Hypothesis: the humoral immune response to oral bacteria provides a stimulus for the development of rheumatoid arthritis

Inflammation. 2004 Dec;28(6):311-8. doi: 10.1007/s10753-004-6641-z.

Abstract

Rheumatoid arthritis (RA) and adult periodontitis share common pathogenetic mechanisms and immunologic and pathological findings. One oral pathogen strongly implicated in the pathogenesis of periodontal disease, Porphyromonas gingivalis, possesses a unique microbial enzyme, peptidylarginine deiminase (PAD), the human equivalent of which has been identified as a susceptibility factor for RA. We suggest that individuals predisposed to periodontal infection are exposed to antigens generated by PAD, with de-iminated fibrin as a likely candidate, which become systemic immunogens and lead to intraarticular inflammation. PAD engendered antigens lead to production of rheumatoid factor-containing immune complexes and provoke local inflammation, both in gingiva and synovium via Fc and C5a receptors.

Publication types

  • Review

MeSH terms

  • Adult
  • Antibody Formation / genetics
  • Antibody Formation / immunology*
  • Arthritis, Rheumatoid / etiology*
  • Arthritis, Rheumatoid / immunology
  • Arthritis, Rheumatoid / microbiology
  • Arthritis, Rheumatoid / pathology
  • Disease Susceptibility / etiology
  • Disease Susceptibility / immunology
  • Disease Susceptibility / microbiology*
  • Disease Susceptibility / pathology
  • Humans
  • Hydrolases / immunology
  • Hydrolases / metabolism
  • Models, Biological*
  • Mouth Mucosa / microbiology*
  • Periodontitis / etiology
  • Periodontitis / microbiology
  • Periodontitis / pathology
  • Porphyromonas gingivalis / enzymology*
  • Porphyromonas gingivalis / pathogenicity
  • Protein-Arginine Deiminases
  • Rheumatoid Factor / biosynthesis
  • Rheumatoid Factor / immunology
  • Synovial Membrane / immunology

Substances

  • Rheumatoid Factor
  • Hydrolases
  • Protein-Arginine Deiminases