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Journal ArticleDOI

Hypothesis: The Humoral Immune Response to Oral Bacteria Provides a Stimulus for the Development of Rheumatoid Arthritis

TLDR
It is suggested that individuals predisposed to periodontal infection are exposed to antigens generated by PAD, with deiminated fibrin as a likely candidate, which become systemic immunogens and lead to intraarticular inflammation.
Abstract
Rheumatoid arthritis (RA) and adult periodontitis share common pathogenetic mechanisms and immunologic and pathological findings. One oral pathogen strongly implicated in the pathogenesis of periodontal disease, Porphyromonas gingivalis, possesses a unique microbial enzyme, peptidylarginine deiminase (PAD), the human equivalent of which has been identified as a susceptibility factor for RA. We suggest that individuals predisposed to periodontal infection are exposed to antigens generated by PAD, with deiminated fibrin as a likely candidate, which become systemic immunogens and lead to intraarticular inflammation. PAD engendered antigens lead to production of rheumatoid factor-containing immune complexes and provoke local inflammation, both in gingiva and synovium via Fc and C5a receptors.

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Journal ArticleDOI

Autoimmunity to specific citrullinated proteins gives the first clues to the etiology of rheumatoid arthritis

TL;DR: Rheumatoid arthritis (RA) is now clearly a true autoimmune disease with accumulating evidence of pathogenic disease‐specific autoimmunity to citrullinated proteins, and both smoking and Porphyromonas gingivalis are attractive etiological agents for further investigation into the gene/environment/autoimmunities triad of RA.
Journal ArticleDOI

Periodontitis in systemic rheumatic diseases.

TL;DR: There is evidence to suggest that periodontitis could indeed be a causal factor in the initiation and maintenance of the autoimmune inflammatory response that occurs in RA.
Journal ArticleDOI

Antibodies to citrullinated alpha-enolase peptide 1 are specific for rheumatoid arthritis and cross-react with bacterial enolase.

TL;DR: The data on sequence similarity and cross-reactivity with bacterial enolase may indicate a role for bacterial infection, particularly with P gingivalis, in priming autoimmunity in a subset of patients with RA.
Journal ArticleDOI

Periodontal inflamed surface area: quantifying inflammatory burden

TL;DR: PISA quantifies the inflammatory burden posed by periodontitis and can be easily and broadly applied.
References
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Journal ArticleDOI

Chromatin–IgG complexes activate B cells by dual engagement of IgM and Toll-like receptors

TL;DR: It is shown that effective activation of RF+ B cells is mediated by IgG2a–chromatin immune complexes and requires the synergistic engagement of the antigen receptor and a member of the MyD88-dependent Toll-like receptor (TLR) family.
Journal ArticleDOI

Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis.

TL;DR: Anti-CCP antibody and RFs of all isotypes predated the onset of RA by several years, indicating that citrullination and the production of anti- CCP and RF autoantibodies are early processes in RA.
Journal ArticleDOI

Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies.

TL;DR: It is shown that autoantibodies reactive with synthetic peptides containing the unusual amino acid citrulline, a posttranslationally modified arginine residue, are specifically present in the sera of RA patients, and the presence of these antibodies early in disease, even before other disease manifestations occur, are indicative for a possible role of citrulling epitopes in the pathogenesis of RA.
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