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Hypothesis: The Humoral Immune Response to Oral Bacteria Provides a Stimulus for the Development of Rheumatoid Arthritis

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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 deiminated 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.

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Authors and Affiliations

  1. Center for Rheumatic and Autoimmune Diseases, Livingston, New Jersey

    Elliot D. Rosenstein (Medical Director) & Laura J. Kushner

  2. Division of Rheumatology, Long Island-Jewish Medical Center, New Hyde Park, New York

    Robert A. Greenwald

  3. Department of Medicine, Division of Rheumatology, New York University, School of Medicine, New York

    Gerald Weissmann

  4. Center for Rheumatic and Autoimmune Diseases, 200 South Orange Avenue, Livingston, New Jersey, 07039

    Elliot D. Rosenstein (Medical Director)

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  1. Elliot D. Rosenstein
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Rosenstein, E.D., Greenwald, R.A., Kushner, L.J. et al. Hypothesis: The Humoral Immune Response to Oral Bacteria Provides a Stimulus for the Development of Rheumatoid Arthritis. Inflammation 28, 311–318 (2004). https://doi.org/10.1007/s10753-004-6641-z

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