TY - JOUR
T1 - Lessons to be learned from periodontitis
AU - Janssen, Koen M. J.
AU - Vissink, Arjan
AU - de Smit, Menke J.
AU - Westra, Johanna
AU - Brouwer, Elisabeth
PY - 2013/3
Y1 - 2013/3
N2 - Purpose of reviewThis article reviews the link between periodontitis and rheumatoid arthritis (RA) with regard to similarities in genetic risk factors and immunopathogenesis. Emphasis is paid to the potential role of the periodontal pathogen Porphyromonas gingivalis in the etiopathogenesis of both periodontitis and RA, in particular by post-translational modification of arginine into citrulline.Recent findingsP. gingivalis, a major periodontal pathogen, is presently known as the only bacterium in the oral flora which contains a peptidyl arginine deiminase enzyme (PAD). This enzyme is necessary for citrullination. As a result, citrullinated proteins and P. gingivalis PAD, PAD2 and PAD4 (expressed by infiltrating neutrophils) are found in periodontal tissues. Autoantibodies directed to citrullinated proteins, so-called anticitrullinated protein antibodies (ACPAs), are found to be present in gingival crevicular fluid originating from inflamed gingival tissue. Furthermore, treatment studies have revealed that nonsurgical periodontal treatment, that is removal of sub-gingival calculus and biofilm deposits, is accompanied by a reduction in the severity of RA.SummaryIn this study the similarities in immune response and tissue degradation between RA and periodontitis are reviewed. It is shown that the two diseases share the same environmental and genetic risk factors, apart from the fact that there is a link between both diseases via citrullination of proteins by human PAD and P. gingivalis PAD.
AB - Purpose of reviewThis article reviews the link between periodontitis and rheumatoid arthritis (RA) with regard to similarities in genetic risk factors and immunopathogenesis. Emphasis is paid to the potential role of the periodontal pathogen Porphyromonas gingivalis in the etiopathogenesis of both periodontitis and RA, in particular by post-translational modification of arginine into citrulline.Recent findingsP. gingivalis, a major periodontal pathogen, is presently known as the only bacterium in the oral flora which contains a peptidyl arginine deiminase enzyme (PAD). This enzyme is necessary for citrullination. As a result, citrullinated proteins and P. gingivalis PAD, PAD2 and PAD4 (expressed by infiltrating neutrophils) are found in periodontal tissues. Autoantibodies directed to citrullinated proteins, so-called anticitrullinated protein antibodies (ACPAs), are found to be present in gingival crevicular fluid originating from inflamed gingival tissue. Furthermore, treatment studies have revealed that nonsurgical periodontal treatment, that is removal of sub-gingival calculus and biofilm deposits, is accompanied by a reduction in the severity of RA.SummaryIn this study the similarities in immune response and tissue degradation between RA and periodontitis are reviewed. It is shown that the two diseases share the same environmental and genetic risk factors, apart from the fact that there is a link between both diseases via citrullination of proteins by human PAD and P. gingivalis PAD.
KW - citrullination
KW - peptidyl arginine deiminase
KW - periodontitis
KW - Porphyromonas gingivalis
KW - rheumatoid arthritis
KW - ACTIVE RHEUMATOID-ARTHRITIS
KW - PORPHYROMONAS-GINGIVALIS
KW - CITRULLINATED PROTEINS
KW - PEPTIDYLARGININE DEIMINASE
KW - AGGRESSIVE PERIODONTITIS
KW - RISK-FACTORS
KW - TOOTH LOSS
KW - DISEASE
KW - AUTOIMMUNITY
KW - PATHOGENESIS
U2 - 10.1097/BOR.0b013e32835d833d
DO - 10.1097/BOR.0b013e32835d833d
M3 - Review article
VL - 25
SP - 241
EP - 247
JO - CURRENT OPINION IN RHEUMATOLOGY
JF - CURRENT OPINION IN RHEUMATOLOGY
SN - 1040-8711
IS - 2
ER -