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  • Alcohol is not the missing link between Porphyromonas gingivalis-related periodontitis and radiological progression in early rheumatoid arthritis

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Correspondence
Alcohol is not the missing link between Porphyromonas gingivalis-related periodontitis and radiological progression in early rheumatoid arthritis
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  1. Julien Hillion1,
  2. Alexandre Bellier2,
  3. Xavier Romand3,4,
  4. Bruno Fautrel5,
  5. Xavier Mariette6,7,
  6. Franck Sagéloli2,
  7. Athan Baillet1,4,
  8. Philippe Gaudin1
  1. 1 Rheumatology Department, Centre Hospitalier Universitaire Grenoble Alpes Hôpital Sud, Echirolles, France
  2. 2 Grenoble, France
  3. 3 Rheumatology Department, Grenoble Alpes University Hospital, Grenoble, France
  4. 4 Univ Grenoble Alpes, GREPI-UGA EA7408, Grenoble, France
  5. 5 Department of Rheumatology, Assistance Publique-Hôpitaux de Paris, University Hospital Pitié-Salpêtrière, Paris, France
  6. 6 INSERM U1184, Center for Immunology of Viral Infections andAutoimmune Diseases, Paris-Sud University, Paris-Saclay University, LeKremlin-Bicêtre, France
  7. 7 Department of Rheumatology, AP-HP, Paris-SudUniversity Hospitals, Le Kremlin Bicêtre Hospital, Le Kremlin-Bicêtre, France
  1. Correspondence to Mr Julien Hillion, Rheumatology Department, Centre Hospitalier Universitaire Grenoble Alpes Hopital Sud, Echirolles 38130, France; julienhillion1{at}hotmail.com

https://doi.org/10.1136/annrheumdis-2019-215603

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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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