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Badillo-Soto MA, Rodríguez-Rodríguez M, Pérez-Pérez ME, Daza-Benitez L, Bollain-Y-Goytia JJ, Carrillo-Jiménez MA, Avalos-Díaz E, Herrera-Esparza R. Potential protein targets of the peptidylarginine deiminase 2 and peptidylarginine deiminase 4 enzymes in rheumatoid synovial tissue and its possible meaning. Eur J Rheumatol 2016; 3:44-49. [PMID: 27708970 DOI: 10.5152/eurjrheum.2015.0055] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 09/05/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The molecular mechanism of citrullination involves the calcium-dependent peptidylarginine deiminase (PAD) family of enzymes. These enzymes induce a stereochemical modification of normal proteins and transform them into autoantigens, which in rheumatoid arthritis trigger a complex cascade of joint inflammatory events followed by chronic synovitis, pannus formation, and finally, cartilage destruction. By hypothesizing that PAD2 and PAD4 enzymes produce autoantigens, we investigated five possible synovial protein targets of PAD enzymes. MATERIAL AND METHODS We measured PAD2, PAD4, and citrullinated proteins in 10 rheumatoid and 10 osteoarthritis synovial biopsies and then assessed the post-translational modifications of fibrinogen, cytokeratin, tubulin, IgG, and vimentin proteins using a double-fluorescence assay with specific antibodies and an affinity-purified anti-citrullinated peptide (CCP) antibody. The degree of co-localization was analyzed, and statistical significance was determined by ANOVA, Fisher's exact test, and regression analysis. RESULTS The principal results of this study demonstrated that citrullinated proteins, such as fibrinogen, IgG, and other probed proteins, were targets of PAD2 and PAD4 activity in rheumatoid synovial biopsies, whereas osteoarthritis biopsies were negative for this enzyme (p<0.0001). An analysis of citrullination sites using the UniProtKB/Swiss-Prot data bank predicts that the secondary structure of the analyzed proteins displays most of the sites for citrullination; a discussion regarding its possible meaning in terms of pathogenesis is made. CONCLUSION Our results support the conclusion that the synovial citrullination of proteins is PAD2 and PAD4 dependent. Furthermore, there is a collection of candidate proteins that can be citrullinated.
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Affiliation(s)
- Martha Adriana Badillo-Soto
- Department of Immunology, Unidad Académica de Ciencias Biológicas, Universidad Autónoma de Zacatecas, Zacatecas, México
| | - Mayra Rodríguez-Rodríguez
- Department of Immunology, Unidad Académica de Ciencias Biológicas, Universidad Autónoma de Zacatecas, Zacatecas, México
| | - María Elena Pérez-Pérez
- Department of Immunology, Unidad Académica de Ciencias Biológicas, Universidad Autónoma de Zacatecas, Zacatecas, México
| | - Leonel Daza-Benitez
- Unidad Médica de Alta Especialidad (UMAE) T1, Instituto Mexicano del Seguro Social (IMSS), León, Guanajuato, México
| | - Juan José Bollain-Y-Goytia
- Department of Immunology, Unidad Académica de Ciencias Biológicas, Universidad Autónoma de Zacatecas, Zacatecas, México
| | | | - Esperanza Avalos-Díaz
- Department of Immunology, Unidad Académica de Ciencias Biológicas, Universidad Autónoma de Zacatecas, Zacatecas, México
| | - Rafael Herrera-Esparza
- Department of Immunology, Unidad Académica de Ciencias Biológicas, Universidad Autónoma de Zacatecas, Zacatecas, México
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302
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Zenobia C, Hajishengallis G. Porphyromonas gingivalis virulence factors involved in subversion of leukocytes and microbial dysbiosis. Virulence 2016; 6:236-43. [PMID: 25654623 PMCID: PMC4601496 DOI: 10.1080/21505594.2014.999567] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The oral bacterium Porphyromonas gingivalis has special nutrient requirements due to its asaccharolytic nature subsisting on small peptides cleaved from host proteins. Using proteases and other virulence factors, P. gingivalis thrives as a component of a polymicrobial community in nutritionally favorable inflammatory environments. In this regard, P. gingivalis has a number of strategies that subvert the host immune response in ways that promote its colonization and facilitate the outgrowth of the surrounding microbial community. The focus of this review is to discuss at the molecular level how P. gingivalis subverts leukocytes to create a favorable environment for a select community of bacteria that, in turn, adversely affects the periodontal tissues.
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Affiliation(s)
- Camille Zenobia
- a Department of Microbiology; University of Pennsylvania School of Dental Medicine ; Philadelphia , PA , USA
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303
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Pratesi F, Panza F, Paolini I, Petrelli F, Puxeddu I, Casigliani-Rabl S, Ancillotti D, Alcaro C, Rovero P, Migliorini P. Fingerprinting of anti-citrullinated protein antibodies (ACPA): specificity, isotypes and subclasses. Lupus 2015; 24:433-41. [PMID: 25801886 DOI: 10.1177/0961203314560005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Anti-citrullinated protein antibodies (ACPA) are a family of rheumatoid arthritis (RA)-specific autoantibodies that recognize the amino acid citrulline, resulting from the post-translational modification of arginine. Peptidyl arginine deiminase, the enzyme responsible for citrullination, is present in humans in different isoforms with different tissue distribution, enzymatic activity and target specificity; nonetheless, the number of proteins citrullinated in physiological or pathological conditions is wide, but not every citrullinated protein is a target for antibodies. In pre-RA patients the immune response to citrullinated antigens is initially restricted, expands with time and, after the onset of the disease, is relatively stable. ACPA are heterogeneous in terms of not only fine specificity but also isotype and IgG subclasses usage. This heterogeneity may be relevant for the immunopathogenesis of RA, conditioning the interaction of antibodies with complement and Fc receptors.
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Affiliation(s)
- F Pratesi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - F Panza
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Paolini
- Toscana Biomarkers Spa, Siena, Italy
| | - F Petrelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Puxeddu
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Casigliani-Rabl
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - D Ancillotti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Alcaro
- Toscana Biomarkers Spa, Siena, Italy
| | - P Rovero
- Toscana Biomarkers Spa, Siena, Italy Department of Pharmacological Sciences, University of Florence, Florence, Italy
| | - P Migliorini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy Toscana Biomarkers Spa, Siena, Italy
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304
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Corsiero E, Bombardieri M, Carlotti E, Pratesi F, Robinson W, Migliorini P, Pitzalis C. Single cell cloning and recombinant monoclonal antibodies generation from RA synovial B cells reveal frequent targeting of citrullinated histones of NETs. Ann Rheum Dis 2015; 75:1866-75. [PMID: 26659717 PMCID: PMC5036240 DOI: 10.1136/annrheumdis-2015-208356] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/01/2015] [Indexed: 12/24/2022]
Abstract
Objectives Rheumatoid arthritis (RA) is characterised by breach of self-tolerance towards citrullinated antigens with generation of anti-citrullinated peptide/proteins antibodies (ACPA). Currently, the nature and source of citrullinated antigens driving the humoral autoimmune response within synovial ectopic lymphoid structures (ELS) is a crucial unknown aspect of RA pathogenesis. Here we characterised the autoreactive B-cell response of lesional B cells isolated from ELS+RA synovium. Methods Single synovial tissue CD19+cells were Fluorescence Activated Cell Sorting (FACS)-sorted and VH/VL Ig genes cloned to generate recombinant monoclonal antibodies (rmAbs) from patients with ELS+/ACPA+RA. Results RA-rmAbs immunoreactivity analysis provided the following key findings: (1) in a chIP-based array containing 300 autoantigens and in a ‘citrullinome’ multiplex assay, a strong reactivity against citrullinated histones H2A/H2B (citH2A/H2B) was observed in ∼40% of RA-rmAbs, followed by cit-fibrinogen and cit-vimentin; (2) anti-citH2A/H2B-reactive RA-rmAbs (but not anti-citH2A/H2B negative) selectively recognised neutrophil extracellular traps (NETs) from peripheral blood and/or RA joint neutrophils; (3) anti-citH2A/citH2B and anti-NET immunobinding was dependent on affinity maturation and was completely abrogated following reversion of hypermutated IgVH/VL genes to germline sequences; (4) ELS+ (not ELS−) RA synovial tissues engrafted into Severe Combined ImmunoDeficiency (SCID) mice released human anti-citH2A/citH2B and anti-NET antibodies in association with the intra-graft expression of CXCL13 and lymphotoxin (LT)-β, two master regulators of ELS. Conclusion We provided novel evidence that B cells differentiated within synovial ELS in the RA joints frequent target deiminated proteins which could be generated during NETosis of RA synovial neutrophils including histones. Thus, NETs could represent a source of citrullinated antigens fuelling the ACPA autoimmune response within the RA synovium.
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Affiliation(s)
- Elisa Corsiero
- Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Michele Bombardieri
- Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Emanuela Carlotti
- Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Federico Pratesi
- Clinical Immunology and Allergy Unit, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Paola Migliorini
- Clinical Immunology and Allergy Unit, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - Costantino Pitzalis
- Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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305
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Schwenzer A, Jiang X, Mikuls TR, Payne JB, Sayles HR, Quirke AM, Kessler BM, Fischer R, Venables PJ, Lundberg K, Midwood KS. Identification of an immunodominant peptide from citrullinated tenascin-C as a major target for autoantibodies in rheumatoid arthritis. Ann Rheum Dis 2015; 75:1876-83. [PMID: 26659718 PMCID: PMC5036245 DOI: 10.1136/annrheumdis-2015-208495] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/06/2015] [Indexed: 12/20/2022]
Abstract
Objectives We investigated whether citrullinated tenascin-C (cTNC), an extracellular matrix protein expressed at high levels in the joints of patients with rheumatoid arthritis (RA), is a target for the autoantibodies in RA. Methods Citrullinated sites were mapped by mass spectrometry in the fibrinogen-like globe (FBG) domain of tenascin-C treated with peptidylarginine deiminases (PAD) 2 and 4. Antibodies to cyclic peptides containing citrullinated sites were screened in sera from patients with RA by ELISA. Potential cross-reactivity with well-established anticitrullinated protein antibody (ACPA) epitopes was tested by inhibition assays. The autoantibody response to one immunodominant cTNC peptide was then analysed in 101 pre-RA sera (median 7 years before onset) and two large independent RA cohorts. Results Nine arginine residues within FBG were citrullinated by PAD2 and PAD4. Two immunodominant peptides cTNC1 (VFLRRKNG-cit-ENFYQNW) and cTNC5 (EHSIQFAEMKL-cit-PSNF-cit-NLEG-cit-cit-KR) were identified. Antibodies to both showed limited cross-reactivity with ACPA epitopes from α-enolase, vimentin and fibrinogen, and no reactivity with citrullinated fibrinogen peptides sharing sequence homology with FBG. cTNC5 antibodies were detected in 18% of pre-RA sera, and in 47% of 1985 Swedish patients with RA and 51% of 287 North American patients with RA. The specificity was 98% compared with 160 healthy controls and 330 patients with osteoarthritis. Conclusions There are multiple citrullination sites in the FBG domain of tenascin-C. Among these, one epitope is recognised by autoantibodies that are detected years before disease onset, and which may serve as a useful biomarker to identify ACPA-positive patients with high sensitivity and specificity in established disease.
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Affiliation(s)
- Anja Schwenzer
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Xia Jiang
- Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Ted R Mikuls
- Department of Medicine, University of Nebraska, Medical Center, Omaha, Nebraska, USA
| | - Jeffrey B Payne
- Department of Medicine, University of Nebraska, Medical Center, Omaha, Nebraska, USA Department of Surgical Specialties, University of Nebraska, Medical Center, College of Dentistry, Lincoln, Nebraska, USA
| | - Harlan R Sayles
- Department of Biostatistics, University of Nebraska, Medical Center, Omaha, Nebraska, USA
| | - Anne-Marie Quirke
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Benedikt M Kessler
- Nuffield Department of Medicine, Target Discovery Institute, University of Oxford, Oxford, UK
| | - Roman Fischer
- Nuffield Department of Medicine, Target Discovery Institute, University of Oxford, Oxford, UK
| | - Patrick J Venables
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Karin Lundberg
- Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kim S Midwood
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
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306
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Cantagrel A, Degboé Y. New autoantibodies associated with rheumatoid arthritis recognize posttranslationally modified self-proteins. Joint Bone Spine 2015; 83:11-7. [PMID: 26639222 DOI: 10.1016/j.jbspin.2015.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 10/22/2022]
Abstract
Citrullination, carbamylation and oxidation are posttranslational modifications of proteins that produce neoepitopes. Rheumatoid arthritis (RA) is an autoimmune disease of which one distinctive feature is the development of B-cell-mediated immunity against these neoepitopes. Antibodies to citrullinated proteins (ACPAs) were identified nearly two decades ago and are now widely used in clinical practice. The identification of additional citrullinated proteins as potential autoantibody targets has suggested new pathophysiological hypotheses and prompted studies of potential associations with disease severity or specific disease patterns. Carbamylation is a nonenzymatic posttranslational modification that produces homocitrullines, against which newly identified autoantibodies different from ACPAs have been found in over 15% of patients with RA. Finally, the development of antibodies to oxidized type II collagen reflects immunization against collagen modified by oxidation in relation to intraarticular oxidative stress. These new autoantibodies are both sensitive and specific and may therefore serve as early disease markers and as useful tools for therapeutic monitoring.
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Affiliation(s)
- Alain Cantagrel
- Centre de rhumatologie, hôpital Purpan, bâtiment Pierre-Paul-Riquet, place du Docteur-Baylac, 31059 Toulouse, France.
| | - Yannick Degboé
- Centre de rhumatologie, hôpital Purpan, bâtiment Pierre-Paul-Riquet, place du Docteur-Baylac, 31059 Toulouse, France
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307
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Mankia K, Emery P. Anti-Porphyromonas gingivalis
Antibodies in Rheumatoid Arthritis: Comment on the Article by Seror et al. Arthritis Rheumatol 2015; 67:3329-30. [DOI: 10.1002/art.39401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/18/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Kulveer Mankia
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital; Leeds UK
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust; Leeds UK
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital; Leeds UK
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust; Leeds UK
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308
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Fisher BA, Cartwright AJ, Quirke AM, de Pablo P, Romaguera D, Panico S, Mattiello A, Gavrila D, Navarro C, Sacerdote C, Vineis P, Tumino R, Lappin DF, Apatzidou D, Apazidou D, Culshaw S, Potempa J, Michaud DS, Riboli E, Venables PJ. Smoking, Porphyromonas gingivalis and the immune response to citrullinated autoantigens before the clinical onset of rheumatoid arthritis in a Southern European nested case-control study. BMC Musculoskelet Disord 2015; 16:331. [PMID: 26537917 PMCID: PMC4634856 DOI: 10.1186/s12891-015-0792-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 10/24/2015] [Indexed: 12/13/2022] Open
Abstract
Background Antibodies to citrullinated proteins (ACPA) occur years before RA diagnosis. Porphyromonas gingivalis expresses its own peptidylarginine deiminase (PPAD), and is a proposed aetiological factor for the ACPA response. Smoking is a risk factor for both ACPA-positive RA and periodontitis. We aimed to study the relation of these factors to the risk of RA in a prospective cohort. Methods We performed a nested case–control study by identifying pre-RA cases in four populations from the European Prospective Investigation into Cancer and nutrition, matched with three controls. Data on smoking and other covariates were obtained from baseline questionnaires. Antibodies to CCP2 and citrullinated peptides from α-enolase, fibrinogen, vimentin and PPAD were measured. Antibodies to arginine gingipain (RgpB) were used as a marker for P.gingivalis infection and validated in a separate cohort of healthy controls and subjects with periodontitis. Results We studied 103 pre-RA cases. RA development was associated with several ACPA specificities, but not with antibodies to citrullinated PPAD peptides. Antibody levels to RgpB and PPAD peptides were higher in smokers but were not associated with risk of RA or with pre-RA autoimmunity. Former but not current smoking was associated with antibodies to α-enolase (OR 4.06; 95 % CI 1.02, 16.2 versus 0.54; 0.09-3.73) and fibrinogen peptides (OR 4.24; 95 % CI 1.2-14.96 versus 0.58; 0.13-2.70), and later development of RA (OR 2.48; 95 % CI 1.27-4.84 versus 1.57; 0.85-2.93), independent of smoking intensity. Conclusions Smoking remains a risk factor for RA well before the clinical onset of disease. In this cohort, P.gingivalis is not associated with pre-RA autoimmunity or risk of RA in an early phase before disease-onset. Antibodies to PPAD peptides are not an early feature of ACPA ontogeny.
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Affiliation(s)
- Benjamin A Fisher
- Rheumatology Research Group, Centre for Translational Inflammation Research, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2WB, UK.
| | | | - Anne-Marie Quirke
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK.
| | - Paola de Pablo
- Rheumatology Research Group, Centre for Translational Inflammation Research, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2WB, UK.
| | - Dora Romaguera
- School of Public Health, Imperial College London, London, UK. .,CIBER-OBN (Fisiopatología de la Obesidad y Nutrición), Madrid, Spain.
| | - Salvatore Panico
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy.
| | - Amalia Mattiello
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy.
| | - Diana Gavrila
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain.
| | - Carmen Navarro
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain.
| | | | | | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M.P.Arezzo" Hospital, ASP Ragusa, Ragusa, Italy.
| | - David F Lappin
- University of Glasgow Dental School, University of Glasgow, Glasgow, UK.
| | | | - Danae Apazidou
- University of Glasgow Dental School, University of Glasgow, Glasgow, UK.
| | - Shauna Culshaw
- University of Glasgow Dental School, University of Glasgow, Glasgow, UK.
| | - Jan Potempa
- Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland. .,Oral Health and Systemic Research Group, School of Dentistry, University of Louisville, Louisville, USA.
| | - Dominique S Michaud
- School of Public Health, Imperial College London, London, UK. .,Department of Epidemiology, Brown University School of Public Health, Providence, USA.
| | - Elio Riboli
- School of Public Health, Imperial College London, London, UK.
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309
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Tsuda R, Ozawa T, Kobayashi E, Hamana H, Taki H, Tobe K, Sugiyama E, Iwamoto M, Imura J, Kishi H, Muraguchi A. Monoclonal antibody against citrullinated peptides obtained from rheumatoid arthritis patients reacts with numerous citrullinated microbial and food proteins. Arthritis Rheumatol 2015; 67:2020-31. [PMID: 25892475 DOI: 10.1002/art.39161] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 04/14/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To investigate the reactivity of monoclonal anti-citrullinated protein antibody (ACPA) obtained from peripheral blood B cells of rheumatoid arthritis (RA) patients with human autoantigens as well as environmental proteins by determining the essential epitope for the ACPA. METHODS A human monoclonal ACPA (cyclic citrullinated peptide antibody 1 [CCP-Ab1]) was obtained by screening peripheral blood lymphocytes from 31 patients with RA using a novel monoclonal antibody-secreting cell (ASC) screening system, the immunospot-array assay on a chip. The essential epitope for CCP-Ab1 was determined using epitope mapping. Then, human, microbial, and plant proteins that share the essential epitope identified were searched using BLAST. Finally, representative proteins identified by the search were produced in vitro, and their reactivity with CCP-Ab1 was examined. RESULTS CCP-Ab1 bound CCP in a citrulline-indispensable manner. In CCP, the 6 amino acid residues required for CCP-Ab1 binding were identified. In the BLAST search, 38 human, 56 viral, 1,383 fungal, 547 bacterial, and 1,072 plant proteins were found to share the essential epitope, and CCP-Ab1 reacted with all of the recombinant citrullinated proteins tested, which included the various environmental factors, such as various plant proteins that are part of the daily diet. CONCLUSION Our findings demonstrate, for the first time, that a monoclonal ACPA (CCP-Ab1) derived from RA patients cross-reacts not only with various autoantigens but also with numerous plant and microbial proteins. We propose that countless environmental factors, including microbes and diet, may trigger the generation of ACPAs that then cross-react with various citrullinated human autoantigens through molecular mimicry to induce RA.
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Affiliation(s)
- Reina Tsuda
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Tatsuhiko Ozawa
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Eiji Kobayashi
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Hiroshi Hamana
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Hirofumi Taki
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Kazuyuki Tobe
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Eiji Sugiyama
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | | | - Johji Imura
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Hiroyuki Kishi
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
| | - Atsushi Muraguchi
- Dana-Farber Cancer Institute, Boston, Massachusetts), Hiroshi Hamana, PhD, Hirofumi Taki, MD, PhD, Kazuyuki Tobe, MD, PhD, Eiji Sugiyama, MD, PhD (current address: Hiroshima University Hospital, Hiroshima, Japan), Johji Imura, MD, PhD, Hiroyuki Kishi, PhD, Atsushi Muraguchi, MD, PhD: University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Sugitani Campus, Toyama, Japan
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Gabarrini G, de Smit M, Westra J, Brouwer E, Vissink A, Zhou K, Rossen JWA, Stobernack T, van Dijl JM, van Winkelhoff AJ. The peptidylarginine deiminase gene is a conserved feature of Porphyromonas gingivalis. Sci Rep 2015; 5:13936. [PMID: 26403779 PMCID: PMC4585897 DOI: 10.1038/srep13936] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/11/2015] [Indexed: 01/27/2023] Open
Abstract
Periodontitis is an infective process that ultimately leads to destruction of the soft and hard tissues that support the teeth (the periodontium). Periodontitis has been proposed as a candidate risk factor for development of the autoimmune disease rheumatoid arthritis (RA). Porphyromonas gingivalis, a major periodontal pathogen, is the only known prokaryote expressing a peptidyl arginine deiminase (PAD) enzyme necessary for protein citrullination. Antibodies to citrullinated proteins (anti-citrullinated protein antibodies, ACPA) are highly specific for RA and precede disease onset. Objective of this study was to assess P. gingivalis PAD (PPAD) gene expression and citrullination patterns in representative samples of P. gingivalis clinical isolates derived from periodontitis patients with and without RA and in related microbes of the Porphyromonas genus. Our findings indicate that PPAD is omnipresent in P. gingivalis, but absent in related species. No significant differences were found in the composition and expression of the PPAD gene of P. gingivalis regardless of the presence of RA or periodontal disease phenotypes. From this study it can be concluded that if P. gingivalis plays a role in RA, it is unlikely to originate from a variation in PPAD gene expression.
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Affiliation(s)
- Giorgio Gabarrini
- Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, the Netherlands
| | - Menke de Smit
- Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, the Netherlands
| | - Johanna Westra
- Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, the Netherlands
| | - Elisabeth Brouwer
- Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, the Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, the Netherlands
| | - Kai Zhou
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - John W A Rossen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Tim Stobernack
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, the Netherlands.,Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, the Netherlands
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311
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Sandhya P, Danda D, Sharma D, Scaria V. Does the buck stop with the bugs?: an overview of microbial dysbiosis in rheumatoid arthritis. Int J Rheum Dis 2015; 19:8-20. [PMID: 26385261 DOI: 10.1111/1756-185x.12728] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The human body is an environmental niche which is home to diverse co-habiting microbes collectively referred as the human microbiome. Recent years have seen the in-depth characterization of the human microbiome and associations with diseases. Linking of the composition or number of the human microbiota with diseases and traits date back to the original work of Elie Metchnikoff. Recent advances in genomic technologies have opened up finer details and dynamics of this new science with higher precision. Microbe-rheumatoid arthritis connection, largely related to the gut and oral microbiomes, has showed up as a result - apart from several other earlier, well-studied candidate autoimmune diseases. Although evidence favouring roles of specific microbial species, including Porphyromonas, Prevotella and Leptotricha, has become clearer, mechanistic insights still continue to be enigmatic. Manipulating the microbes by traditional dietary modifications, probiotics, and antibiotics and by currently employed disease-modifying agents seems to modulate the disease process and its progression. In the present review, we appraise the existing information as well as the gaps in knowledge in this challenging field. We also discuss the future directions for potential clinical applications, including prevention and management of rheumatoid arthritis using microbial modifications.
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Affiliation(s)
- Pulukool Sandhya
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Disha Sharma
- GN Ramachandran Knowledge Center for Genome Informatics, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi, India.,Faculty of Life Sciences, Academy of Scientific and Innovative Research (AcSIR), Delhi, India
| | - Vinod Scaria
- GN Ramachandran Knowledge Center for Genome Informatics, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi, India.,Faculty of Life Sciences, Academy of Scientific and Innovative Research (AcSIR), Delhi, India
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312
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Reichert S, Schlumberger W, Dähnrich C, Hornig N, Altermann W, Schaller HG, Schulz S. Association of levels of antibodies against citrullinated cyclic peptides and citrullinated α-enolase in chronic and aggressive periodontitis as a risk factor of Rheumatoid arthritis: a case control study. J Transl Med 2015; 13:283. [PMID: 26319714 PMCID: PMC4552989 DOI: 10.1186/s12967-015-0625-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/31/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Periodontal disease could be a risk factor for rheumatoid arthritis (RA). It is assumed that the bacterial strain Porphyromonas gingivalis mediates citrullination of host peptides and thereby the generation of RA-associated autoantibodies in genetically predisposed individuals. For that reason non-RA individuals who suffered from generalized aggressive (GAgP, N = 51) and generalized chronic periodontitis (GChP, N = 50) were investigated regarding the occurrence of antibodies against citrullinated cyclic peptides (anti-CCP) and citrullinated α-enolase peptide-1 (anti-CEP-1) in comparison to non-RA non-periodontitis controls (N = 89). Furthermore, putative associations between infections with five periodontopathic bacteria or expression of certain human leucocyte antigens (HLA) to these autoantibodies were investigated. METHODS The presence of anti-CCP and anti-CEP-1 in plasma samples was conducted with enzyme linked immunosorbent assay. Subgingival plaque specimens were taken from the deepest pocket of each quadrant and pooled. For detection of DNA of five periodontopathic bacteria PCR with sequence specific oligonucleotides was carried out. Low resolution HLA typing was carried out with PCR with sequence specific primers. Differences between patients and controls were assessed using Chi square test with Yates correction or Fisher`s exact test if the expected number n in one group was <5. RESULTS Two patients with GAgP (3.9%), no patient with GChP and two controls (2.2%, pFisher = 0.662) were positive for anti-CEP-1 whereas no study participant was anti-CCP positive. Individuals with P. gingivalis were slightly more often anti-CEP-1 positive in comparison to individuals without P. gingivalis (3.2 vs. 1.1%, pFisher = 0.366). Carrier of HLA-DQB1*06 or the HLA combination DRB1*13; DRB3*; DQB1*06 were slightly more anti-CEP-1 positive (6.1 and 4.3%) than no carriers (0.7 and 0%, pFisher 0.053). CONCLUSIONS GAgP and GChP and the presence of periodontopathic bacteria are not associated with an increased risk for occurrence of anti-CCP and anti-CEP-1 autoantibodies. The putative relationship between periodontitis and RA should be investigated in further studies.
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Affiliation(s)
- Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther University Halle-Wittenberg, Große Steinstrasse 19, 06108, Halle (Saale), Germany.
| | | | | | | | - Wolfgang Altermann
- HLA Laboratory (Ghatt), Martin-Luther University Halle-Wittenberg, Halle, Germany.
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin-Luther University Halle-Wittenberg, Große Steinstrasse 19, 06108, Halle (Saale), Germany.
| | - Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther University Halle-Wittenberg, Große Steinstrasse 19, 06108, Halle (Saale), Germany.
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313
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Periodontal disease and subgingival microbiota as contributors for rheumatoid arthritis pathogenesis: modifiable risk factors? Curr Opin Rheumatol 2015; 26:424-9. [PMID: 24807405 DOI: 10.1097/bor.0000000000000076] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Since the early 1900s, the role of periodontal disease in the pathogenesis of rheumatoid arthritis has been a matter of intense research. The last decade has witnessed many advances supporting a link between periodontitis, the presence of specific bacterial species (i.e. Porphyromonas gingivalis) and their effects in immune response. This review will examine available evidence on the individuals. RECENT FINDINGS Epidemiological studies have stressed the commonalities shared by periodontal disease and rheumatoid arthritis. Many groups have focused their attention toward understanding the periodontal microbiota and its alterations in states of health and disease. The presence of circulating antibodies against periodontopathic bacteria and associated inflammatory response has been found in both rheumatoid arthritis (RA) patients and individuals at-risk for disease development. Most recently, the periodontal microbiota of smokers and patients with RA has been elucidated, revealing profound changes in the bacterial communities compared with those of healthy controls. This has led to several small clinical trials of progressive disease treatment as adjuvant for disease-modifying therapy in RA. SUMMARY Smoking and periodontal disease are emerging risk factors for the development of RA. Epidemiological, clinical, and basic research has further strengthened this association, pointing toward changes in the oral microbiota as possible contributors to systemic inflammation and arthritis.
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314
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Laugisch O, Wong A, Sroka A, Kantyka T, Koziel J, Neuhaus K, Sculean A, Venables PJ, Potempa J, Möller B, Eick S. Citrullination in the periodontium--a possible link between periodontitis and rheumatoid arthritis. Clin Oral Investig 2015; 20:675-83. [PMID: 26264638 DOI: 10.1007/s00784-015-1556-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 07/31/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aim of the present study was to assess human and bacterial peptidylarginine deiminase (PAD) activity in the gingival crevicular fluid (GCF) in the context of serum levels of antibodies against citrullinated epitopes in rheumatoid arthritis and periodontitis. MATERIALS AND METHODS Human PAD and Porphyromonas gingivalis-derived enzyme (PPAD) activities were measured in the GCF of 52 rheumatoid arthritis (RA) patients (48 with periodontitis and 4 without) and 44 non-RA controls (28 with periodontitis and 16 without). Serum antibodies against citrullinated epitopes were measured by ELISA. Bacteria being associated with periodontitis were determined by nucleic-acid-based methods. RESULTS Citrullination was present in 26 (50%) RA patients and 23 (48%) controls. PAD and PPAD activities were detected in 36 (69%) and 30 (58%) RA patients, respectively, and in 30 (68%) and 21 (50%) controls, respectively. PPAD activity was higher in RA and non-RA patients with periodontitis than in those without (p = 0.038; p = 0.004), and was detected in 35 of 59 P. gingivalis-positive samples, and in 16 of 37 P. gingivalis-negative samples in association with high antibody levels against that species. CONCLUSIONS PAD and PPAD activities within the periodontium are elevated in RA and non-RA patients with periodontitis. PPAD secreted by P. gingivalis residing in epithelial cells may exert its citrullinating activity in distant regions of the periodontium or even distant tissues. CLINICAL RELEVANCE In periodontitis, the citrullination of proteins/peptides by human and bacterial peptidylarginine deiminases may generate antibodies after breaching immunotolerance in susceptible individuals.
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Affiliation(s)
- Oliver Laugisch
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Alicia Wong
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387, Krakow, Poland
| | - Aneta Sroka
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387, Krakow, Poland
| | - Tomasz Kantyka
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387, Krakow, Poland
- Malopolska Center of Biotechnology, Jagiellonian University, 30-387, Krakow, Poland
| | - Joanna Koziel
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387, Krakow, Poland
| | - Klaus Neuhaus
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Patrick J Venables
- Kennedy Institute, Nuffield Dept of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, UK
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387, Krakow, Poland
- Malopolska Center of Biotechnology, Jagiellonian University, 30-387, Krakow, Poland
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, 40202, USA
| | - Burkhard Möller
- Department of Rheumatology, Clinical Immunology and Allergology, University Hospital of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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315
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Lee JY, Choi IA, Kim JH, Kim KH, Lee EY, Lee EB, Lee YM, Song YW. Association between anti-Porphyromonas gingivalis or anti-α-enolase antibody and severity of periodontitis or rheumatoid arthritis (RA) disease activity in RA. BMC Musculoskelet Disord 2015; 16:190. [PMID: 26265263 PMCID: PMC4542108 DOI: 10.1186/s12891-015-0647-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/27/2015] [Indexed: 01/29/2023] Open
Abstract
Background Periodontitis (PD) has been reported to be associated with rheumatoid arthritis (RA). Porphyromonas gingivalis (P. gingivalis) is a gram-negative anaerobic bacterium that is recognized as one of the major pathogenic organisms in PD and is the only bacterium known to express peptidylarginine deiminase (PAD). Antibody against human α-enolase (ENO1) is one of the autoantibodies in RA. ENO1 is a highly conserved protein, and could be a candidate molecule for molecular mimicry between bacterial and human proteins. In the present study, we measured serum antibody against P. gingivalis and human ENO1 in patients with RA and investigated their association with the severity of PD or disease activity of RA. Methods Two hundred, forty-eight patients with RA and 85 age- and sex-matched healthy controls were evaluated by rheumatologic and periodontal examinations. The serum levels of anti-P. gingivalis and anti-ENO1 antibodies were measured by an enzyme-linked immunosorbent assay (ELISA). Results Patients with RA had significantly higher levels of anti-P. gingivalis and anti-ENO1 antibody titers than the controls (p = 0.002 and 0.0001, respectively). Anti-P. gingivalis antibody titers significantly correlated with anti-ENO1 antibody titers in RA patients (r = 0.30, p < 0.0001). There were significant correlations between anti-P. gingivalis antibody titers and the gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP) and clinical attachment level (CAL) (p = 0.038, 0.004, 0.004 and 0.002, respectively) in RA. Anti-P. gingivalis antibody titers were not correlated with disease activity score 28 (DAS28) or anti-CCP titer. However, anti-ENO1 antibody titers were significantly correlated not only with the periodontal indices, such as PPD, BOP, and CAL (p = 0.013, 0.023 and 0.017, respectively), but also RA clinical characteristics, such as DAS28, anti-CCP titer, and ESR (p = 0.009, 0.015 and 0.001, respectively). Conclusion Anti-P. gingivalis and anti-ENO1 antibody titers were correlated with the severity of PD in RA. Anti-ENO1 antibody titers, but not anti-P. gingivalis antibody titers, were further associated with RA disease activity. Electronic supplementary material The online version of this article (doi:10.1186/s12891-015-0647-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joo Youn Lee
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology and College of Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.
| | - In Ah Choi
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
| | - Jin-Hee Kim
- Department of Periodontology, School of Dentistry, Seoul National University, Seoul, South Korea.
| | - Kyoung-Hwa Kim
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
| | - Eun Young Lee
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
| | - Eun Bong Lee
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
| | - Yong-Moo Lee
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
| | - Yeong Wook Song
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology and College of Medicine, Medical Research Center, Seoul National University, Seoul, South Korea. .,Division of Rheumatology, Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
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316
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Relationship between Periodontitis and Rheumatoid Arthritis: Review of the Literature. Mediators Inflamm 2015; 2015:259074. [PMID: 26347200 PMCID: PMC4539505 DOI: 10.1155/2015/259074] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 06/08/2015] [Accepted: 06/24/2015] [Indexed: 12/12/2022] Open
Abstract
Periodontitis (PD) and rheumatoid arthritis (RA) are immunoinflammatory diseases where leukocyte infiltration and inflammatory mediators induce alveolar bone loss, synovitis, and joint destruction, respectively. Thus, we reviewed the relationship between both diseases considering epidemiological aspects, mechanical periodontal treatment, inflammatory mediators, oral microbiota, and antibodies, using the keywords “periodontitis” and “rheumatoid arthritis” in PubMed database between January 2012 and March 2015, resulting in 162 articles. After critical reading based on titles and abstracts and following the inclusion and exclusion criteria, 26 articles were included. In the articles, women over 40 years old, smokers and nonsmokers, mainly constituted the analyzed groups. Eight studies broached the epidemiological relationship with PD and RA. Four trials demonstrated that the periodontal treatment influenced the severity of RA and periodontal clinical parameters. Nine studies were related with bacteria influence in the pathogenesis of RA and the presence of citrullinated proteins, autoantibodies, or rheumatoid factor in patients with PD and RA. Five studies investigated the presence of mediators of inflammation in PD and RA. In summary, the majority of the articles have confirmed that there is a correlation between PD and RA, since both disorders have characteristics in common and result from an imbalance in the immunoinflammatory response.
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317
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Horton DB, Scott FI, Haynes K, Putt ME, Rose CD, Lewis JD, Strom BL. Antibiotic Exposure and Juvenile Idiopathic Arthritis: A Case-Control Study. Pediatrics 2015; 136. [PMID: 26195533 PMCID: PMC4516942 DOI: 10.1542/peds.2015-0036] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Recent evidence has linked childhood antibiotic use and microbiome disturbance to autoimmune conditions. This study tested the hypothesis that antibiotic exposure was associated with newly diagnosed juvenile idiopathic arthritis (JIA). METHODS We performed a nested case-control study in a population-representative medical records database from the United Kingdom. Children with newly diagnosed JIA were compared with age- and gender-matched control subjects randomly selected from general practices containing at least 1 case, excluding those with inflammatory bowel disease, immunodeficiency, or other systemic rheumatic diseases. Conditional logistic regression was used to examine the association between antibacterial antibiotics (including number of antibiotic courses and timing) and JIA after adjusting for significant confounders. RESULTS Any antibiotic exposure was associated with an increased rate of developing JIA (adjusted odds ratio: 2.1 [95% confidence interval: 1.2-3.5]). This relationship was dose dependent (adjusted odds ratio over 5 antibiotic courses: 3.0 [95% confidence interval: 1.6-5.6]), strongest for exposures within 1 year of diagnosis, and did not substantively change when adjusting for number or type of infections. In contrast, nonbacterial antimicrobial agents (eg, antifungal, antiviral) were not associated with JIA. In addition, antibiotic-treated upper respiratory tract infections were more strongly associated with JIA than untreated upper respiratory tract infections. CONCLUSIONS Antibiotics were associated with newly diagnosed JIA in a dose- and time-dependent fashion in a large pediatric population. Antibiotic exposure may play a role in JIA pathogenesis, perhaps mediated through alterations in the microbiome.
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Affiliation(s)
- Daniel B. Horton
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;,Division of Rheumatology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Frank I. Scott
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;,Division of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kevin Haynes
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;,Clinical Epidemiology, HealthCore, Wilmington, Delaware; and
| | - Mary E. Putt
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Carlos D. Rose
- Division of Rheumatology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - James D. Lewis
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;,Division of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brian L. Strom
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;,Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey
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318
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Montgomery AB, Kopec J, Shrestha L, Thezenas ML, Burgess-Brown NA, Fischer R, Yue WW, Venables PJ. Crystal structure of Porphyromonas gingivalis peptidylarginine deiminase: implications for autoimmunity in rheumatoid arthritis. Ann Rheum Dis 2015. [PMID: 26209657 PMCID: PMC4893104 DOI: 10.1136/annrheumdis-2015-207656] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Periodontitis (PD) is a known risk factor for rheumatoid arthritis (RA) and there is increasing evidence that the link between the two diseases is due to citrullination by the unique bacterial peptidylarginine deiminase (PAD) enzyme expressed by periodontal pathogen Pophyromonas gingivalis (PPAD). However, the precise mechanism by which PPAD could generate potentially immunogenic peptides has remained controversial due to lack of information about the structural and catalytic mechanisms of the enzyme. OBJECTIVES By solving the 3D structure of PPAD we aim to characterise activity and elucidate potential mechanisms involved in breach of tolerance to citrullinated proteins in RA. METHODS PPAD and a catalytically inactive mutant PPAD(C351A) were crystallised and their 3D structures solved. Key residues identified from 3D structures were examined by mutations. Fibrinogen and α-enolase were incubated with PPAD and P. gingivalis arginine gingipain (RgpB) and citrullinated peptides formed were sequenced and quantified by mass spectrometry. RESULTS Here, we solve the crystal structure of a truncated, highly active form of PPAD. We confirm catalysis is mediated by the following residues: Asp130, His236, Asp238, Asn297 and Cys351 and show Arg152 and Arg154 may determine the substrate specificity of PPAD for C-terminal arginines. We demonstrate the formation of 37 C-terminally citrullinated peptides from fibrinogen and 11 from α-enolase following incubation with tPPAD and RgpB. CONCLUSIONS PPAD displays an unequivocal specificity for C-terminal arginine residues and readily citrullinates peptides from key RA autoantigens. The formation of these novel citrullinated peptides may be involved in breach of tolerance to citrullinated proteins in RA.
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Affiliation(s)
- Anna B Montgomery
- Kennedy institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jolanta Kopec
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Leela Shrestha
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Marie-Laetitia Thezenas
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Nicola A Burgess-Brown
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Roman Fischer
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Wyatt W Yue
- Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Patrick J Venables
- Kennedy institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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319
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Janssen KMJ, de Smit MJ, Brouwer E, de Kok FAC, Kraan J, Altenburg J, Verheul MK, Trouw LA, van Winkelhoff AJ, Vissink A, Westra J. Rheumatoid arthritis-associated autoantibodies in non-rheumatoid arthritis patients with mucosal inflammation: a case-control study. Arthritis Res Ther 2015; 17:174. [PMID: 26155788 PMCID: PMC4496865 DOI: 10.1186/s13075-015-0690-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 06/17/2015] [Indexed: 01/29/2023] Open
Abstract
Introduction Rheumatoid arthritis–associated autoantibodies (RA-AAB) can be present in serum years before clinical onset of rheumatoid arthritis (RA). It has been hypothesized that initiation of RA-AAB generation occurs at inflamed mucosal surfaces, such as in the oral cavity or lungs. The aim of this study was to assess systemic presence of RA-AAB in patients without RA who had oral or lung mucosal inflammation. Methods The presence of RA-AAB (immunoglobulin A [IgA] and IgG anti-cyclic citrullinated peptide 2 antibodies (anti-CCP2), IgM and IgA rheumatoid factor (RF), IgG anti-carbamylated protein antibodies and IgG and IgA anti-citrullinated peptide antibodies against fibrinogen, vimentin and enolase) were determined in sera of non-RA patients with periodontitis (PD, n = 114), bronchiectasis (BR, n = 80) or cystic fibrosis (CF, n = 41). Serum RA-AAB levels were compared with those of periodontally healthy controls (n = 36). Patients with established RA (n = 86) served as a reference group. Association of the diseases with RA-AAB seropositivity was assessed with a logistic regression model, adjusted for age, sex and smoking. Results Logistic regression analysis revealed that IgG anti-CCP seropositivity was associated with BR and RA, whereas the association with PD was borderline significant. IgA anti-CCP seropositivity was associated with CF and RA. IgM RF seropositivity was associated with RA, whereas the association with BR was borderline significant. IgA RF seropositivity was associated with CF and RA. Apart from an influence of smoking on IgA RF in patients with RA, there was no influence of age, sex or smoking on the association of RA-AAB seropositivity with the diseases. Anti-CarP levels were increased only in patients with RA. The same held for IgG reactivity against all investigated citrullinated peptides. Conclusion Although overall levels were low, RA-AAB seropositivity was associated with lung mucosal inflammation (BR and CF) and may be associated with oral mucosal inflammation (PD). To further determine whether mucosal inflammation functions as a site for induction of RA-AAB and precedes RA, longitudinal studies are necessary in which RA-AAB of specifically the IgA isotype should be assessed in inflamed mucosal tissues and/or in their inflammatory exudates.
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Affiliation(s)
- Koen M J Janssen
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
| | - Menke J de Smit
- Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
| | - Elisabeth Brouwer
- Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands.
| | - Fenne A C de Kok
- Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands.
| | - Jan Kraan
- Department of Pulmonology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
| | - Josje Altenburg
- Department of Pulmonary Diseases, Medical Center Alkmaar, Alkmaar, The Netherlands.
| | - Marije K Verheul
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Leendert A Trouw
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands. .,Department of Medical Microbiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
| | - Johanna Westra
- Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands.
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320
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Shimada A, Kobayashi T, Ito S, Okada M, Murasawa A, Nakazono K, Yoshie H. Expression of anti-Porphyromonas gingivalis peptidylarginine deiminase immunoglobulin G and peptidylarginine deiminase-4 in patients with rheumatoid arthritis and periodontitis. J Periodontal Res 2015; 51:103-11. [PMID: 26094771 DOI: 10.1111/jre.12288] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Autoimmunity against citrullinated proteins through peptidylarginine deiminase (PAD) may be involved in the pathophysiology of rheumatoid arthritis (RA). The present study evaluated the serum levels of antibodies to citrullinated proteins and to Porphyromonas gingivalis PAD (PPAD), and the endogenous expression of PAD-4, in individuals with and without RA, as well as before and after periodontal treatment. MATERIAL AND METHODS The study participants consisted of 52 patients with RA (RA group) and 26 age-, gender- and smoking status-matched healthy controls (non-RA group). Of the 52 patients, 26 were randomly assigned to receive oral hygiene instruction and supragingival scaling (RA subgroup). After periodontal and rheumatologic assessments, the serum levels of anti-cyclic citrullinated peptide (CCP) immunoglobulin G (IgG), anti-PPAD IgG and PAD-4 were determined using ELISA. RESULTS The serum levels of anti-CCP IgG and anti-PPAD IgG were significantly higher in the RA group than in the non-RA group (p < 0.001 and p = 0.03). A significant, positive correlation was observed between the serum levels of anti-PPAD IgG and anti-CCP IgG (p = 0.04), but not between the serum levels of PAD-4 and anti-CCP IgG. Multiple logistic regression analyses revealed a significant association between anti-PPAD IgG responses and RA after adjustment for age, gender and smoking (p = 0.004). Supragingival scaling significantly improved the periodontal condition and disease activity of RA (p < 0.05), but failed to decrease the serum levels of anti-CCP IgG, anti-PPAD IgG and PAD-4 after 2 mo of treatment. CONCLUSION These results might suggest an association between anti-PPAD IgG and anti-CCP IgG responses, implicating a role for PPAD in protein citrullination in patients with RA and periodontitis.
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Affiliation(s)
- A Shimada
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Kobayashi
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - S Ito
- Niigata Rheumatic Center, Shibata, Japan
| | - M Okada
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - A Murasawa
- Niigata Rheumatic Center, Shibata, Japan
| | - K Nakazono
- Niigata Rheumatic Center, Shibata, Japan
| | - H Yoshie
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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321
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Ogrendik M. Periodontal Pathogens are Likely to be Responsible for the Development of Ankylosing Spondylitis. Curr Rheumatol Rev 2015; 11:47-49. [PMID: 26002454 PMCID: PMC4997922 DOI: 10.2174/1573397111666150522094821] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 01/06/2023]
Abstract
The role of oral bacteria in the etiology of ankylosing spondylitis (AS) is examined in this review. Periodontitis is related to AS to a significant degree, and periodontitis is significantly more prevalent in patients with AS. Anti-Pophyromonas gingivalis and anti-Prevotella intermedia antibodies titers are higher in AS patients than in healthy subjects. Eight randomized controlled trials that used sulfasalazine were reviewed. Moxifloxacin and rifamycin are significantly effective in the treatment of AS. Periodontal pathogens are likely to be responsible for the development of AS in genetically susceptible individuals. These results will guide more comprehensive and efficacious treatment strategies for AS.
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Affiliation(s)
- Mesut Ogrendik
- Kozagac District, 253 Street, Park Apt house No:45-47, D:4, Buca-IZMIR, Turkey
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322
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Bright R, Proudman S, Rosenstein E, Bartold P. Is there a link between carbamylation and citrullination in periodontal disease and rheumatoid arthritis? Med Hypotheses 2015; 84:570-6. [DOI: 10.1016/j.mehy.2015.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 10/30/2014] [Accepted: 03/01/2015] [Indexed: 01/12/2023]
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323
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The Role of Posttranslational Protein Modifications in Rheumatological Diseases: Focus on Rheumatoid Arthritis. J Immunol Res 2015; 2015:712490. [PMID: 26090496 PMCID: PMC4451265 DOI: 10.1155/2015/712490] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/16/2015] [Accepted: 02/05/2015] [Indexed: 01/12/2023] Open
Abstract
The definition of posttranslational modification (PTM) encompasses a wide group of chemical reactions that allow modification and modulation of protein functions. The regulation of PTMs is crucial for the activity and survival of the cells. Dysregulation of PTMs has been observed in several pathological conditions, including rheumatoid arthritis (RA). RA is a systemic autoimmune disease primarily targeting the joints. The three PTMs mainly involved in this disease are glycosylation, citrullination, and carbamylation. Glycosylation is essential for antigen processing and presentation and can modulate immunoglobulin activity. Citrullination of self-antigens is strongly associated with RA, as demonstrated by the presence of antibodies directed to anti-citrullinated proteins in patients' sera. Carbamylation and its dysregulation have been recently associated with RA. Aim of this review is to illustrate the most significant alterations of these PTMs in RA and to evaluate their possible involvement in the pathogenesis of the disease.
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324
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de Smit MJ, Westra J, Brouwer E, Janssen KMJ, Vissink A, van Winkelhoff AJ. Periodontitis and Rheumatoid Arthritis: What Do We Know? J Periodontol 2015; 86:1013-9. [PMID: 25968957 DOI: 10.1902/jop.2015.150088] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Currently, in the field of rheumatology, there is much attention given towards the possible causality between periodontitis and rheumatoid arthritis (RA), specifically regarding the role of Porphyromonas gingivalis (Pg). This bacterium is unique, having a citrullinating enzyme. Antibodies against citrullinated proteins are rather specific for RA. METHODS Because causality is ultimately tested in longitudinal cohort studies which currently do not exist for periodontitis and RA, this commentary applied Bradford Hill criteria on the existing literature to assess causality as the most likely interpretation of this association. CONCLUSIONS From an epidemiologic point of view, patients with RA have a higher incidence of periodontal disease than individuals without RA. In addition, there is a dose-response pattern in the association between the severity of periodontitis and RA disease activity. There are indications that periodontitis precedes RA, but there is no evidence yet available to show that Pg plays a direct role in this temporal relationship. The role of the unique characteristic of citrullination by Pg remains unexplained. However, in animal models, citrullination by Pg plays a distinct role in the development and aggravation of experimental arthritis. Although the role of Pg in RA remains speculative, a causative role for periodontitis as a chronic inflammatory disease caused by infectious agents in RA seems biologically plausible.
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Affiliation(s)
- Menke J de Smit
- Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Johanna Westra
- Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen
| | - Elisabeth Brouwer
- Department of Rheumatology and Clinical Immunology, University of Groningen and University Medical Center Groningen
| | - Koen M J Janssen
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.,Department of Medical Microbiology, University of Groningen and University Medical Center Groningen
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325
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The association between rheumatoid arthritis and periodontitis. Best Pract Res Clin Rheumatol 2015; 29:189-201. [PMID: 26362738 DOI: 10.1016/j.berh.2015.03.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 02/23/2015] [Accepted: 03/02/2015] [Indexed: 01/07/2023]
Abstract
The relationship between rheumatoid arthritis and poor oral health has been recognised for many decades. The association between periodontal infection and the risk of developing RA has been the subject of epidemiological, clinical and basic science research in recent times. Converging and reproducible evidence now makes a clear case for the role of specific periodontal infective pathogens in initiating, amplifying and perpetuating rheumatoid arthritis. The unique enzymatic properties of the periodontal pathogen Porphyromonas gingivalis and its contribution to the burden of citrullinated peptides is now well established. The impact of localized infection such as periodontitis in shaping specific anti-citrullinated peptide immune responses highlights a key area for treatment, prevention and risk assessment in rheumatoid arthritis.
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326
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Hashimoto M, Yamazaki T, Hamaguchi M, Morimoto T, Yamori M, Asai K, Isobe Y, Furu M, Ito H, Fujii T, Terao C, Mori M, Matsuo T, Yoshitomi H, Yamamoto K, Yamamoto W, Bessho K, Mimori T. Periodontitis and Porphyromonas gingivalis in preclinical stage of arthritis patients. PLoS One 2015; 10:e0122121. [PMID: 25849461 PMCID: PMC4388350 DOI: 10.1371/journal.pone.0122121] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/17/2015] [Indexed: 12/12/2022] Open
Abstract
Purpose To determine whether the presence of periodontitis (PD) and Porphyromonas gingivalis (Pg) in the subgingival biofilm associates with the development of rheumatoid arthritis (RA) in treatment naïve preclinical stage of arthritis patients. Methods We conducted a prospective cohort study of 72 consecutive patients with arthralgia who had never been treated with any anti-rheumatic drugs or glucocorticoids. Periodontal status at baseline was assessed by dentists. PD was defined stringently by the maximal probing depth≧4 mm, or by the classification by the 5th European Workshop in Periodontology (EWP) in 2005 using attachment loss. Up to eight plaque samples were obtained from each patient and the presence of Pg was determined by Taqman PCR. The patients were followed up for 2 years and introduction rate of methotrexate (MTX) treatment on the diagnosis of RA was compared in patients with or without PD or Pg. Results Patients with PD (probing depth≧4mm) had higher arthritis activity (p = 0.02) and higher risk for future introduction of MTX treatment on the diagnosis of RA during the follow up than patients without PD (Hazard ratio 2.68, p = 0.03). Arthritis activity and risk for MTX introduction increased with the severity of PD assessed by EWP, although not statistically significant. On the other hand, presence of Pg was not associated with arthritis activity (p = 0.72) or the risk for MTX introduction (p = 0.45). Conclusion In treatment naïve arthralgia patients, PD, but not the presence of Pg, associates with arthritis activity and future requirement of MTX treatment on the diagnosis of RA.
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Affiliation(s)
- Motomu Hashimoto
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- * E-mail:
| | - Toru Yamazaki
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Morimoto
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Masashi Yamori
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keita Asai
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yu Isobe
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Moritoshi Furu
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takao Fujii
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chikashi Terao
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masato Mori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Matsuo
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Yoshitomi
- Center for Innovation in Immunoregulative Technology and Therapeutics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keiichi Yamamoto
- Department of Clinical Epidemiology and Biostatistics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Kurashiki, Japan
| | - Kazuhisa Bessho
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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327
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Affiliation(s)
- Robert Hal Scofield
- Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA; Medical Service, Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma, USA.
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328
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Animal models of rheumatoid arthritis: How informative are they? Eur J Pharmacol 2015; 759:278-86. [PMID: 25824900 DOI: 10.1016/j.ejphar.2015.03.047] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/06/2015] [Accepted: 03/12/2015] [Indexed: 12/19/2022]
Abstract
Animal models of arthritis are widely used to de-convolute disease pathways and to identify novel drug targets and therapeutic approaches. However, the high attrition rates of drugs in Phase II/III rates means that a relatively small number of drugs reach the market, despite showing efficacy in pre-clinical models. There is also increasing awareness of the ethical issues surrounding the use of animal models of disease and it is timely, therefore, to review the relevance and translatability of animal models of arthritis. In this paper we review the most commonly used animal models in terms of their pathological similarities to human rheumatoid arthritis as well as their response to drug therapy. In general, the ability of animal models to predict efficacy of biologics in man has been good. However, the predictive power of animal models for small molecules has been variable, probably because of differences in the levels of target knockdown achievable in vivo.
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329
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Oxidative and other posttranslational modifications in extracellular vesicle biology. Semin Cell Dev Biol 2015; 40:8-16. [PMID: 25721811 DOI: 10.1016/j.semcdb.2015.02.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 12/16/2022]
Abstract
Extracellular vesicles including exosomes, microvesicles and apoptotic vesicles, are phospholipid bilayer surrounded structures secreted by cells universally, in an evolutionarily conserved fashion. Posttranslational modifications such as oxidation, citrullination, phosphorylation and glycosylation play diverse roles in extracellular vesicle biology. Posttranslational modifications orchestrate the biogenesis of extracellular vesicles. The signals extracellular vesicles transmit between cells also often function via modulating posttranslational modifications of target molecules, given that extracellular vesicles are carriers of several active enzymes catalysing posttranslational modifications. Posttranslational modifications of extracellular vesicles can also contribute to disease pathology by e.g. amplifying inflammation, generating neoepitopes or carrying neoepitopes themselves.
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330
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Åhlin E, Elshafie AI, Nur MAM, Rönnelid J. Anti‐Citrullinated Peptide Antibodies in Sudanese Patients with
L
eishmania donovani
Infection Exhibit Reactivity not Dependent on Citrullination. Scand J Immunol 2015; 81:201-8. [DOI: 10.1111/sji.12265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 12/21/2014] [Indexed: 11/29/2022]
Affiliation(s)
- E. Åhlin
- Department of Immunology, Genetics and Pathology Uppsala University Uppsala Sweden
| | - A. I. Elshafie
- Department of Immunology, Genetics and Pathology Uppsala University Uppsala Sweden
- Department of Pathology and Microbiology Alribat University Hospital Khartoum Sudan
| | - M. A. M. Nur
- Unit of Rheumatology Alribat University Hospital Khartoum Sudan
| | - J. Rönnelid
- Department of Immunology, Genetics and Pathology Uppsala University Uppsala Sweden
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331
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Abstract
Periodontitis is a dysbiotic inflammatory disease with an adverse impact on systemic health. Recent studies have provided insights into the emergence and persistence of dysbiotic oral microbial communities that can mediate inflammatory pathology at local as well as distant sites. This Review discusses the mechanisms of microbial immune subversion that tip the balance from homeostasis to disease in oral or extra-oral sites.
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332
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Payne JB, Golub LM, Thiele GM, Mikuls TR. The Link Between Periodontitis and Rheumatoid Arthritis: A Periodontist's Perspective. CURRENT ORAL HEALTH REPORTS 2015; 2:20-29. [PMID: 25657894 PMCID: PMC4312393 DOI: 10.1007/s40496-014-0040-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In this review, we critically evaluate the case-control studies examining the relationship between rheumatoid arthritis (RA) and periodontitis, two common chronic inflammatory diseases with a similar host-mediated pathogenesis. We review the "two-hit" periodontitis model that our group previously proposed, in which we elucidate how a systemic disease such as RA can potentially exacerbate or initiate periodontitis. Furthermore, we discuss adjunctive host modulation therapy, originally developed for periodontitis (i.e., subantimicrobial-dose doxycycline alone or in combination with an anti-inflammatory agent), to simultaneously mitigate RA and periodontitis. Finally, we review studies describing periodontal treatment effects on both RA disease activity measures and systemic inflammation. Current evidence suggests that an association exists between periodontitis and RA. Well-designed multicenter longitudinal clinical trials and studies with sufficient sample sizes are needed to ascertain the temporal relationship between these two diseases and whether periodontal treatment can reduce the severity of RA or prevent its onset.
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Affiliation(s)
- Jeffrey B. Payne
- Department of Surgical Specialties, Division of Periodontics, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE USA
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE USA
- Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, 40th & Holdrege, Lincoln, NE 68583 USA
| | - Lorne M. Golub
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, New York 11794-8700 USA
| | - Geoffrey M. Thiele
- Omaha Veterans Affairs Medical Center (VAMC) and Nebraska Arthritis Outcomes Research Center, Division of Rheumatology, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, 983025 Nebraska Medical Center, Omaha, NE 68198-3025 USA
| | - Ted R. Mikuls
- Omaha Veterans Affairs Medical Center (VAMC) and Nebraska Arthritis Outcomes Research Center, Division of Rheumatology, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, 983025 Nebraska Medical Center, Omaha, NE 68198-3025 USA
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333
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Zhao S, Goodson NJ. Smoking and comorbidities in rheumatoid arthritis: what we know and what we can do? ACTA ACUST UNITED AC 2015. [DOI: 10.2217/ijr.14.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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334
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Valesini G, Gerardi MC, Iannuccelli C, Pacucci VA, Pendolino M, Shoenfeld Y. Citrullination and autoimmunity. Autoimmun Rev 2015; 14:490-7. [PMID: 25636595 DOI: 10.1016/j.autrev.2015.01.013] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/19/2015] [Indexed: 01/27/2023]
Abstract
Autoimmune diseases are characterized by the body's own immune system attack to the self-tissues, a condition enabled, in predisposed subjects, by the reduction of self-tolerance. A central role has been recently recognized to post-translational modifications, since they can promote generation of neo-(auto)antigens and in turn an autoimmune response. During the last years great attention has been paid to citrullination, because of its role in inducing anti-citrullinated proteins/peptide antibodies (ACPA), a class of autoantibodies with diagnostic, predictive and prognostic value for Rheumatoid Arthritis (RA). Nonetheless, citrullination has been reported to be a process present in a wide range of inflammatory tissues. Indeed, citrullinated proteins have been detected also in other inflammatory arthritides and in inflammatory conditions other than arthritides (polymyositis, inflammatory bowel disease and chronic tonsillitis). Moreover, environmental exposure to cigarette smoke and nanomaterials of air pollution may be able to induce citrullination in lung cells prior to any detectable onset of inflammatory responses, suggesting that protein citrullination could be considered as a sign of early cellular damage. Accordingly, citrullination seems to be implicated in all those para-physiological processes, such as cells death pathways, in which intracellular calcium concentration raises to higher levels than in physiologic conditions: hence, peptidylarginine deiminases enzymes are activated during apoptosis, autophagy and NETosis, processes which are well-known to be implicated in autoimmunity. Taken together, these data support the hypothesis that rather than being a disease-dependent process, citrullination is an inflammatory-dependent condition that plays a central role in autoimmune diseases.
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Affiliation(s)
- Guido Valesini
- Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia - Sapienza Università di Roma, Rome, Italy.
| | - Maria C Gerardi
- Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia - Sapienza Università di Roma, Rome, Italy
| | - Cristina Iannuccelli
- Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia - Sapienza Università di Roma, Rome, Italy
| | - Viviana A Pacucci
- Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia - Sapienza Università di Roma, Rome, Italy
| | - Monica Pendolino
- Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia - Sapienza Università di Roma, Rome, Italy
| | - Yehuda Shoenfeld
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Tel-Aviv University, Israel
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335
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Lugli EB, Correia RESM, Fischer R, Lundberg K, Bracke KR, Montgomery AB, Kessler BM, Brusselle GG, Venables PJ. Expression of citrulline and homocitrulline residues in the lungs of non-smokers and smokers: implications for autoimmunity in rheumatoid arthritis. Arthritis Res Ther 2015; 17:9. [PMID: 25600626 PMCID: PMC4349479 DOI: 10.1186/s13075-015-0520-x] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 01/07/2015] [Indexed: 12/15/2022] Open
Abstract
Introduction Smoking is a well-established risk factor for rheumatoid arthritis (RA), and it has been proposed that smoking-induced citrullination renders autoantigens immunogenic. To investigate this mechanism, we examined human lung tissue from 40 subjects with defined smoking status, with or without chronic obstructive pulmonary disease (COPD), and control tissues from other organs for citrullinated proteins and the deiminating enzymes peptidylarginine deiminase type-2 (PAD2) and -4 (PAD4). Methods Lung tissue samples, dissected from lobectomy specimens from 10 never smokers, 10 smokers without airflow limitation, 13 COPD smokers and eight COPD ex-smokers, and control tissue samples (spleen, skeletal muscle, liver, ovary, lymph node, kidney and heart), were analysed for citrullinated proteins, PAD2 and PAD4 by immunoblotting. Citrulline and homocitrulline residues in enolase and vimentin were analysed by partial purification by gel electrophoresis followed by mass spectrometry in 12 of the lung samples and one from each control tissues. Band intensities were scored semi-quantitatively and analysed by two-tailed Mann-Whitney T-test. Results Within the lung tissue samples, citrullinated proteins, PAD2 and PAD4 were found in all samples, with an increase in citrullination in COPD (P = 0.039), but minimal difference between smokers and non-smokers (P = 0.77). Citrullination was also detected at lower levels in the tissues from other organs, principally in lymph node, kidney and skeletal muscle. Mass spectrometry of the lung samples showed that vimentin was citrullinated at positions 71, 304, 346, 410 and 450 in non-smokers and smokers both with and without COPD. A homocitrulline at position 104 was found in four out of six COPD samples and one out of six non-COPD. Citrulline-450 was also found in three of the control tissues. There were no citrulline or homocitrulline residues demonstrated in α-enolase. Conclusions We have shown evidence of citrullination of vimentin, a major autoantigen in RA, in both non-smokers and smokers. The increase in citrullinated proteins in COPD suggests that citrullination in the lungs of smokers is mainly due to inflammation. The ubiquity of citrullination of vimentin in the lungs and other tissues suggests that the relationship between smoking and autoimmunity in RA may be more complex than previously thought. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0520-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elena B Lugli
- Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, UK.
| | - Raquel E S M Correia
- Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, UK.
| | - Roman Fischer
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7FZ, UK.
| | - Karin Lundberg
- Karolinska Institute, Department of Medicine, Solnavägen 1, Solna, 171 76, Stockholm, Sweden.
| | - Ken R Bracke
- Laboratory for Translational Research of Obstructive Pulmonary Disease, Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan, 185-9000, Ghent, Belgium.
| | - Anna B Montgomery
- Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, UK.
| | - Benedikt M Kessler
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7FZ, UK.
| | - Guy G Brusselle
- Laboratory for Translational Research of Obstructive Pulmonary Disease, Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan, 185-9000, Ghent, Belgium.
| | - Patrick J Venables
- Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, Oxford, OX3 7FY, UK.
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336
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Sofat N, Wait R, Robertson SD, Baines DL, Baker EH. Interaction between extracellular matrix molecules and microbial pathogens: evidence for the missing link in autoimmunity with rheumatoid arthritis as a disease model. Front Microbiol 2015; 5:783. [PMID: 25642219 PMCID: PMC4294210 DOI: 10.3389/fmicb.2014.00783] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 12/21/2014] [Indexed: 12/29/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterized by inflammation followed by tissue rebuilding or fibrosis. A failure by the body to regulate inflammation effectively is one of the hallmarks of RA. The interaction between the external environment and the human host plays an important role in the development of autoimmunity. In RA, the observation of anti-cyclic citrullinated peptide antibodies (ACPA) to autoantigens is well recognized. Citrullination is a post-translational modification mediated by peptidyl arginine deiminases, which exist in both mammalian and bacterial forms. Previous studies have shown how proteins expressed in the human extracellular matrix (ECM) acquire properties of damage-associated molecular patterns (DAMPs) in RA and include collagens, tenascin-C, and fibronectin (FN). ECM DAMPs can further potentiate tissue damage in RA. Recent work has shown that citrullination in RA occurs at mucosal sites, including the oral cavity and lung. Mucosal sites have been linked with bacterial infection, e.g., periodontal disease, where exogenous pathogens are implicated in the development of autoimmunity via an infectious trigger. Proteases produced at mucosal sites, both by bacteria and the human host, can induce the release of ECM DAMPs, thereby revealing neoepitopes which can be citrullinated and lead to an autoantibody response with further production of ACPA. In this perspectives article, the evidence for the interplay between the ECM and bacteria at human mucosal surfaces, which can become a focus for citrullination and the development of autoimmunity, is explored. Specific examples, with reference to collagen, fibrinogen, and FN, are discussed.
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Affiliation(s)
- Nidhi Sofat
- Institute of Infection and Immunity, St George's, University of London London, UK
| | - Robin Wait
- The Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford Oxford, UK
| | - Saralili D Robertson
- Institute of Infection and Immunity, St George's, University of London London, UK
| | - Deborah L Baines
- Institute of Infection and Immunity, St George's, University of London London, UK
| | - Emma H Baker
- Institute of Infection and Immunity, St George's, University of London London, UK
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337
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Scher JU, Abramson SB. The microbiome in rheumatic diseases. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00019-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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338
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Utility of Autoantibodies as Biomarkers for Diagnosis and Staging of Neurodegenerative Diseases. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 122:1-51. [DOI: 10.1016/bs.irn.2015.05.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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339
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Gnotobiology and the Study of Complex Interactions between the Intestinal Microbiota, Probiotics, and the Host. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00008-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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340
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Prevotella copri and the microbial pathogenesis of rheumatoid arthritis. ACTA ACUST UNITED AC 2014; 11:61-3. [PMID: 25555460 DOI: 10.1016/j.reuma.2014.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 10/20/2014] [Accepted: 11/07/2014] [Indexed: 12/27/2022]
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341
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Salemi S, Biondo MI, Fiorentino C, Argento G, Paolantonio M, Di Murro C, Malagnino VA, Canzoni M, Diamanti AP, D'Amelio R. Could early rheumatoid arthritis resolve after periodontitis treatment only?: case report and review of the literature. Medicine (Baltimore) 2014; 93:e195. [PMID: 25501069 PMCID: PMC4602768 DOI: 10.1097/md.0000000000000195] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Rheumatoid arthritis (RA) is an immune-mediated polyarthritis; currently no pathogenic agent has been identified as a disease trigger. A patient with RA, presumably caused by periodontal infection, whose remission has been observed after periodontitis treatment in absence of specific RA therapy, is reported here for the first time, to our knowledge. A 61-year-old male patient presented migrant arthritis associated with antibodies against citrullinated protein antigens positivity. The clinical features allowed to make RA diagnosis according to the 2010 European League against Rheumatism/American College of Rheumatology RA classification criteria. X-ray of the second upper molar showed chronic apical periodontitis. After its treatment, arthritis remission has been observed in the absence of specific RA therapy. It has been suggested that periodontitis may have a trigger role in RA pathogenesis. This could be explained by the enzymatic action of Porphyromonas gingivalis, probably leading to break tolerance to collagen. The identification and subsequent treatment of periodontitis should therefore be considered pivotal in RA prophylaxis and management.
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Affiliation(s)
- Simonetta Salemi
- From the Division of Allergy, Clinical Immunology and Rheumatology (SS, MIB, CF, MC, APD, RD); Division of Radiology (GA), S. Andrea University Hospital, Sapienza University of Rome, Rome; Department of Periodontology (MP, CDM), G. D'Annunzio University; and Department of Endodontics (VAM), G. D'Annunzio University, Chieti-Pescara, Italy
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342
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Arunachalam LT. Autoimmune correlation of rheumatoid arthritis and periodontitis. J Indian Soc Periodontol 2014; 18:666-9. [PMID: 25425834 PMCID: PMC4239762 DOI: 10.4103/0972-124x.142470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 12/25/2013] [Indexed: 11/17/2022] Open
Abstract
Rheumatoid arthritis and periodontitis, both, chronic inflammatory diseases share certain common diagnostic, pathological, immunogenetic and therapeutic features. A recently discovered enzymatic mimicry between human and bacterial species is novel and it opens up a new terrain for therapeutic blockade in the management of rheumatoid arthritis.
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343
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van der Woude D, Toes REM, Scherer HU. How undifferentiated arthritis evolves into chronic arthritis. Best Pract Res Clin Rheumatol 2014; 28:551-64. [PMID: 25481549 DOI: 10.1016/j.berh.2014.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Undifferentiated arthritis (UA) is a frequently occurring clinical presentation with a variable outcome. While some forms of UA will spontaneously remit, other forms will progress to chronic arthritis; an outcome that would preferably be prevented. Which immunological factors are normally at the basis of resolution of inflammation, and what, on the other hand, causes inflammation to persist? This review provides an overview of the immunological mechanisms involved in these two scenarios, including specific examples of how these mechanisms apply, or can be influenced in rheumatic diseases. Furthermore, what do we know about risk factors for chronic arthritis, such as the development of autoantibodies? The recent years have provided many insights concerning risk factors for autoantibody-positive versus autoantibody-negative rheumatoid arthritis, which are discussed along with a possible pathophysiological model incorporating autoantibodies into the larger process of disease development. Finally, the evolution of the autoantibody response over time is described.
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Affiliation(s)
- D van der Woude
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
| | - R E M Toes
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
| | - H U Scherer
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
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344
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Ksiazek M, Mizgalska D, Enghild JJ, Scavenius C, Thogersen IB, Potempa J. Miropin, a novel bacterial serpin from the periodontopathogen Tannerella forsythia, inhibits a broad range of proteases by using different peptide bonds within the reactive center loop. J Biol Chem 2014; 290:658-70. [PMID: 25389290 DOI: 10.1074/jbc.m114.601716] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
All prokaryotic genes encoding putative serpins identified to date are found in environmental and commensal microorganisms, and only very few prokaryotic serpins have been investigated from a mechanistic standpoint. Herein, we characterized a novel serpin (miropin) from the human pathogen Tannerella forsythia, a bacterium implicated in initiation and progression of human periodontitis. In contrast to other serpins, miropin efficiently inhibited a broad range of proteases (neutrophil and pancreatic elastases, cathepsin G, subtilisin, and trypsin) with a stoichiometry of inhibition of around 3 and second-order association rate constants that ranged from 2.7 × 10(4) (cathepsin G) to 7.1 × 10(5) m(-1)s(-1) (subtilisin). Inhibition was associated with the formation of complexes that were stable during SDS-PAGE. The unusually broad specificity of miropin for target proteases is achieved through different active sites within the reactive center loop upstream of the P1-P1' site, which was predicted from an alignment of the primary structure of miropin with those of well studied human and prokaryotic serpins. Thus, miropin is unique among inhibitory serpins, and it has apparently evolved the ability to inhibit a multitude of proteases at the expense of a high stoichiometry of inhibition and a low association rate constant. These characteristics suggest that miropin arose as an adaptation to the highly proteolytic environment of subgingival plaque, which is exposed continually to an array of host proteases in the inflammatory exudate. In such an environment, miropin may function as an important virulence factor by protecting bacterium from the destructive activity of neutrophil serine proteases. Alternatively, it may act as a housekeeping protein that regulates the activity of endogenous T. forsythia serine proteases.
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Affiliation(s)
- Miroslaw Ksiazek
- From the Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland,
| | - Danuta Mizgalska
- From the Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
| | - Jan J Enghild
- Center for Insoluble Protein Structures (inSPIN) and Interdisciplinary Nanoscience Center (iNANO) at the Department of Molecular Biology and Genetics, Aarhus University, Aarhus DK-8000, Denmark, and
| | - Carsten Scavenius
- Center for Insoluble Protein Structures (inSPIN) and Interdisciplinary Nanoscience Center (iNANO) at the Department of Molecular Biology and Genetics, Aarhus University, Aarhus DK-8000, Denmark, and
| | - Ida B Thogersen
- Center for Insoluble Protein Structures (inSPIN) and Interdisciplinary Nanoscience Center (iNANO) at the Department of Molecular Biology and Genetics, Aarhus University, Aarhus DK-8000, Denmark, and
| | - Jan Potempa
- From the Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland, Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky 40202
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345
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Konig MF, Bingham CO, Andrade F. PPAD is not targeted as a citrullinated protein in rheumatoid arthritis, but remains a candidate for inducing autoimmunity. Ann Rheum Dis 2014; 74:e8. [PMID: 25381231 DOI: 10.1136/annrheumdis-2014-206681] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Maximilian F Konig
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Clifton O Bingham
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Felipe Andrade
- Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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346
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Abstract
Multiple studies demonstrate that there is a period of development of rheumatoid arthritis (RA) during which there are elevations of disease-related biomarkers, including autoantibodies, in the absence of and prior to the development of RA; this period can be termed 'preclinical RA'. These 'preclinical' autoantibodies including rheumatoid factor and antibodies to citrullinated protein antigens, and more recent studies have also identified additional autoantibodies and a wide range of inflammatory biomarkers. These findings in conjunction with established and emerging data about genetic and environmental risk factors for RA support a model of disease development where certain factors lead to an initial triggering of RA-related autoimmunity that expands over time to the point where symptomatic arthritis classifiable as RA develops. Herein will be reviewed updates in the field, as well as a discussion of current limitations of our understanding of preclinical RA, and potential future directions for study.
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347
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Fuggle NR, Howe FA, Allen RL, Sofat N. New insights into the impact of neuro-inflammation in rheumatoid arthritis. Front Neurosci 2014; 8:357. [PMID: 25414636 PMCID: PMC4222329 DOI: 10.3389/fnins.2014.00357] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/17/2014] [Indexed: 12/28/2022] Open
Abstract
Rheumatoid arthritis (RA) is considered to be, in many respects, an archetypal autoimmune disease that causes activation of pro-inflammatory pathways resulting in joint and systemic inflammation. RA remains a major clinical problem with the development of several new therapies targeted at cytokine inhibition in recent years. In RA, biologic therapies targeted at inhibition of tumor necrosis factor alpha (TNFα) have been shown to reduce joint inflammation, limit erosive change, reduce disability and improve quality of life. The cytokine TNFα has a central role in systemic RA inflammation and has also been shown to have pro-inflammatory effects in the brain. Emerging data suggests there is an important bidirectional communication between the brain and immune system in inflammatory conditions like RA. Recent work has shown how TNF inhibitor therapy in people with RA is protective for Alzheimer's disease. Functional MRI studies to measure brain activation in people with RA to stimulus by finger joint compression, have also shown that those who responded to TNF inhibition showed a significantly greater activation volume in thalamic, limbic, and associative areas of the brain than non-responders. Infections are the main risk of therapies with biologic drugs and infections have been shown to be related to disease flares in RA. Recent basic science data has also emerged suggesting that bacterial components including lipopolysaccharide induce pain by directly activating sensory neurons that modulate inflammation, a previously unsuspected role for the nervous system in host-pathogen interactions. In this review, we discuss the current evidence for neuro-inflammation as an important factor that impacts on disease persistence and pain in RA.
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Affiliation(s)
- Nicholas R Fuggle
- Institute of Infection and Immunity, St. George's University London, UK
| | - Franklyn A Howe
- Neuroscience Research Centre, Institute of Cardiovascular and Cell Sciences, St. George's University London, UK
| | - Rachel L Allen
- Institute of Infection and Immunity, St. George's University London, UK
| | - Nidhi Sofat
- Institute of Infection and Immunity, St. George's University London, UK
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348
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Holers VM. Insights from populations at risk for the future development of classified rheumatoid arthritis. Rheum Dis Clin North Am 2014; 40:605-20. [PMID: 25437280 PMCID: PMC4250577 DOI: 10.1016/j.rdc.2014.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Rheumatoid arthritis (RA) develops through a series of stages. In the seropositive subset of classified RA patients, a preclinical stage is present for years before the onset of clinically apparent disease. Relevant preclinical biomarkers include autoantibodies, alterations of lymphoid populations, elevated cytokines/chemokines, genetic/genomic factors, imaging studies, clinical findings, dietary and environmental biomarkers, cardiovascular disease risk assessment, microbiome analyses, and metabolomic changes. Identifying the population of asymptomatic subjects at sufficiently high risk for disease to be informative and representative of "preclinical patients" is a challenge. This article reviews the results of analyses that have been undertaken in these "at-risk" subjects.
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Affiliation(s)
- V Michael Holers
- Division of Rheumatology, University of Colorado School of Medicine, Room 3102E, 1775 Aurora Court, Aurora, CO 80045, USA.
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349
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Gawron K, Bereta G, Nowakowska Z, Lazarz-Bartyzel K, Lazarz M, Szmigielski B, Mizgalska D, Buda A, Koziel J, Oruba Z, Chomyszyn-Gajewska M, Potempa J. Peptidylarginine deiminase from Porphyromonas gingivalis contributes to infection of gingival fibroblasts and induction of prostaglandin E2 -signaling pathway. Mol Oral Microbiol 2014; 29:321-32. [PMID: 25176110 DOI: 10.1111/omi.12081] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2014] [Indexed: 12/27/2022]
Abstract
Porphyromonas gingivalis (P. gingivalis) expres-ses the enzyme peptidylarginine deiminase (PPAD), which has a strong preference for C-terminal arginines. Due to the combined activity of PPAD and Arg-specific gingipains, P. gingivalis on the cell surface is highly citrullinated. To investigate the contribution of PPAD to the interaction of P. gingivalis with primary human gingival fibroblasts (PHGF) and P. gingivalis-induced synthesis of prostaglandin E2 (PGE2 ), PHGF were infected with wild-type P. gingivalis ATCC 33277, an isogenic PPAD-knockout strain (∆ppad) or a mutated strain (C351A) expressing an inactive enzyme in which the catalytic cysteine has been mutated to alanine (PPAD(C351A) ). Cells were infected in medium containing the mutants alone or in medium supplemented with purified, active PPAD. PHGF infection was assessed by colony-forming assay, microscopic analysis and flow cytometry. Expression of cyclo-oxygenase 2 (COX-2) and microsomal PGE synthase-1 (mPGES-1), key factors in the prostaglandin synthesis pathway, was examined by quantitative reverse transcription polymerase chain reaction (qRT-PCR), while PGE2 synthesis was evaluated by enzyme immunoassay. PHGF were infected more efficiently by wild-type P. gingivalis than by the ∆ppad strain, which correlated with strong induction of COX-2 and mPGES-1 expression by wild-type P. gingivalis, but not by the PPAD activity-null mutant strains (Δppad and C351A). The impaired ability of the Δppad strain to adhere to and/or invade PHGF and both Δppad and C351A to stimulate the PGE2 -synthesis pathway was fully restored by the addition of purified PPAD. The latter effect was strongly inhibited by aspirin. Collectively, our results implicate PPAD activity, but not PPAD itself, as an important factor for gingival fibroblast infection and activation of PGE2 synthesis, the latter of which may strongly contribute to bone resorption and eventual tooth loss.
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Affiliation(s)
- K Gawron
- Microbiology Department, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
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350
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Bielecka E, Scavenius C, Kantyka T, Jusko M, Mizgalska D, Szmigielski B, Potempa B, Enghild JJ, Prossnitz ER, Blom AM, Potempa J. Peptidyl arginine deiminase from Porphyromonas gingivalis abolishes anaphylatoxin C5a activity. J Biol Chem 2014; 289:32481-7. [PMID: 25324545 DOI: 10.1074/jbc.c114.617142] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Evasion of killing by the complement system, a crucial part of innate immunity, is a key evolutionary strategy of many human pathogens. A major etiological agent of chronic periodontitis, the Gram-negative bacterium Porphyromonas gingivalis, produces a vast arsenal of virulence factors that compromise human defense mechanisms. One of these is peptidylarginine deiminase (PPAD), an enzyme unique to P. gingivalis among bacteria, which converts Arg residues in polypeptide chains into citrulline. Here, we report that PPAD citrullination of a critical C-terminal arginine of the anaphylatoxin C5a disabled the protein function. Treatment of C5a with PPAD in vitro resulted in decreased chemotaxis of human neutrophils and diminished calcium signaling in monocytic cell line U937 transfected with the C5a receptor (C5aR) and loaded with a fluorescent intracellular calcium probe: Fura-2 AM. Moreover, a low degree of citrullination of internal arginine residues by PPAD was also detected using mass spectrometry. Further, after treatment of C5 with outer membrane vesicles naturally shed by P. gingivalis, we observed generation of C5a totally citrullinated at the C-terminal Arg-74 residue (Arg74Cit). In stark contrast, only native C5a was detected after treatment with PPAD-null outer membrane vesicles. Our study suggests reduced antibacterial and proinflammatory capacity of citrullinated C5a, achieved via lower level of chemotactic potential of the modified molecule, and weaker cell activation. In the context of previous studies, which showed crosstalk between C5aR and Toll-like receptors, as well as enhanced arthritis development in mice infected with PPAD-expressing P. gingivalis, our findings support a crucial role of PPAD in the virulence of P. gingivalis.
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Affiliation(s)
- Ewa Bielecka
- From the Department of Laboratory Medicine, Medical Protein Chemistry, Lund University, SE-205 02 Malmö, Sweden, the Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
| | - Carsten Scavenius
- the Department of Molecular Biology and Genetics and Interdisciplinary Nanoscience Center, Aarhus University, DK-8000 Aarhus, Denmark
| | - Tomasz Kantyka
- the Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
| | - Monika Jusko
- From the Department of Laboratory Medicine, Medical Protein Chemistry, Lund University, SE-205 02 Malmö, Sweden
| | - Danuta Mizgalska
- the Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
| | - Borys Szmigielski
- the Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
| | - Barbara Potempa
- the Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky 40202, and
| | - Jan J Enghild
- the Department of Molecular Biology and Genetics and Interdisciplinary Nanoscience Center, Aarhus University, DK-8000 Aarhus, Denmark
| | - Eric R Prossnitz
- the Department of Cell Biology and Physiology, University of New Mexico, Albuquerque, New Mexico 87131
| | - Anna M Blom
- From the Department of Laboratory Medicine, Medical Protein Chemistry, Lund University, SE-205 02 Malmö, Sweden,
| | - Jan Potempa
- the Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
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