title: Association of Anti-Porphyromonas gingivalis Antibody Titers With Nonsmoking Status in Early Rheumatoid Arthritis: Results From the Prospective French Cohort of Patients With Early Rheumatoid Arthritis.
abstract: OBJECTIVE
  To investigate the possible link between Porphyromonas gingivalis infection and rheumatoid arthritis (RA), according to antibody profile, genetic and environmental factors, and RA severity.
  
  
  METHODS
  For assessing P gingivalis infection, serum levels of antibodies directed against P gingivalis lipopolysaccharide were measured in 694 patients with early RA who were not exposed to steroids or disease-modifying antirheumatic drugs. Anti-P gingivalis antibody titers were compared between patients with early RA and various control groups, and according to various patient characteristics.
  
  
  RESULTS
  Anti-P gingivalis antibody titers did not significantly differ between patients with RA and controls and did not significantly differ with anti-citrullinated protein antibody (ACPA), rheumatoid factor (RF), or HLA shared epitope status. Anti-P gingivalis antibody titers were significantly higher among patients who had never smoked compared to patients who had ever smoked (P = 0.0049). Among nonsmokers, high anti-P gingivalis antibody levels were associated with a higher prevalence of erosive change (47.5% versus 33.3% with modified Sharp/van der Heijde score erosion subscale ≥1; P = 0.0135).
  
  
  CONCLUSIONS
  In this large early RA cohort, we did not detect any association of anti-P gingivalis antibodies with RA or with ACPA status. These results suggest that the association of periodontitis and RA could be linked to bacterial species other than P gingivalis or to a mechanism other than citrullination. Nevertheless, we found higher anti-P gingivalis antibody titers in nonsmokers. In addition, in this population of nonsmokers, high anti-P gingivalis antibody titers were associated with more severe disease. We hypothesize that the role of tobacco in RA pathogenesis is so high that the effect of P gingivalis could be revealed only in a population not exposed to tobacco.
authors.affiliation: Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, AP-HP, Université Paris-Sud, and INSERM U1012, Le Kremlin Bicêtre, France.
authors.forename: Raphaèle
authors.initials: R
authors.lastname: Seror
authors.affiliation: EA 1254, Université de Rennes 1, and Université Européenne de Bretagne, Rennes, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Le Gall-David
authors.affiliation: EA 1254, Université de Rennes 1, and Université Européenne de Bretagne, Rennes, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Bonnaure-Mallet
authors.affiliation: Université de Bordeaux, Bordeaux, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Schaeverbeke
authors.affiliation: Université de Toulouse, Toulouse, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cantagrel
authors.affiliation: EA 1254, Université de Rennes 1, and Université Européenne de Bretagne, Rennes, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Minet
authors.affiliation: Centre National de Référence des Maladies Auto-Immunes Rares, INSERM UMRS 1109, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, and Université de Strasbourg, Strasbourg, France.
authors.forename: Jacques-Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.affiliation: Hôpitaux Universitaires Paris-Sud, AP-HP, and Université Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Chanson
authors.affiliation: Université Paris-Descartes, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ravaud
authors.affiliation: Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, AP-HP, Université Paris-Sud, and INSERM U1012, Le Kremlin Bicêtre, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D016866:Bacteroidaceae Infections / Q000097:blood / Q000150:complications / Q000276:immunology; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D004777:Environment; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology; D016966:Porphyromonas gingivalis / Q000276:immunology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide