Serum Antibodies to Oral Anaerobic Bacteria in Patients With Rheumatoid Arthritis

Mesut Ogrendik, MD; Siranus Kokino, MD; Ferda Ozdemir, MD; Philip S. Bird, BSc, MSc, PhD; Stephen Hamlet, BSc, MSc

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In This Article

Abstract and Introduction

Background: This study was conducted to determine the component that causes the disease in rheumatoid arthritis (RA), which shows great resemblance to periodontitis in a pathologic context.
Materials and Methods: Within this study, the pathogen-specific IgG levels formed against Porphyromonas gingivalis FDC 381, Prevotella melaninogenica ATCC 25845, Actinobacillus actinomycetemcomitans Y4, Bacteroides forsythus ATCC 43047, and Prevotella intermedia 25611 oral bacteria were researched from the blood serum samples of 30 RA patients and 20 healthy controls with the enzyme-linked immunosorbent assay (ELISA) method.
Results: The IgG levels of P gingivalis, P intermedia, P melaninogenica, and B forsythus were found to be significantly higher in RA patients when compared with those of the controls. Of the other bacteria antibodies, A actinomycetemcomitans was not found at greater levels in RA serum samples in comparison with the healthy samples.
Conclusion: The antibodies formed against P gingivalis, P intermedia, P melaninogenica, and B forsythus could be important to the etiopathogenesis of RA.

Rheumatoid arthritis (RA) is a polyarticular, chronic, inflammatory, and systemic disease.[1] In many previous studies, this rheumatic disease was found at high ratios for individuals with periodontitis and RA shows resemblance to periodontitis in many aspects pathologically.[2,3] HLA-DR4 tissue antigens are found at high frequencies in both patients with periodontitis and with RA. HLA-DR4 tissue antigens and their subtypes are directly associated with each disease.[4,5]

Porphyromonas gingivalis, Prevotella intermedia, Prevotella melaninogenica , and Bacteroides forsythus are gram-negative small basil quality obligate anaerobic bacteria and are held directly responsible for the formation of periodontitis (Periodontopathic bacteria). These bacteria usually secrete brown-black pigments and form colonies when they reproduce in blood agar plates used for their cultivation.[6] These bacteria were classified in the Bacteroides genus until 1988 and 1990, when they were reclassified to the Porphyromonas and Prevotella genera, respectively, in accordance with new classification strategies made by Shah and Collins.[7,8]

These bacteria are members of the normal human mouth flora, where they cause endodontitis, odontogenic inflammation, gingivitis, and mainly periodontitis. They are also found commensally in the body flora, where they cause chronic sinusitis, chronic recurrent tonsillitis, bronchitis, pneumonia, chronic otitis media, parotitis, intra-abdominal infection, genitourinary infection, and wound infections in immune-suppressed individuals as well as when in conjunction with facultative anaerobic bacteria (ie, Streptococcus pyogenes, Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumonia, Proteus mirabilis, and Escherichia coli ).[9]

A significant point here is that, although these bacteria are obligate anaerobic bacteria, when in conjunction with the facultative anaerobic bacteria mentioned above, they lead to mixed types of infections. In this study, we investigated the oral Bacteroides, Porphyromonas, and Prevotella bacteria antibodies usually found in periodontitis etiopathogenesis but from serum samples of RA patients.

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