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- Title
Antibodies to Porphyromonas gingivalis Indicate Interaction Between Oral Infection, Smoking, and Risk Genes in Rheumatoid Arthritis Etiology.
- Authors
Kharlamova, Nastya; Jiang, Xia; Sherina, Natalia; Potempa, Barbara; Israelsson, Lena; Quirke, Anne‐Marie; Eriksson, Kaja; Yucel‐Lindberg, Tülay; Venables, Patrick J.; Potempa, Jan; Alfredsson, Lars; Lundberg, Karin
- Abstract
Objective To investigate the role of the periodontal pathogen Porphyromonas gingivalis in the etiology of rheumatoid arthritis (RA) by analyzing the antibody response to the P gingivalis virulence factor arginine gingipain type B (RgpB) in relation to anti-citrullinated protein antibodies (ACPAs), smoking, and HLA-DRB1 shared epitope (SE) alleles in patients with periodontitis, patients with RA, and controls. Methods Anti-RgpB IgG was measured by enzyme-linked immunosorbent assay in 65 periodontitis patients and 59 controls without periodontitis, and in 1,974 RA patients and 377 controls without RA from the Swedish population-based case-control Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study. Autoantibody status, smoking habits, and genetic data were retrieved from the EIRA database. Differences in antibody levels were examined using the Mann-Whitney U test. Unconditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs) for the association of anti-RgpB IgG with different subsets of RA patients. Results Anti-RgpB antibody levels were significantly elevated in periodontitis patients compared to controls without periodontitis, in RA patients compared to controls without RA, and in ACPA-positive RA patients compared to ACPA-negative RA patients. There was a significant association between anti-RgpB IgG and RA (OR 2.96 [95% CI 2.00, 4.37]), which was even stronger than the association between smoking and RA (OR 1.37 [95% CI 1.07, 1.74]), and in ACPA-positive RA there were interactions between anti-RgpB antibodies and both smoking and the HLA-DRB1 SE. Conclusion Our study suggests that the previously reported link between periodontitis and RA could be accounted for by P gingivalis infection, and we conclude that P gingivalis is a credible candidate for triggering and/or driving autoimmunity and autoimmune disease in a subset of RA patients.
- Subjects
SWEDEN; ALLELES; CHRONIC diseases; CONFIDENCE intervals; ENZYME-linked immunosorbent assay; GENETIC polymorphisms; PERIODONTITIS; QUESTIONNAIRES; RESEARCH funding; RHEUMATOID arthritis; STATISTICAL sampling; SMOKING; STATISTICS; LOGISTIC regression analysis; DATA analysis; CASE-control method; BACTERIAL antibodies; DATA analysis software; DESCRIPTIVE statistics; GRAM-negative anaerobic bacteria; ODDS ratio; MANN Whitney U Test
- Publication
Arthritis & Rheumatology, 2016, Vol 68, Issue 3, p604
- ISSN
2326-5191
- Publication type
Article
- DOI
10.1002/art.39491