Journal
INFLAMMATION
Volume 28, Issue 6, Pages 311-318Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10753-004-6641-z
Keywords
rheumatoid arthritis; periodontitis; Porphyromonas gingivalis; peptidylarginine deiminase; citrulline
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Rheumatoid arthritis (RA) and adult periodontitis share common pathogenetic mechanisms and immunologic and pathological findings. One oral pathogen strongly implicated in the pathogenesis of periodontal disease, Porphyromonas gingivalis, possesses a unique microbial enzyme, peptidylarginine deiminase (PAD), the human equivalent of which has been identified as a susceptibility factor for RA. We suggest that individuals predisposed to periodontal infection are exposed to antigens generated by PAD, with deiminated fibrin as a likely candidate, which become systemic immunogens and lead to intraarticular inflammation. PAD engendered antigens lead to production of rheumatoid factor-containing immune complexes and provoke local inflammation, both in gingiva and synovium via Fc and C5a receptors.
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