Toothaches can cause and aggravate rheumatoid arthritis, and this bacteria is involved!

*For medical professional reading reference only

Clinical knowledge points that rheumatologists cannot miss

• Higher serum levels of Porphyromonas gingivalis may be an important marker of aggressive periodontal disease
  
  
  • A study from the United States reported a positive association between Porphyromonas gingivalis and periodontal disease, the most effective predictor of periodontal disease in adolescents
    
    
    • Several studies have demonstrated that Porphyromonas gingivalis can cause the human immune system to react with it to produce anti-CCP antibodies, which can promote the occurrence of RA in genetically susceptible individuals
      
      
      • Several studies have shown that RA patients have developed anti-CCP antibodies 5 years before diagnosis
        
        
        • Porphyromonas gingivalis induces an inflammatory response, and this bacterium is more likely to invade healthy and inflamed tissues than other bacteria such as Candida
          
          Seror et al.
          
          ▎New angle:

          The study by Ziebolz et al.

          
          
          
          
          
          A newly published meta-analysis on July 18, 2022 answers this question
          
          

          Figure 1: Main characteristics of studies selected for the meta-analysis

          The 28 studies represented 28 independent populations
          .
          
          The results of the meta-analysis showed that individuals exposed to Porphyromonas gingivalis had a significantly increased risk of developing rheumatoid arthritis, with an overall pooled OR of 1.
          86 (95%CI 1.
          43-2.
          43)
          Figure 2: Forest plot of binary data for association between P.
          gingivalis and RA
          .
          
          

           

          Subgroup analysis showed that the combined OR values ​​from European (OR=2.
          17, 95%CI 1.
          46-3.
          22) and North American (OR=2.
          50, 95%CI 1.
          23-5.
          08) populations were significantly higher than those from Asian populations (OR=1.
          11, 95%) CI 1.
          03~1.
          20)
          .
          
          

           

          Figure 3: Results of subgroup analysisIn addition, the sensitivity analysis of the 28 included studies also supports the reliability and robustness of the above conclusions
          .
          In conclusion, the conclusions of the above meta-analysis suggest that P.
          gingivalis exposure is a potential risk factor for RA
          .
          
          Prompt diagnosis and management decisions of Porphyromonas gingivalis antimicrobial therapy may prevent the onset and exacerbation of RA
          .
          
          More research is still needed to confirm the causal relationship between P.
          gingivalis exposure and the onset of RA
          .
          
          

          Summarize

          1.
          Periodontitis bacteria can prompt the immune system to produce anti-CCP antibodies, which in turn promotes the occurrence of RA
          .
          2.
          Maintaining oral hygiene, frequent scaling and early treatment when periodontal disease occurs may prevent the occurrence of RA
          .
          3.
          Rheumatologists should pay more attention to the periodontal problems of RA patients.
          Periodontal problems are more common in RA patients, and periodontal treatment may improve the symptoms and signs of RA to a certain extent
          .
          
          references:

          [1] Zhang Zhiyi.
          "Stomatology.
          The 9th Edition".
          Beijing: People's Health Publishing House, 2018

          [2] Gómez-Bañuelos E, Mukherjee A, Darrah E, Andrade F.
          Rheumatoid Arthritis-Associated Mechanisms of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.
          J Clin Med.
          2019;8(9):1309.
          Published 2019 Aug 26.
          doi:10.
          3390 /jcm8091309 

          [3] Johansson L, Sherina N, Kharlamova N, et al.
          Concentration of antibodies against Porphyromonas gingivalis is increased before the onset of symptoms of rheumatoid arthritis [published correction appears in Arthritis Res Ther.
          2016 Nov 4;18(1):257 ].
          Arthritis Res Ther.
          2016;18(1):201.
          Published 2016 Sep 7.
          doi:10.
          1186/s13075-016-1100-4

          [4] Li Y, Guo R, Oduro PK, et al.
          The Relationship Between Porphyromonas Gingivalis and Rheumatoid Arthritis: A Meta-Analysis.
          Front Cell Infect Microbiol.
          2022;12:956417.
          Published 2022 Jul 18.
          doi:10.
          3389/fcimb .
          2022.
          956417

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          Source of this article: Rheumatism and Immunity Channel of the Medical Community Author of this article: Yao Xiaoyan Review of this
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