Porphyromonas gulae and PPAD antibodies are not related to citrullination in rheumatoid arthritis

• Published in: Clinical oral investigations Vol. 27; no. 7; pp. 3509 - 3519
• Main Authors: Castellar-Mendoza, Camilo, Castillo, Diana Marcela, Chila-Moreno, Lorena, Bautista-Molano, Wilson, Romero-Sánchez, Consuelo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2023; Springer Nature B.V
• Subjects: Anti-Citrullinated Protein Antibodies - metabolism; Antibodies; Arthritis, Rheumatoid; C-reactive protein; Citrullination; Citrulline; Dental health; Dentistry; Diagnostic tests; Enzyme-linked immunosorbent assay; Erythrocyte sedimentation rate; Gram-negative bacteria; Gum disease; Humans; Medicine; Oral hygiene; Pathophysiology; Peptides; Peptides - metabolism; Periodontics; Periodontitis; Periodontitis - microbiology; Porphyromonas; Porphyromonas gingivalis; Protein-Arginine Deiminases - metabolism; Rheumatoid arthritis; Rheumatoid factor; Immunology; Periodontitis; Rheumatoid arthritis; Rheumatology; Antibodies; Bacteria; Periodontium; Porphyromonas gulae
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-023-04964-w

Introduction
Porphyromonas gulae
have the enzyme PPAD, as
P. gingivalis
, which is responsible for citrullination related to the pathophysiology of rheumatoid arthritis and periodontitis; this implies the presence of two species of PPAD-producing bacteria in the mouth as well as the presence of citrullinated proteins. There are no previous reports or studies investigating an association between
P. gulae
PPAD in rheumatoid arthritis (RA).
Objective
To assess the presence of
P. gulae
and anti-citrullinated peptide antibodies of
P. gulae
PAD in patients with RA and their possible relationship with clinical activity markers.
Subjects and methods
A total of 95 patients with RA and 95 controls were included. Erythrocyte sedimentation rate (ESR), C-reactive protein, anti-citrullinated protein antibodies (ACPAs) and rheumatoid factor (RF) were measured. Activity index-28 (DAS28) and SCDAI. The periodontal diagnosis was established. Presence of
P. gulae
and
P. gingivalis
. An ELISA was used to determine antibodies against citrullinated peptides of
P. gulae
PAD.
Results
A
P. gulae
frequency of 15.8% was observed in the RA group and 9.5% in the control group. Higher levels of ACPA were found in the
P. gulae
-positive patients of the RA group, finding no significant difference, but if in patients positive for
P. gingivalis
with statistical significance (
p
= 0.0001). The frequency of anti-VDK-cit and anti-LPQ-cit9 antibodies to PPAD of
P. gulae
was higher in the RA group than in the control group without significant difference. No relationship was found with the clinical variables despite the presence of
P. gulae
and anti-citrullinated peptide antibodies of
P. gulae
PPAD in patients with RA
Conclusions
It was not possible to establish a connection with clinical variables in RA and
P. gulae
; as a result, the presence of
P. gingivalis
continues to contribute significantly to the increase in antibodies against citrullinated proteins/peptides from exogenous sources of citrullination in RA and periodontitis.