Periodontal pathogens and the association between periodontitis and rheumatoid arthritis in Korean adults.

Purpose: Periodontitis and rheumatoid arthritis (RA) share a similar inflammatory pathogenesis. Porphyromonas gingivalis ( Pg ) can induce anticyclic-citrullinated peptide autoantibodies (anti-CCP antibodies), a key factor in the development of RA. This study aimed at evaluating the relationships between the 2 diseases and identifying the clinical implications thereof, with a focus on periodontal pathogens in Korean adults.

Methods: A total of 260 RA patients and 86 age- and sex-matched control patients without arthritis were enrolled in this prospective cross-sectional study. Periodontal indices and the prevalence and amount of periodontal pathogens were compared between the groups. Correlations between periodontal and RA indices were examined, as were correlations between 9 periodontal pathogens and RA indices.

Results: The RA group had significantly higher values than the control group for all investigated periodontal indices ( P <0.05) except the number of teeth. The gingival index (GI) was correlated with the disease activity score 28 (DAS28) ( r =0.125, P =0.049), RA disease duration ( r =0.253, P <0.001), erythrocyte sedimentation rate (ESR) ( r =0.162, P =0.010), and anti-CCP antibody titer ( r =0.205, P =0.004). Probing pocket depth (PPD) was correlated with ESR ( r =0.139, P =0.027) and anti- Pg antibody titer ( r =0.203, P =0.001). Bleeding on probing (BOP) was correlated with DAS28 ( r =0.137, P =0.030), RA disease duration ( r =0.202, P =0.001), ESR ( r =0.136, P =0.030), anti- Pg antibody titer ( r =0.177, P =0.005), and anti-CCP antibody titer ( r =0.188, P =0.007). Clinical attachment level (CAL) and periodontitis severity were correlated with anti- Pg antibody titer (the former r =0.201, P =0.002; the latter r =0.175, P =0.006). The quantity of Pg was positively correlated with the serum anti- Pg antibody titer ( r =0.148, P =0.020).

Conclusions: The GI, BOP, and PPD showed positive relationships with several RA indices. The anti- Pg antibody titer had positive relationships with PPD, BOP, CAL, and periodontitis severity. Thus, increasing values of periodontal indices could be used as a risk indicator of disease development in RA patients, and an increasing anti- Pg antibody titer could be considered as a warning sign in RA patients suffering with periodontitis.