Periodontal Disease and P. Gingivalis in Rheumatoid Arthritis

Periodontal Disease and P. Gingivalis in Rheumatoid Arthritis

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.

Inclusion Criteria:

• Age 19 years or older
• Diagnosis of rheumatoid arthritis, or osteoarthritis
• Have 9 or more evaluable posterior teeth (out of a total of 28 teeth, excluding third molars)
• Willing and able to provide informed consent

Exclusion Criteria:

• Received tetracyclines within the last 6 months.
• Need for antibiotic premedication for dental probing.
• Pregnant or breast feeding