protein expression and functional difference of membrane-bound and soluble receptor activator of NF-kappaB ligand: modulation of the expression by osteotropic factors and cytokines. Biochemical and Biophysical Research Communications. 2000;275(3):768-775.
  7. Garib B. T., Qaradaxi S. S. Temporomandibular joint problems and periodontal condition in rheumatoid arthritis patients in relation to their rheumatologic status. Journal of Oral and Maxillofacial Surgery. 2011;69(12):2971-2978.
  8. Liubchenko G. A., Appleberry H. C., Striebich C. C., et al. Rheumatoid arthritis is associated with signalling alterations in naturally occurring autoreactive B- lymphocytes. Journal of Autoimmunity. 2013;40(1):111-121.
  9. Renvert S, Berglund JS, Persson GR, Söderlin MK. The association between rheumatoid arthritis and periodontal disease in a population-based cross-sectional case-control study. BMC rheumatology. 2020 Dec;4:1-8.
  10. Potempa J, Mydel P, Koziel J. The case for periodontitis in the pathogenesis of rheumatoid arthritis. Nat Rev Rheumatol. 2017;13(10):606-20.
  11. Ayravainen L, Leirisalo-Repo M, Kuuliala A, Ahola K, Koivuniemi R, Meurman JH, et al. Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population. MBJ Open. 2017;7(1): e011916.
  12. Ogrendik M. Rheumatoid arthritis is an autoimmune disease caused by periodontal pathogens. Int J Gen Med. 2013 May 24;6:383-6.
  13. Katz J, Goultschin J, Benoliel R, Brautbar C. Human leukocyte antigen (HLA) DR4. Positive association with rapidly progressing periodontitis. J Periodontal. 1987;58:607-10.
  14. De Pablo P, Dietrich T McAlindon TE. Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population. J Rheumatol. 2008; 35:70-6.
  15. Berthelot JM, Le Goff B. Rheumatoid arthritis and periodontal disease. Joint Bone Spine. 2010;77:537-41.
  16. Detert J, Pischon N, Burmester GR, Buttgereit F. The association between rheumatoid arthritis and periodontal disease. Arthritis Res Ther. 2010;12:218.
  17. Lundberg K, Wegner N, Yucel-Lindberg T, Venables PJ. Periodontitis in RA- the citrullinated enolase connection. Nat Rev Rheumatol. 2010;6:727-30.
  18. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum.2010 Sep;62(9):2569–2581.
  19. Benli M, Batool F, Stutz C, Petit C, Jung S, Huck O. Orofacial manifestations and dental management of systemic lupus erythematosus: a review. Oral Dis. 2021 Mar;27(2):151–167.
  20. Cornell P. Don’t forget to clean your teeth: does informing patients about the link between dental hygiene and rheumatoid arthritis encourage better dental care? Musculoskeletal Care. 2013 Sep;11(2):121–124.
  21. Cross M, Smith E, Hoy D, Carmona L, Wolfe F, Vos T, Williams B, Gabriel S, Lassere M, Johns N. The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(7):1316–1322.
  22. Eriksson K, Nise L, Kats A, Luttropp E, Catrina AI, Askling J, Jansson L, Alfredsson L, Klareskog L, Lundberg K. Prevalence of periodontitis in patients with established rheumatoid arthritis: a Swedish population based case-control study. PloS One. 2016; 11(5):e0155956.
  23. Fuggle NR, Smith TO, Kaul A, Sofat N. Hand to mouth: a systematic review and meta-analysis of the association between rheumatoid arthritis and periodontitis. Front Immunol. 2016 Mar 2;7:80.
  24. Hitchon CA, Khan S, Elias B, Lix LM, Peschken CA. Prevalence and incidence of rheumatoid arthritis in Canadian First Nations and non–First Nations people: a population-based study. J Clin Rheumatol. 2019;26(5):169–175.
  25. Liao F, Li Z, Wang Y, Shi B, Gong Z, Cheng X. Porphyromonas gingivalis may play an important role in the pathogenesis of periodontitis-associated rheumatoid arthritis. Medical hypotheses. 2009 Jun 1;72(6):732-5.
  26. Mikuls TR, Payne JB, Yu F, Thiele GM, Reynolds RJ, Cannon GW, Markt J, McGowan D, Kerr GS, Redman RS, Reimold A. Periodontitis and Porphyromonas gingivalis in patients with rheumatoid arthritis. Arthritis & rheumatology. 2014 May;66(5):1090-100.
  27. Abou-Raya A., Abou-Raya S., Abu-Elkheir H.: Periodontal disease and rheumatoid arthritis: Is there a link? Scand J. Rheumatol., 2005; 34: 408-410.
  28. Albandar J.M., Streckfus C.F., Adesanya M.R., Winn D.M.: Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. J. Periodontol., 2000; 71: 1874-1881.
  29. Al-Katma M.K., Bissada N.F., Bordeaux J.M., Sue J., Askari A.D.: Control of periodontal infection reduces the severity of active rheumatoid arthritis. J. Clin. Rheumatol., 2007; 13: 134-137.
  30. Amano A., Nakagawa I., Okahashi N., Hamada N.: Variations of Porphyromonas gingivalis fimbriae in relation to microbial pathogenesis. J. Periodontal Res., 2004; 39: 136-142.
  31. Andrian E., Grenier D., Rouabhia M.: In vitro models of tissue penetration and destruction by Porphyromonas gingivalis. Infect Immun., 2004; 72: 4689-4698.
  32. Mangat P., Wegner N., Venables P.J., Potempa J.: Bacterial and human peptidylarginine deiminases: targets for inhibiting the autoimmune response in rheumatoid arthritis. Arthritis Res. Ther., 2010; 12: 209-217.
  33. Marotte H., Farge P., Gaudin P., Alexandre C., Mougin B., Miossec P.: The association between periodontal disease and joint destruction in rheumatoid arthritis extends the link between the HLA-DR shared eptiope and severity of bone destruction. Ann. Rheum. Dis., 2006; 65: 905-909.
  34. Martinez-Martinez R.E., Abud-Mendoza C., Patiño-Marin N., RizoRodríguez J.C., Little J.W., Loyola-Rodríguez J.P.: Detection of periodontal bacterial DNA in serum and synovial fluid in refractory rheumatoid arthritis patients. J. Clin. Periodontol., 2009; 36: 1004-1010.
  35. Mayer Y., Elimelech R., Balbir-Gurman A., Braun-Moscovici Y., Machtei E.E.: Periodontal condition of patients with autoimmune diseases and the effect of anti- tumor necrosis factor-α therapy. J. Periodontol., 2013; 84: 136-142.
  36. McGraw W.T., Potempa J., Farley D., Travis J.: Purification, characterization, and sequence analysis of a potential virulence factor from Porphyromonas gingivalis, peptidylarginine deiminase. Infect. Immun., 1999; 67: 3248-3256.
  37. Weinberg J.B., Pippen A.M., Greenberg C.S.: Extravascular fibrin formation and dissolution in synovial tissue of patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum., 1991; 34: 996-1005.
  38. Wygrecka M., Marsh L.M., Morty R.E., Henneke I., Guenther A., Lohmeyer J., Markart P., Preissner K.T.: Enolase-1 promotes plasminogen-mediated recruitment of monocytes to the acutely inflamed lung. Blood, 2009; 113: 5588-5598.
  39. Yang X., Wang J., Liu C., Grizzle W.E., Yu S., Zhang S., Barnes S., Koopman W.J., Mountz J.D., Kimberly R.P., Zhang H.G.: Cleavage of p53-vimentin complex enhances tumor necrosis factor-related apoptosis-inducing ligand-mediated apoptosis of rheumatoid arthritis synovial fibroblasts. Am. J. Pathol., 2005; 167: 705-719.
  40. Yilmaz O., Watanabe K., Lamont R.J.: Involvement of integrins in fimbriae- mediated binding and invasion by Porphyromonas gingivalis. Cell. Microbiol., 2002; 4: 305-314.
  41. Andersen RB, Elling P. Immunofluorescent demonstration of intracellular fibrin in synovial tissue. Ann. Rheum. Dis. 1972 Jan;31(1): 59–64.
  42. Bartold PM, Marshall RI, Haynes DR. Periodontitis and rheumatoid arthritis: a review. J. Periodontol. 2005 Nov;76(11 Suppl): 2066–2074.
  43. Berthelot JM, Le Goff B. Rheumatoid arthritis and periodontal disease. Joint Bone Spine. 2010 Dec;77: 537–41.
  44. Biyikoglu B, Buduneli N. Gingival crevicular fluid MMP-8 and -13 and TIMP-1 levels in patients with rheumatoid arthritis and inflammatory periodontal disease. J. Periodontol. 2009 Aug;80: 1307–1314.
  45. Bonfil JJ, Dillier FL, Mercier P, Reviron D. A case control study of the role of HLADR4 in severe periodontitis and rapidly progressive periodontitis. J Clin. Periodontol. 1999 Feb;26: 77–84.
  46. Cantley MD, Haynes DR, Marino V, Bartold PM. Pre-existing periodontitis exacerbates experimental arthritis in mouse model. J Clin. Periodontol. 2011 Jun;38(6): 532–541.
  47. De Pablo P, Chapple IL, Buckley CD, Dietrich T. Periodontitis in systemic rheumatic disease. Nat Rev Rheumatol. 2009 Apr;5: 218–224.
  48. Dissik A, Redman RS, Jones M, Rangan BV, Reimold A. Association of periodontitis with rheumatoid arthritis: a pilot study. J Periodontol. 2010 Feb;81: 223–230.
  49. Genco RJ. Host response in periodontal diseases: Current concepts. J. Periodontol. 1992 Apr;63: 338–355.
  50. van Oosterhout M, Bajema I, Levarht EW, Toes RE, Huizinga TW, van Laar JM. Differences in synovial tissue infiltrates between anti-cyclic citrullinated peptide-positive rheumatoid arthritis and anti-cyclic citrullinated peptide-negative rheumatoid arthritis. Arthritis Rheum. 2008 Jan;58(1):53–60.
  51. MacGregor AJ, Snieder H, Rigby AS, Koskenvuo M, Kaprio J, Aho K, et al. Characterizing the quantitative genetic contribution to rheumatoid arthritis using data from twins. Arthritis Rheum. 2000 Apr;43(1):30–7.
  52. Teles R, Sakellari D, Teles F, Konstantinidis A, Kent R, Socransky S, et al. Relationships among gingival crevicular fluid biomarkers, clinical parameters of periodontal disease, and the subgingival microbiota. J Periodontol. 2010 Mar;81(1):89–98.

Regular Issue Subscription Review Article
Volume 01
Issue 01
Received April 5, 2024
Accepted April 16, 2024
Published May 3, 2024