Periodontitis in RA-the citrullinated enolase connection.
Autoimmunity in rheumatoid arthritis (RA) is characterized by an antibody response to citrullinated proteins. Two of the risk factors for RA-HLA-DRB1 shared epitope alleles and smoking-are also associated with periodontitis, which is largely, but not exclusively, caused by Porphyromonas gingivalis infection. Furthermore, RA and periodontitis have a similar pathophysiology, characterized by destructive inflammation. The citrullination of proteins by P. gingivalis and the subsequent generation of autoantigens that drive autoimmunity in RA represents a possible causative link between these two diseases. Antibodies directed towards the immunodominant epitope of human citrullinated α-enolase cross-react with a conserved sequence on citrullinated P. gingivalis enolase. On the basis of this cross-reactivity, in this Perspectives article we explore the hypothesis of molecular mimicry in the etiology of RA, with citrullinated enolase as the specific antigen involved.
Lundberg
Karin
K
The Kennedy Institute of Rheumatology, Imperial College London, 65 Aspenlea Road, London W6 8LH, UK.
Wegner
Natalia
N
Yucel-Lindberg
Tülay
T
Venables
Patrick J
PJ
D001172:Arthritis, Rheumatoid / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D015551:Autoimmunity / Q000502:physiology; D016866:Bacteroidaceae Infections / Q000150:complications; D002956:Citrulline / Q000378:metabolism; D006801:Humans; D010518:Periodontitis / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D010751:Phosphopyruvate Hydratase / Q000276:immunology / Q000502:physiology*; D016966:Porphyromonas gingivalis / Q000502:physiology; D012307:Risk Factors
D002956:Citrulline; D010751:Phosphopyruvate Hydratase
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