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

ED Rosenstein, RA Greenwald, LJ Kushner… - Inflammation, 2004 - Springer
ED Rosenstein, RA Greenwald, LJ Kushner, G Weissmann
Inflammation, 2004Springer
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 …
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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