Interconnected Pathologies: Exploring the Relationship Between Rheumatoid Arthritis and Periodontitis
Abstract
Rheumatoid arthritis (RA) and periodontitis are chronic inflammatory diseases that share common pathogenic mechanisms and risk factors. Emerging evidence suggests a bidirectional relationship between these two conditions, with RA patients exhibiting a higher prevalence and severity of periodontitis, and periodontal disease exacerbating systemic inflammation and joint destruction in RA. This review explores the intricate interplay between RA and periodontitis, focusing on shared inflammatory pathways, immune dysregulation, and genetic predisposition. Epidemiological studies supporting the association between RA and periodontitis are discussed, along with potential confounders and effect modifiers. Clinical implications for the management of patients with RA-associated periodontitis are highlighted, emphasizing the importance of interdisciplinary collaboration and personalized treatment approaches. Understanding the complex relationship between RA and periodontitis is essential for optimizing patient care and improving outcomes in individuals affected by these chronic inflammatory conditions.
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Pischon N, Pischon T, Kroger J, Gulmez E, Kleber BM, Bernimoulin JP, et al. Association among rheumatoid arthritis, oral hygiene, and periodontitis. Journal of Periodontology. 2008 Nov;79(11):979-86.
Mercado FB, Marshall RI, Bartold PM. Inter-relationships between rheumatoid arthritis and periodontal disease. A review. Journal of Clinical Periodontology. 2003 Apr;30(5):761-72.
Potikuri D, Dannana KC, Kanchinadam S, Agrawal S, Kancharla A, Rajasekhar L, et al. Periodontal disease is significantly higher in non-smoking treatment-naive rheumatoid arthritis patients: results from a case-control study. Annals of the Rheumatic Diseases. 2012 May 1;71(5):1541-4.
Okada M, Kobayashi T, Ito S, Yokoyama T, Komatsu Y, Abe A, et al. Periodontal treatment decreases levels of antibodies to Porphyromonas gingivalis and citrulline in patients with rheumatoid arthritis and periodontitis. Journal of Periodontology. 2013 Dec;84(12):e74-84.
Detert J, Pischon N, Burmester GR, Buttgereit F. The association between rheumatoid arthritis and periodontal disease. Arthritis Research & Therapy. 2010 Feb 18;12(5):218.
Scher JU, Ubeda C, Equinda M, Khanin R, Buischi Y, Viale A, et al. Periodontal disease and the oral microbiota in new-onset rheumatoid arthritis. Arthritis & Rheumatism. 2012 Nov;64(10):3083-94.
Bingham CO, Moni M. Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions. Current Opinion in Rheumatology. 2013 Mar 1;25(2):345-53.
Lundberg K, Wegner N, Yucel-Lindberg T, Venables PJ. Periodontitis in RA-the citrullinated enolase connection. Nature Reviews Rheumatology. 2010 Jul;6(12):727.
Dissick A, Redman RS, Jones M, Rangan BV, Reimold A, Griffiths GR, et al. Association of periodontitis with rheumatoid arthritis: a pilot study. Journal of Periodontology. 2010 Oct;81(10):223-30.
Araújo VM, Melo IM, Lima V. Relationship between periodontitis and rheumatoid arthritis: Review of the literature. Mediators of Inflammation. 2015 Jun 9;2015.
Wegner N, Wait R, Sroka A, Eick S, Nguyen KA, Lundberg K, et al. Peptidylarginine deiminase from Porphyromonas gingivalis citrullinates human fibrinogen and α-enolase: implications for autoimmunity in rheumatoid arthritis. Arthritis & Rheumatism. 2010 Jun;62(9):2662-72.
Pischon N, Hoedke D, Kurth T, Wellmann J, Knöfler M, Rothenbacher D, et al. Fatty liver, obesity and periodontitis. Journal of Clinical Periodontology. 2008 May;35(5):391-6.
Kobayashi T, Ito S, Yamamoto K, Sugita N, Kuroda T, Yamamoto K, et al. Risk of periodontitis in systemic sclerosis: a cross-sectional study of Japanese patients. Rheumatology. 2012 Jan 1;51(1):141-5.
Bingham CO, Moni M, Kavanaugh A. Comparative radiographic features of erosions in adult-onset Still's disease and rheumatoid arthritis by a standardized reading panel. Arthritis Care & Research. 2010 May;62(5):573-9.
de Pablo P, Dietrich T, Chapple IL, Milward M, Chowdhury M, Charles PJ, et al. The autoantibody repertoire in periodontitis: a role in the induction of autoimmunity to citrullinated proteins in rheumatoid arthritis?. Annals of the Rheumatic Diseases. 2014 Jan 1;73(3):580-6.
Mikuls TR, Thiele GM, Deane KD, Payne JB, O'Dell JR, Yu F, et al. Porphyromonas gingivalis and disease-related autoantibodies in individuals at increased risk of rheumatoid arthritis. Arthritis & Rheumatism. 2012 May;64(11):3522-30.
Mikuls TR, Payne JB, Yu F, Thiele GM, Reynolds RJ, Cannon GW, et al. Periodontitis and Porphyromonas gingivalis in patients with rheumatoid arthritis. Arthritis & Rheumatism. 2014 Mar;66(5):1090-100.
de Smit M, Westra J, Vissink A, Doornbos-van der Meer B, Brouwer E, van Winkelhoff AJ. Periodontitis in established rheumatoid arthritis patients: a cross-sectional clinical, microbiological and serological study. Arthritis Research & Therapy. 2012 Dec;14(6):R222.
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 epitope and severity of bone destruction. Annals of the Rheumatic Diseases. 2006 Jul 1;65(7):905-9.
Leech MT, Bartold PM. The association between rheumatoid arthritis and periodontitis. Best Practice & Research Clinical Rheumatology. 2015 Feb 1;29(2):189-201.
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