Subgingival microbiome profiles in patients with established rheumatoid arthritis (RA) are similar to those observed in patients with osteoarthritis (OA), according to a study published in Rheumatology.1

Several previous studies have suggested an association between periodontitis and the pathogenesis of RA.2-12 Therefore, researchers hypothesized that patients with established RA would demonstrate a unique subgingival microbiome when compared with OA control patients and that this difference would be independent of periodontitis status.

Using samples and data from a large case-control study, the researchers profiled and compared the subgingival microbiome of patients with RA (n=260) and OA (n=296). They found that the results of this study failed to support the existence of a robust subgingival microbial fingerprint that could be used to discriminate patients with RA from those with OA.


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They did, however, find that the factors most closely associated with subgingival microbial composition included periodontitis, smoking, being married, and Caucasian race. This coincides with data reported in the full cohort that patients with RA were more likely to have periodontitis than patients with OA (38% vs 27%; P =.007).11

In contrast, the full cohort identified Prevotella and Leptotrichia taxa in greater abundance in patients with untreated RA compared with healthy control patients independent of periodontitis, but in this study, there was a decreased subgingival abundance of operational taxonomic units including Prevotella in RA cases compared with controls.1,11

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“Leveraging data from a large case-control study and accounting for multiple factors known to influence oral health status, results from this study failed to identify a subgingival microbial fingerprint that could reliably discriminate RA from OA patients,” the study authors concluded.1

References

  1. Mikuls TR, Walker C, Qiu F, et al. The subgingival microbiome in patients with established rheumatoid arthritis [published online March 19, 2018]. Rheumatology. doi: 10.1093/rheumatology/key052
  2. Bello-Gualtero JM, Lafaurie GI, Hoyos LX, et al. Periodontal disease in individuals with a genetic risk of developing arthritis and early rheumatoid arthritis: a cross-sectional study. J Periodontol. 2016;87:346-356.
  3. de Pablo P, Dietrich T, McAlindon TE. Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population. J Rheumatol. 2008;35:70-76.
  4. de Smit MD, Westra J, Vissink A, et al. Periodontitis in established rheumatoid arthritis patients: a crosssectional clinical, microbiological and serological study. Arthritis Res Ther. 2012;14:R222.
  5. Dissick A, Redman RS, Jones M, et al. Association of periodontitis with rheumatoid arthritis: a pilot study. J Periodontol. 2010;81:223-230.
  6. Kässer UR, Gleissner C, Dehne F, et al. Risk for periodontal disease in patients with longstanding rheumatoid arthritis. Arthritis Rheum 1997;40:2248-2251.
  7. Malmstrom M, Calonius PE. Teeth loss and the inflammation of teeth-supporting tissues in rheumatoid disease. Scand J Rheumatol 1975;4:49-55.
  8. Mercado FB, Marshall RI, Klestov AC, Bartold PM. Relationship between rheumatoid arthritis and periodontitis. J Periodontol 2001;72:779-787.
  9. Mikuls TR, Payne JB, Yu F, et al. Periodontitis and Porphyromonas gingivalis in patients with rheumatoid arthritis. Arthritis Rheumatol 2014;66:1090-1100.
  10. Pischon N, Pischon T, Kröger J, et al. Association among rheumatoid arthritis, oral hygiene, and periodontitis. J Periodontol 2008;79:979-986.
  11. Scher JU, Ubeda C, Equinda M, et al. Periodontal disease and the oral microbiota in new-onset rheumatoid arthritis. Arthritis Rheum 2012;64:3083-3094.
  12. Tolo K, Jorkjend L. Serum antibodies and loss of periodontal bone in patients with rheumatoid arthritis. J Clin Periodontol 1990;17:288-291.