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Antibodies against Porphyromonas gingivalis in seropositive arthralgia patients do not predict development of rheumatoid arthritis
  1. Menke de Smit1,
  2. Lotte Arwen van de Stadt2,3,
  3. Koen M J Janssen4,
  4. Berber Doornbos-van der Meer5,
  5. Arjan Vissink4,
  6. Arie Jan van Winkelhoff6,
  7. Elisabeth Brouwer5,
  8. Johanna Westra5,
  9. Dirkjan van Schaardenburg3,7
  1. 1Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  2. 2Sanquin Research and Landsteiner Laboratory, Academic Medical Center, Amsterdam, The Netherlands
  3. 3Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands
  4. 4Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  5. 5Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  6. 6Department of Medical Microbiology, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  7. 7Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Menke de Smit, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, PO Box 196, Groningen 9700 AD, The Netherlands; m.j.de.smit{at}umcg.nl

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Clinical studies point towards an association between periodontitis and rheumatoid arthritis (RA).1 ,2 A pathogenic role is suggested for Porphyromonas gingivalis.3 P gingivalis may contribute to the pathogenesis of RA by breaking immune tolerance through formation of (bacterial and human) citrullinated proteins, leading to anticitrullinated protein antibody production (ACPA).4 ,5 Since ACPA production precedes RA development6 and because P gingivalis IgG antibodies are long-term stable in untreated periodontitis patients,7 we investigated whether anti-P gingivalis antibody levels are prognostic for development of RA, by assessing these antibodies in a cohort of 289 adults at risk for RA. Patients with arthralgia and seropositivity for IgM-rheumatoid factor (IgM-RF) and/or ACPA were selected from a prospective follow-up study on arthritis development.8 They are further referred to as seropositive arthralgia patients (SAP); their median follow-up was 30 months (IQR 13–49).

Baseline sera were used for measurement of ACPA, IgM-RF, C-reactive protein (CRP) and HLA-DRB1 SE carrier status.8 IgA, IgG and IgM antibody levels against P gingivalis were determined by in-house ELISA with a pooled lysate of clinical isolates of P gingivalis as …

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