Symptoms of periodontitis and antibody responses to Porphyromonas gingivalis in juvenile idiopathic arthritis

• Type of Material: Article
• Authors: Lauren Lange, Ann and Robert H. Lurie Children’s Hospital of Chicago; Geoffrey M. Thiele, VA Nebraska-Western Iowa Health Care System; Courtney McCracken, Emory University; Gabriel Wang, Emory University; Lori A. Ponder, Children’s Healthcare of Atlanta; Sheila Angeles-Han, Emory University; Kelly Rouster Stevens, Emory University; Aimee O. Hersh, University of Utah; Larry Vogler, Emory University; John F. Bohnsack, University of Utah; Shelly Abramowicz, Emory University; Ted R. Mikuls, VA Nebraska-Western Iowa Health Care System; Sampath Prahalad, Emory University
• Language: English
• Date: 2016-02-09
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © Lange et al. 2016. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12969-016-0068-6
• Title of Journal or Parent Work: Pediatric Rheumatology
• ISSN: 1546-0096
• Volume: 14
• Issue: 1
• Start Page: 8
• End Page: 8
• Grant/Funding Information: Supported by a Medical Student Research Preceptorship Award from Rheumatology Research Foundation, The Arthritis Foundation, The National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01-AR060893), The Marcus Foundation Inc., The Val A Browning Charitable Foundation, and the Emory-Children’s Pediatric Research Center Biostatistics Core.
• Keywords: Rheumatology; DISEASE; Science & Technology; Anti-citrullinated peptide antibody; Porphyromonas gingivalis; ONSET RHEUMATOID-ARTHRITIS; Periodontitis; CLASSIFICATION; Juvenile idiopathic arthritis; RISK; Pediatrics; Life Sciences & Biomedicine; Prevotella intermedia
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Dentistry; Health Sciences, Medicine and Surgery

Abstract

Background: The association between rheumatoid arthritis (RA) and periodontitis is well established. Some children with juvenile idiopathic arthritis (JIA) phenotypically resemble adults with RA, characterized by the presence of anti-cyclic citrullinated peptide (CCP) antibodies. We sought to investigate an association between CCP-positive JIA and symptoms of periodontitis and antibodies to oral microbiota. Methods: Antibodies to oral pathogens Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum were measured using ELISA in 71 children with CCP-positive JIA and 74 children with CCP-negative JIA. Oral health history was collected from 37 children with CCP-positive JIA and 121 children with CCP-negative JIA. T-tests, Chi-square tests, Mann-Whitney U tests, and multivariable regression were used to compare the groups. Results: Compared to those with CCP-negative JIA, children with CCP-positive JIA were more likely to be female, older and non-Caucasian. Anti-P. gingivalis (p <0.003) and anti-P. intermedia (p <0.008) IgG antibody titers were higher in the CCP-positive cohort. Differences in P. gingivalis antibody titers remained significant after adjusting for age (p = 0.007). Children with CCP-positive JIA more likely reported tender/bleeding gums (43% vs. 24%, p < 0.02) compared to children with CCP-negative JIA. After controlling for age at collection, the odds of having tender/bleeding gums were 2.2 times higher in the CCP-positive group compared (95% CI 0.98 - 4.83; p = 0.056). Conclusions: Children with CCP-positive JIA have higher antibody titers to P. gingivalis and more symptoms of poor oral health, supporting a possible role for periodontitis in the etiology of CCP-positive JIA.