An infectious and inflammatory disease of the gums that causes tooth loss is probably responsible for rheumatoid arthritis
Dental problems caused by gum disease, or “parondotopathy”, are pre-existing to the onset of rheumatoid arthritis. The study also shows a causal relationship between the loss of jaw bone and high levels of a molecule that induces bone resorption in the blood: RANK-L.
This is what emerges from research from Umeå University in Sweden presented in the journal Arthritis & Rheumatology.
A strong link between periodontitis and polyarthritis
The loss of jawbone caused by inflammation secondary to the overgrowth of bacteria in the gum tissue is characteristic of both periodontitis – a disease that results in tooth loss – and rheumatoid arthritis. Despite the differences in inflammation from periodontitis or rheumatoid arthritis, it has now been established that there is a correlation between the two.
“For example, it is known that people with rheumatoid arthritis have tooth loss to a large extent and that treatments to treat periodontitis also relieve joint pain in rheumatoid arthritis.” “Until now, however, it was not known whether there was a causal relationship between the two,” says Pernilla Lundberg, senior lecturer in the Department of Odontology at Umeå University, and one of the researchers at the origin of the study.
A multidisciplinary collaboration
As part of a collaboration, Pernilla Lundberg and Solbritt Rantapää-Dahlqvist, researcher in the Department of Public Health and Clinical Medicine at Umeå University, analyzed the prevalence of jaw bone loss on x-rays dental treatment of patients suffering from rheumatoid arthritis. The x-rays were taken before the arthritis symptoms developed and were compared to x-rays from similar controls anywhere other than the arthritis. All of the study participants had repeatedly donated blood to the Northern Sweden Medical Biobank. The dental x-rays were collected from the attending dentists.
Periodontitis pre-existing polyarthritis
The results published in the journal Arthritis & Rheumatology, show for the first time that people who later develop rheumatoid arthritis have gum disease shown on x-rays. People with rheumatoid arthritis also develop periodontitis to a greater extent over time. Among people who later developed rheumatoid arthritis, the highest degree of bone loss from the jaw bone was detected in people who also had high levels of RANK-L in the blood, a molecule that induces the bone resorption.
“Our results indicate a causal relationship between periodontitis and rheumatoid arthritis, but more clinical studies and studies on the mechanisms involved are needed to prove the existence of a causal relationship with certainty, ”explains Solbritt Rantapää-Dahlqvist.
The bacteria associated with periodontitis are Porphyromonas gingivalis, which was involved in a mechanism of citrullination of proteins at the origin of anti-CCP antibodies which are found in rheumatoid arthritis the most aggressive. It is not currently known whether the origin of rheumatoid arthritis is in the lung or in the mouth, but the infectious origin is becoming increasingly important.
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