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We have read with great interest the paper from Courbon et al providing the first in vivo demonstration of arthritis induced by oral priming with Porphyromonas gingivalis in rats, though an increased prevalence of periodontal diseases has been observed in rheumatoid arthritis (RA) for a century.1 This major agent of periodontal disease is one of the only bacterium known to express a peptidylarginine deiminase. Citrullinated epitopes, generated by its enzymatic activity, bind to HLA-DRB1*04:01/04 with higher affinity than uncitrullinated epitopes, leading to an enhanced T-cell response 2 and trigger the production of anti-citrullinated protein antibody (ACPA).
Alcohol consumptio is a major risk factor for chronic periodontitis. Interestingly, two articles suggested an association between long-term moderate alcohol drinking and reduced risk of RA onset.3 Moreover, an inverse relationship between moderate alcohol consumption and radiological progression was suggested in men with early RA but not in women in two independent RA patient cohorts.4
Therefore, we investigated relationship between P. gingivalis infection, alcohol consumption, gender and radiological progression in American College of Radiology/European League Against Rheumatism (ACR/EULAR) 2010 early RA patients of the ESPOIR cohort (ethic no 020307).
Patients presented with inflammatory arthritis of …
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