Study Reveals Link Between Rheumatoid Arthritis & Gum Problems

Rheumatoid arthritis (RA), which causes excruciating joint swelling, is a type of autoimmune illness in which the immune system mistakenly attacks otherwise healthy tissue in a patient’s joint. There is a connection between RA patients and those who have more periodontal disease, according to earlier observational research (gum disease).

Most RA patients have anti-citrullinated protein antibodies (ACPAs) in their blood. As they can predict clinical diagnosis over several years, ACPAs found in the blood are the best early detection technique for future RA pathology due to their strong correlation. Those with RA who also have high blood levels of ACPAs are more likely to develop gum disease.

Researchers from Stanford University wanted to find out if there was a more effective way to connect these overlapping observations.

In blood samples taken from a group of five RA patients with and without gum disease at weekly intervals for a year, researchers examined the presence of bacterial RNA. In patients with both RA and periodontal disease, they discovered RNA signatures inside clusters of activated immune cells that linked with both the presence of oral bacteria in the blood and with flare-ups of arthritis.

The presence of the bacterium was determined to be citrullinated (enzymatically changed), and this alteration supplied the anti-citrullinated protein antibodies with more targets to assault. Further investigation revealed that oral sample bacteria were already citrullinated.

Although this was a hopeful finding, it was still just a correlation between illnesses that had been recognized to overlap in the past. The question the researchers sought to answer was whether the immunological response to the bacterium was brought on by the germs themselves or by RA.

They, therefore, adopted a more causal strategy and made an effort to directly induce in vitro identical gene expression responses. Blood samples from healthy people were combined with oral bacteria taken from healthy people, and researchers tested the mixture for the presence of a particular RNA when compared to blood samples from RA patients.

They discovered the strong expression of the particular RNA after six and twenty hours, showing that not only may oral bacteria cause a systemic inflammatory response if they enter the bloodstream, but also that the response is not limited to people who already have RA.

Further research, according to the researchers, is required to ascertain whether better oral hygiene has therapeutic advantages for the treatment of RA.

The paper, “Oral mucosal breaks trigger anti-citrullinated bacterial and human protein antibody responses in rheumatoid arthritis,” is published in the journal Science Translational Medicine.

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