Subgingival microbiome of rheumatoid arthritis patients in relation to their disease status and periodontal health

• Published in: PloS one Vol. 13; no. 9; p. e0202278
• Main Authors: Beyer, Kathrin, Zaura, Egija, Brandt, Bernd W, Buijs, Mark J, Brun, Johan G, Crielaard, Wim, Bolstad, Anne Isine
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19-09-2018; Public Library of Science (PLoS)
• Subjects: Aged; Anti-Inflammatory Agents - therapeutic use; Arthritis; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - drug therapy; Biology and Life Sciences; Bleeding; Communities; Correlation analysis; Cross-Sectional Studies; Dentistry; Deoxyribonucleic acid; Disease prevention; DNA; DNA, Bacterial - analysis; DNA, Bacterial - classification; DNA, Bacterial - genetics; Drugs; Family medical history; Female; Gingiva - drug effects; Gingiva - microbiology; Gum disease; Health risks; Humans; Inflammatory diseases; Laboratories; Longitudinal studies; Male; Medical records; Medicine and Health Sciences; Microbiomes; Microbiota (Symbiotic organisms); Microbiota - drug effects; Microbiota - genetics; Microorganisms; Middle Aged; Oral hygiene; Patients; Periodontal disease; Periodontitis; Periodontitis - complications; Periodontitis - drug therapy; Periodontitis - microbiology; Porphyromonas gingivalis - genetics; Prednisolone; Prednisolone - therapeutic use; Remission; Rheumatoid arthritis; Rheumatology; Risk analysis; Risk factors; RNA, Ribosomal, 16S - genetics; rRNA 16S; Sequence Analysis, DNA; Smoking; Therapy; Tumor necrosis factor-TNF; Norway; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0202278

Rheumatoid arthritis (RA) and periodontitis are chronic inflammatory diseases that share common risk factors. However, the bidirectional relationship between RA and periodontal disease is not fully understood. This study was undertaken to describe the bacterial component of the subgingival microbiome in RA patients and to relate this to RA disease activity and periodontal status.
Patients with chronic established RA (N = 78) were periodontally examined and their subgingival plaque samples were collected; their clinical and laboratory data on RA status and medication were obtained from medical records. Bacterial DNA was quantified by universal 16S rDNA qPCR, and Porphyromonas gingivalis by species-specific qPCR. For microbiome assessment, 16S rDNA amplicon sequencing was performed.
Active RA was diagnosed in 58% of the patients and periodontitis in 82% (mild: 9%, moderate: 55%, severe: 18%). P. gingivalis was present in 14% of the samples. Different levels of gingival bleeding, periodontal probing depth, RA disease status, prednisolone use and smoking were associated with significantly different microbiome compositions. Two subgingival microbial community types were discerned.
In RA patients with active disease, anti-inflammatory medication as part of RA therapy was associated with better oral health status and a healthier subgingival microbiome compared to that of RA patients in remission, especially those in remission who were current smokers. RA patients in remission with current smoking status may particularly benefit from a systematic periodontal treatment program. The potential role of microbial community types in patient stratification and personalized therapy should be assessed in longitudinal studies.