Periodontal microbiota in a cohort of Egyptian patients with rheumatoid arthritis and their relation to serum and gingival anticitrullinated peptide protein antibodies and different disease parameters

الملخص EN

Objective The possibility of infectious trigger at the gingival site in rheumatoid arthritis (RA) was reported in previous studies.

The aim of our study is to determine the organisms causing periodontitis (PD) in a cohort of Egyptian patients with RA and their relation to serum and gingival anticitrullinated peptide protein antibodies (ACPA) level and other disease parameters.

Patients and methods A prospective cohort study was conducted on 100 consecutive Egyptian patients with RA.

Disease activity was assessed by applying disease activity score-28, and functional status was measured using health assessment questionnaire.

Dental examination, serum rheumatoid factor, ACPA in serum and gingival crevicular fluid (GCF), and radiograph of the hands were done for all patients.

GCF culture was performed for all cases with PD for Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), and Prevotella intermedia (Pi).

Results Of the 100 patients, 66 patients had PD; of them, GCF culture was performed, and Pg, Aa, and Pi were found in 60.6, 15.2, and 30.3% of patients with RA with PD, respectively.

Gingival ACPA showed significant higher level with Pg than Pi cases (P=0.047).

No statistically significant difference was detected on comparing Pg with Aa or Aa with Pi.

Aa-positive cases were associated with significantly higher level of C-reactive protein than Pi-positive cases (P=0.029), whereas no statistical significant difference was detected between Pg- and Aa-positive or Pi-positive cases.

Conclusion Our findings support the relationship between PD and infectious trigger at the gingival site and RA.

Pg is the most prevalent periodontal microbiota in our cohort of patients with RA with PD that is associated with significant higher level of gingival ACPA.

None of the detected organisms correlated with the degree of RA activity or other disease parameters, apart from significantly higher C-reactive protein level with Aa.