Potential Role of Periodontopathogens in Rheumatoid Arthritis

Periodontal disease, particularly the chronic form of periodontitis, is a widespread inflammatory condition caused by pathogenic bacteria, such as Porphyromonas gingivalis. This review explores the potential role of periodontopathogens, particularly Porphyromonas gingivalis, in the development and progression of rheumatoid arthritis. Rheumatoid arthritis is a systemic autoimmune disorder characterized by joint inflammation and damage. Both periodontitis and rheumatoid arthritis share common inflammatory mechanisms, driven by proinflammatory cytokines and immune dysregulation. Porphyromonas gingivalis, via its pathogenic determinants, that is, gingipains and peptidyl arginine deiminase, facilitates the citrullination of proteins, leading to the generation of anti-citrullinated protein antibodies, a key feature in rheumatoid arthritis pathogenesis. The reciprocal relationship between periodontitis and rheumatoid arthritis is further supported through evidence showing that individuals with periodontitis are at a higher risk for rheumatoid arthritis, and vice versa. Both circumstances exhibit similar inflammatory pathways, involving cytokines like tumor necrosis factor alpha, interleukin 1 and interleukin 6 and tissue degradation mediated by matrix metalloproteinases.