title: Periodontal disease and the oral microbiota in new-onset rheumatoid arthritis.
abstract: OBJECTIVE
  To profile the abundance and diversity of subgingival oral microbiota in patients with never-treated, new-onset rheumatoid arthritis (RA).
  
  
  METHODS
  Periodontal disease (PD) status, clinical activity, and sociodemographic factors were determined in patients with new-onset RA, patients with chronic RA, and healthy subjects. Multiplexed-454 pyrosequencing was used to compare the composition of subgingival microbiota and establish correlations between the presence/abundance of bacteria and disease phenotypes. Anti-Porphyromonas gingivalis antibody testing was performed to assess prior exposure to the bacterial pathogen P gingivalis.
  
  
  RESULTS
  The more advanced forms of periodontitis were already present at disease onset in patients with new-onset RA. The subgingival microbiota observed in patients with new-onset RA was distinct from that found in healthy controls. In most cases, however, these microbial differences could be attributed to the severity of PD and were not inherent to RA. The presence and abundance of P gingivalis were also directly associated with the severity of PD and were not unique to RA. The presence of P gingivalis was not correlated with anti-citrullinated protein antibody (ACPA) titers. Overall exposure to P gingivalis was similar between patients with new-onset RA and controls, observed in 78% of patients and 83% of controls. The presence and abundance of Anaeroglobus geminatus correlated with the presence of ACPAs/rheumatoid factor. Prevotella and Leptotrichia species were the only characteristic taxa observed in patients with new-onset RA irrespective of PD status.
  
  
  CONCLUSIONS
  Patients with new-onset RA exhibited a high prevalence of PD at disease onset, despite their young age and paucity of smoking history. The subgingival microbiota profile in patients with new-onset RA was similar to that in patients with chronic RA and healthy subjects whose PD was of comparable severity. Although colonization with P gingivalis correlated with the severity of PD, overall exposure to P gingivalis was similar among the groups. The role of A geminatus and Prevotella/Leptotrichia species in this process merits further study.
authors.affiliation: Division of Rheumatology, New York University and New York University Hospital for Joint Diseases, New York, New York 10003, USA. Jose.Scher@nyumc.org
authors.forename: Jose U
authors.initials: JU
authors.lastname: Scher
authors.forename: Carles
authors.initials: C
authors.lastname: Ubeda
authors.forename: Michele
authors.initials: M
authors.lastname: Equinda
authors.forename: Raya
authors.initials: R
authors.lastname: Khanin
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Buischi
authors.forename: Agnes
authors.initials: A
authors.lastname: Viale
authors.forename: Lauren
authors.initials: L
authors.lastname: Lipuma
authors.forename: Mukundan
authors.initials: M
authors.lastname: Attur
authors.forename: Michael H
authors.initials: MH
authors.lastname: Pillinger
authors.forename: Gerald
authors.initials: G
authors.lastname: Weissmann
authors.forename: Dan R
authors.initials: DR
authors.lastname: Littman
authors.forename: Eric G
authors.initials: EG
authors.lastname: Pamer
authors.forename: Walter A
authors.initials: WA
authors.lastname: Bretz
authors.forename: Steven B
authors.initials: SB
authors.lastname: Abramson
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D054892:Metagenome; D008875:Middle Aged; D009055:Mouth / Q000276:immunology / Q000382:microbiology*; D010518:Periodontitis / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000276:immunology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires