title: Periodontal pathogens participate in synovitis in patients with rheumatoid arthritis in clinical remission: a retrospective case-control study.
abstract: OBJECTIVE
  The objective of this study was to investigate the role of periodontal pathogens in RA in remission.
  
  
  METHODS
  Twenty-one patients with active RA and 70 patients in clinical remission, including 48 patients with synovitis [US power Doppler (USPD)(+) group] and 22 patients without synovitis [USPD(-) group] were clinically assessed by US. CRP, ESR, haemoglobin, MMP-3, RF and ACPA were measured. Antibody titres against four types of periodontal pathogen [Aggregatibacter actinomycetemcomitans, Eikenella corrodens (Ec), Porphyromonas gingivalis and Prevotella intermedia (Pi)] were analysed using ELISA.
  
  
  RESULTS
  Musculoskeletal US examination showed that 68.6% of patients with RA in clinical remission exhibited synovitis. CRP, ESR, haemoglobin, MMP-3 and RF levels in both the USPD(+) and USPD(-) groups were clearly lower compared with the RA group in non-remission. The IgG serum antibody titre against Ec in the non-remission RA(+) group was significantly greater than that in the USPD(+) group, and the IgG antibody titre against Pi in the non-remission RA and USPD(+) groups was greater than in the USPD(-) group.
  
  
  CONCLUSIONS
  More than half of RA patients in remission showed persistent synovitis. This synovitis may be associated with periodontal disease-causing Pi. Thus, treating periodontal disease should also be considered in order to achieve more profound remission of RA.
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College, t-takeuchi@poh.osaka-med.ac.jp.
authors.forename: Tohru
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: Department of Hygiene and Public Health, Division of Preventive and Social Medicine, Osaka Medical College and.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Yoshikawa
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Hiramatsu
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ishida
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Makino
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Kinki University, Osaka, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takasugi
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D016866:Bacteroidaceae Infections / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D055113:Chronic Periodontitis / Q000382:microbiology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D018713:Prevotella intermedia / Q000276:immunology / Q000302:isolation & purification; D012074:Remission Induction; D012189:Retrospective Studies; D013585:Synovitis / Q000000981:diagnostic imaging / Q000382:microbiology*; D014463:Ultrasonography
chemical_list: D000907:Antibodies, Bacterial; D018501:Antirheumatic Agents; D015415:Biomarkers; D007074:Immunoglobulin G
keywords: clinical remission; periodontal pathogen; periodontitis; power Doppler; rheumatoid arthritis; ultrasonography