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| Name | Class |
|---|---|
| Dallas VA Medical Center | FED |
| Washington D.C. Veterans Affairs Medical Center | FED |
| VA Salt Lake City Health Care System | FED |
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Periodontitis (PD) has been postulated to be a risk factor for the onset and progression of rheumatoid arthritis (RA). Recent reports suggest that infection with Porphyromonas gingivalis (P. gingivalis), a major oral pathogen in PD, could play a pivotal role in the development RA. The objective of this study is to examine the relationship of PD and P. gingivalis infection with the risk and severity of RA.
In this study, we will examine whether periodontitis (PD) and P. gingivalis impact rheumatoid arthritis (RA) risk by enrolling 300 patients with RA and 300 comparator patients with osteoarthritis and comparing results from comprehensive dental examinations and antibody responses to P. gingivalis. We will examine whether these associations are modified by the presence of certain genetic risk factors previously implicated in RA and whether evidence of infection with P. gingivalis precedes RA onset by examining banked sera from the Department of Defense Serum Repository (DoDSR) and the Studies of the Etiology of RA (SERA). We also plan to explore whether there are novel proteins expressed by P. gingivalis that drive autoimmunity in RA and whether immune responses to these bacterial proteins predict the future development of RA.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Participants with Rheumatoid Arthritis | Rheumatoid arthritis patients Digital xray of jaw and teeth Blood draw questionnaires Periodontal Examination Bilateral digital xray of hands |
| |
| Osteoarthritis | Osteoarthritis patients Digital xray of jaw and teeth Blood draw questionnaires Periodontal Examination |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Digital xray of jaw and teeth | Radiation | one time xray of jaw and teeth |
|
| Measure | Description | Time Frame |
|---|---|---|
| Show the associations of periodontitis with RA are primarily due to infection with P. gingivalis | Clinically defined PD will be more common in RA patients than in controls. 1.B.: Clinically defined PD will be associated with greater RA disease severity including autoantibody status and the presence and extent of radiographic disease progression. 1.C.: The associations of clinically defined PD with RA risk and severity will be explained by the presence of antibody to P. gingivalis. | within thirty days of enrollment |
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Inclusion Criteria:
Exclusion Criteria:
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UNebraskapatients Omaha VA Medical Center
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| Name | Affiliation | Role |
|---|---|---|
| Ted R Mikuls, MD, MSPH | University of Nebraska | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Veterans Affairs Medical Center, Omaha | Omaha | Nebraska | 68105 | United States |
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| D010003 | Osteoarthritis |
| D010510 | Periodontal Diseases |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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Blood specimens (serum, plasma and DNA)will be collected during a one time visit. Also bacterial samples will be collected from the gums of the subject's mouth.
| Blood draw | Procedure | Three to four tablespoons of blood drawn. |
|
| questionnaires | Other | completed questionnaires regarding patient's health and functional ability. |
|
| Periodontal Examination | Procedure | Periodontal examination including measurement of gum pockets with a probe. Bacterial samples taken. |
|
| Bilateral digital xray of hands | Other | One time digital xray of hands |
|
| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |