Periodontal disease and the oral microbiota in new-onset rheumatoid arthritis.
Arthritis Rheum.
2012 May 10. doi:
10.1002/art.34539. [Epub ahead of print]
Scher JU,
Ubeda C,
Equinda
M,
Khanin R,
Buischi
Y,
Viale A,
Lipuma L,
Attur M,
Pillinger
MH,
Weissmann
G,
Littman
DR,
Pamer EG,
Bretz WA,
Abramson
SB.
Source
New York University School of
Medicine and NYU Hospital for Joint Diseases, New York, New York.
Jose.Scher@nyumc.org.
Abstract
OBJECTIVE.: To profile the subgingival oral microbiota
abundance
and diversity in never-treated, new-onset rheumatoid arthritis (NORA)
patients.
METHODS.: Periodontal disease (PD) status, clinical activity and
sociodemographic factors were determined in patients with NORA, chronic RA
(CRA)
and healthy subjects. Massively parallel pyrosequencing was used to compare
the
composition of subgingival microbiota and establish correlations between
presence/abundance of bacteria and disease phenotypes. Anti-P. gingivalis
antibodies were tested to assess prior exposure. RESULTS.: The more advanced
forms of periodontitis are already present at disease onset in NORA
patients.
The subgingival microbiota of NORA is distinct from controls. In most cases,
however, these differences can be attributed to PD severity and are not
inherent
to RA. The presence and abundance of P. gingivalis is directly associated
with
PD severity as well, is not unique to RA, and does not correlate with
anti-citrullinated peptide antibody (ACPA) titers. Overall exposure to P.
gingivalis is similar in RA and controls, observed in 78.4% and 83.3%,
respectively. Anaeroglobus geminatus correlated with ACPA/RF presence.
Prevotella and Leptotrichia species are the only characteristic taxa in the
NORA
group irrespective of PD status. CONCLUSIONS.: NORA
patients exhibit a high prevalence of PD at disease onset, despite their
young
age and paucity of smoking history. The subgingival microbiota of NORA
patients
is similar to CRA and healthy subjects of comparable PD severity. Although
colonization with P. gingivalis correlates with PD severity, overall
exposure is
similar among groups. The role of A. geminatus and Prevotella/Leptotrichia
species in this process merits further study.
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