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Kobayashi T, Bartold PM. Periodontitis and periodontopathic bacteria as risk factors for rheumatoid arthritis: A review of the last 10 years. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:263-272. [PMID: 37674898 PMCID: PMC10477376 DOI: 10.1016/j.jdsr.2023.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
Rheumatoid arthritis (RA) is characterized by chronic inflammatory destruction of joint tissue and is caused by an abnormal autoimmune response triggered by interactions between genetics, environmental factors, and epigenetic and posttranslational modifications. RA has been suggested to be interrelated with periodontitis, a serious form or stage of chronic inflammatory periodontal disease associated with periodontopathic bacterial infections, genetic predisposition, environmental factors, and epigenetic influences. Over the last decade, a number of animal and clinical studies have been conducted to assess whether or not periodontitis and associated periodontopathic bacteria constitute risk factors for RA. The present review introduces recent accumulating evidence to support the associations of periodontitis and periodontopathic bacteria with the risk of RA or the outcome of RA pharmacological treatment with disease-modifying antirheumatic drugs. In addition, the results from intervention studies have suggested an improvement in RA clinical parameters after nonsurgical periodontal treatment. Furthermore, the potential causal mechanisms underlying the link between periodontitis and periodontopathic bacteria and RA are summarized.
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Affiliation(s)
- Tetsuo Kobayashi
- General Dentistry and Clinical Education Unit, Faculty of Dentistry & Medical and Dental Hospital, Niigata University, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan
| | - Peter Mark Bartold
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia 5005, Australia
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Chen J, Li S, Zhu J, Su W, Jian C, Zhang J, Wu J, Wang T, Zhang W, Zeng F, Chang S, Jia L, Su J, Zhao Y, Wang J, Zeng F. Multi-omics profiling reveals potential alterations in rheumatoid arthritis with different disease activity levels. Arthritis Res Ther 2023; 25:74. [PMID: 37138305 PMCID: PMC10155393 DOI: 10.1186/s13075-023-03049-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/07/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic, systemic autoimmune inflammatory disease, the pathogenesis of which is not clear. Clinical remission, or decreased disease activity, is the aim of treatment for RA. However, our understanding of disease activity is inadequate, and clinical remission rates for RA are generally poor. In this study, we used multi-omics profiling to study potential alterations in rheumatoid arthritis with different disease activity levels. METHODS Fecal and plasma samples from 131 rheumatoid arthritis (RA) patients and 50 healthy subjects were collected for 16S rRNA sequencing, internally transcribed spacer (ITS) sequencing, and liquid chromatography-tandem mass spectrometry (LC-MS/MS). The PBMCS were also collected for RNA sequencing and whole exome sequencing (WES). The disease groups, based on 28 joints and ESR (DAS28), were divided into DAS28L, DAS28M, and DAS28H groups. Three random forest models were constructed and verified with an external validation cohort of 93 subjects. RESULTS Our findings revealed significant alterations in plasma metabolites and gut microbiota in RA patients with different disease activities. Moreover, plasma metabolites, especially lipid metabolites, demonstrated a significant correlation with the DAS28 score and also associations with gut bacteria and fungi. KEGG pathway enrichment analysis of plasma metabolites and RNA sequencing data demonstrated alterations in the lipid metabolic pathway in RA progression. Whole exome sequencing (WES) results have shown that non-synonymous single nucleotide variants (nsSNV) of the HLA-DRB1 and HLA-DRB5 gene locus were associated with the disease activity of RA. Furthermore, we developed a disease classifier based on plasma metabolites and gut microbiota that effectively discriminated RA patients with different disease activity in both the discovery cohort and the external validation cohort. CONCLUSION Overall, our multi-omics analysis confirmed that RA patients with different disease activity were altered in plasma metabolites, gut microbiota composition, transcript levels, and DNA. Our study identified the relationship between gut microbiota and plasma metabolites and RA disease activity, which may provide a novel therapeutic direction for improving the clinical remission rate of RA.
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Affiliation(s)
- Jianghua Chen
- Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
- Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Shilin Li
- Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Jing Zhu
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Su
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Congcong Jian
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jie Zhang
- Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Jianhong Wu
- Department of Rheumatology and Immunology, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Tingting Wang
- Department of Rheumatology and Immunology, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Weihua Zhang
- Department of Rheumatology and Immunology, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Fanwei Zeng
- Sichuan Province Orthopaedic Hospital, Chengdu, Sichuan, China
| | - Shengjia Chang
- Shantou University Medical College, Shantou University, Guangdong, China
| | - Lihua Jia
- Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jiang Su
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Yi Zhao
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Jing Wang
- The National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Fanxin Zeng
- Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China.
- Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, Sichuan, China.
- Department of Big Data and Biomedical AI, College of Future Technology, Peking University, Beijing, 100871, China.
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Ruiz-Limón P, Mena-Vázquez N, Moreno-Indias I, Manrique-Arija S, Lisbona-Montañez JM, Cano-García L, Tinahones FJ, Fernández-Nebro A. Collinsella is associated with cumulative inflammatory burden in an established rheumatoid arthritis cohort. Biomed Pharmacother 2022; 153:113518. [DOI: 10.1016/j.biopha.2022.113518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 12/11/2022] Open
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Oral and Intestinal Bacterial Substances Associated with Disease Activities in Patients with Rheumatoid Arthritis: A Cross-Sectional Clinical Study. J Immunol Res 2022; 2022:6839356. [PMID: 35224112 PMCID: PMC8881124 DOI: 10.1155/2022/6839356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 01/19/2022] [Accepted: 01/27/2022] [Indexed: 01/02/2023] Open
Abstract
Intestinal bacterial compositions of rheumatoid arthritis (RA) patients have been reported to be different from those of healthy people. Dysbiosis, imbalance of the microbiota, is widely known to cause gut barrier damage, resulting in an influx of bacteria and their substances into host bloodstreams in animal studies. However, few studies have investigated the effect of bacterial substances on the pathophysiology of RA. In this study, eighty-seven active RA patients who had inadequate responses to conventional synthetic disease-modifying antirheumatic drugs or severe comorbidities were analyzed for correlations between many factors such as disease activities, disease biomarkers, intestinal bacterial counts, fecal and serum lipopolysaccharide (LPS), LPS-binding protein (LBP), endotoxin neutralizing capacity (ENC), and serum antibacterial substance IgG and IgA antibody levels by multiple regression analysis with consideration for demographic factors such as age, sex, smoking, and methotrexate treatment. Serum LBP levels, fecal LPS levels, total bacteria counts, serum anti-LPS from Porphyromonas gingivalis (Pg-LPS) IgG antibody levels, and serum anti-Pg-LPS IgA antibody levels were selected for multiple regression analysis using Spearman’s correlation analysis. Serum LBP levels were correlated with disease biomarker levels, such as erythrocyte sedimentation rate (
), C-reactive protein (
), matrix metalloproteinase-3 (
), and IL-6 (
), and were inversely correlated with hemoglobin (
). Anti-Pg-LPS IgG antibody levels were inversely correlated with activity indices such as patient global assessments using visual analogue scale (VAS) (
) and painVAS (
). Total bacteria counts were correlated with ENC (
), and inversely correlated with serum LPS (
) and anti-Pg-LPS IgA antibody levels (
). These results suggest that substances from oral and gut microbiota may influence disease activity in RA patients.
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New Studies of Pathogenesis of Rheumatoid Arthritis with Collagen-Induced and Collagen Antibody-Induced Arthritis Models: New Insight Involving Bacteria Flora. Autoimmune Dis 2021; 2021:7385106. [PMID: 33833871 PMCID: PMC8016593 DOI: 10.1155/2021/7385106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/30/2020] [Accepted: 03/04/2021] [Indexed: 12/23/2022] Open
Abstract
Much public research suggests that autoimmune diseases such as rheumatoid arthritis (RA) are induced by aberrant “self” immune responses attacking autologous tissues and organ components. However, recent studies have reported that autoimmune diseases may be triggered by dysbiotic composition changes of the intestinal bacteria and an imbalance between these bacteria and intestinal immune systems. However, there are a few solid concepts or methods to study the putative involvement and relationship of these inner environmental factors in RA pathogenesis. Fortunately, Collagen-Induced Arthritis (CIA) and Collagen Antibody-Induced Arthritis (CAIA) models have been widely used as animal models for studying the pathogenesis of RA. In addition to RA, these models can be extensively used as animal models for studying complicated hypotheses in many diseases. In this review, we introduce some basic information about the CIA and CAIA models as well as how to apply these models effectively to investigate relationships between the pathogenesis of autoimmune diseases, especially RA, and the dysbiosis of intestinal bacterial flora.
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Durlik-Popińska K, Żarnowiec P, Lechowicz Ł, Gawęda J, Kaca W. Antibodies Isolated from Rheumatoid Arthritis Patients against Lysine-Containing Proteus mirabilis O3 (S1959) Lipopolysaccharide May React with Collagen Type I. Int J Mol Sci 2020; 21:ijms21249635. [PMID: 33348817 PMCID: PMC7767033 DOI: 10.3390/ijms21249635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 02/03/2023] Open
Abstract
Most rheumatic diseases, including rheumatoid arthritis (RA), are characterized by immune disorders that affect antibody activity. In the present study, using Dot blot and ELISA assay, we showed that patients with rheumatic disease produced significantly more antibodies against lipopolysaccharide (LPS) P. mirabilis O3 compared to healthy donors (p < 0.05), and affinity purified antibodies against LPS O3 may cross-react with collagen type I. It was demonstrated that purified of antibodies isolated from RA patients sera, reacted stronger with the collagen than healthy donors (p = 0.015), and cross-reaction was correlated with level of anti-citrullinated peptide antibodies (r = 0.7, p = 0.003). Moreover, using six different lipopolysaccharides were demonstrated the significant correlations in sera reactivity among lysine-containing lipopolysaccharides observed in patients’ sera (p < 0.05). Using Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) it was shown that unique wavenumbers of sera spectra correlate with reactivity with lipopolysaccharides allowing distinguish patients from healthy blood donors. Antibodies adsorption by synthetic antigens shows that in patients’ group anti-LPS O3 antibodies can be adsorbed by both amides of galacturonic acid and lysine or threonine, which suggests less specificity of antibodies binding with non-carbohydrate LPS component. The observed correlations suggest that non-carbohydrate components of LPS may be an important epitope for less specific anti-LPS antibodies, which might lead to cross-reactions and affect disease development.
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Affiliation(s)
- Katarzyna Durlik-Popińska
- Department of Microbiology and Parasitology, Institute of Biology, Jan Kochanowski University, 25-369 Kielce, Poland; (P.Ż.); (Ł.L.); (W.K.)
- Correspondence:
| | - Paulina Żarnowiec
- Department of Microbiology and Parasitology, Institute of Biology, Jan Kochanowski University, 25-369 Kielce, Poland; (P.Ż.); (Ł.L.); (W.K.)
| | - Łukasz Lechowicz
- Department of Microbiology and Parasitology, Institute of Biology, Jan Kochanowski University, 25-369 Kielce, Poland; (P.Ż.); (Ł.L.); (W.K.)
| | - Józef Gawęda
- Rheumatology Clinic ARTIMED, 25-022 Kielce, Poland;
| | - Wiesław Kaca
- Department of Microbiology and Parasitology, Institute of Biology, Jan Kochanowski University, 25-369 Kielce, Poland; (P.Ż.); (Ł.L.); (W.K.)
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Vergara Serpa OV, Cortina Gutiérrez A, Serna Otero DA, Zuluaga Salazar JF, Reyes Jaraba CA. Porphyromonas gingivalis ligada a enfermedad periodontal y su relación con la artritis reumatoide: identificación de nuevos mecanismos biomoleculares. ACTA ODONTOLÓGICA COLOMBIANA 2020. [DOI: 10.15446/aoc.v10n2.85185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: revisar la literatura científica existente con respecto a la patogenicidad de Porphyromonas gingivalis, ligada a enfermedad periodontal (EP) (disbiosis oral), y su asociación con la activación de mecanismos fisiopatológicos en la artritis reumatoide (AR), a fin de exponer los nuevos mecanismos biomoleculares implicados. Métodos: búsqueda sistemática en la base de datos del Medical Subject Headings (MeSH), PubMed, Science Direct, Nature y Google académico usando las palabras clave: Aggregatibacter actinomycetemcomitans; artritis reumatoide; citrulinación; disbiosis; odontología; periodontitis; Porphyromonas gingivalis y reumatología. De un total de 297 publicaciones, se seleccionaron 52, todas a partir del año 2018; la selección fue hecha a partir de los criterios de inclusión y exclusión establecidos por los autores. Resultados: la infección por Porphyromonas gingivalis, ligada a la EP, está fuertemente implicada en la patogénesis y desarrollo de AR. Su relación se vincula con el proceso de citrulinación y producción de anticuerpos antipéptidos citrulinados. Se han identificado asociaciones entre la virulencia microbiana de dicho agente y la expresión de múltiples genes, relacionados con la activación de la respuesta inmune y el inicio del proceso inflamatorio crónico. Conclusiones: existe una alta asociación entre la patogenia de ambas enfermedades, donde microorganismos ligados a la EP, como Porphyromonas gingivalis, tienen la capacidad de aumentar la citrulinación, galactosilación, fucosilación, así como la excesiva glicosilación de Fragmentos de unión al antígeno (Fab), y por lo tanto, la agresividad de la AR.
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Kitamura K, Shionoya H, Terato K, Suzuki S, Fukai R, Uda S, Abe C, Takemori H, Nishimura K, Baba H, Waritani T, Katayama K. Comment on: 'Metagenome-wide association study of gut microbiome revealed novel aetiology of rheumatoid arthritis in the Japanese population' by Kishikawa et al. Ann Rheum Dis 2020; 81:e71. [PMID: 32471901 DOI: 10.1136/annrheumdis-2020-217808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Kaori Kitamura
- Research Lab Section 5, Asama Chemical Co Ltd, Tokyo, Japan
| | | | - Kuniaki Terato
- Research and Development, Chondrex, Inc, Redmond, Washington, USA
| | - Suguru Suzuki
- Research Lab Section 5, Asama Chemical Co Ltd, Tokyo, Japan
| | - Richio Fukai
- Pharmacology, Fukai Pharmacy, Asahikawa, Hokkaido, Japan
| | - Shinichi Uda
- Rheumatology, Uda Clinic of Rheumatology, Fukuyama, Hiroshima, Japan
| | - Chiyuki Abe
- Rheumatology, Abe Clinic Internal Medicine, Tokyo, Japan
| | - Hiromitsu Takemori
- Rheumatology, Aomori Prefectural Central Hospital, Aomori, Aomori, Japan
| | - Keita Nishimura
- Rheumatology, Teikyo University School of Medicine, Tokyo, Japan
| | | | - Takaki Waritani
- Research and Development, Chondrex, Inc, Redmond, Washington, USA
| | - Kou Katayama
- Rheumatology, Katayama Orthopedic Rheumatology Clinic, Asahikawa, Hokkaido, Japan
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