The surprising body location that could expose Rheumatoid Arthritis early on

Researchers at the Academic Center for Dentistry Amsterdam have unveiled a promising approach for the early detection of rheumatoid arthritis (RA). This development allows patients to promptly begin suitable treatment, resulting in improved outcomes for this autoimmune disorder, which arises from a mix of genetic and environmental factors.

The study, published in the journal Arthritis & Rheumatology, reveals that the oral cavity, specifically the oral microbiome and periodontal health, may serve as a valuable diagnostic tool in identifying RA at its earliest stages.

The study involved a comprehensive analysis of data from three distinct groups, each containing 50 individuals. The first group consisted of participants with early RA, the second group was a control group of healthy individuals without RA or other autoimmune conditions, and the third group comprised those at an elevated risk for RA, exhibiting symptoms such as arthralgia or the presence of anti-citrullinated peptide antibodies (ACPA) in their blood serum. ACPA antibodies are known to appear long before the clinical manifestation of RA symptoms and serve as a crucial biomarker for the disease.

All participants underwent thorough dental and periodontal evaluations, including assessments of gum inflammation or bleeding, tooth loss, fillings, cavities, and the presence of removable dentures. In addition, samples were collected from the tongue’s coating, saliva, and subgingival plaque. Participants were also questioned about their oral hygiene habits and the last time they brushed their teeth.

The outcomes of the control group revealed no difference in the participants’ periodontal well-being or dental plaque accumulation. However, notable distinctions were observed in the composition of the microbial communities within the saliva and on the tongue’s coating.

The dangerous bacteria

Elevated levels of Prevotella and Veillonella bacteria were discovered in the saliva of individuals exhibiting early RA symptoms or possessing risk factors for the condition, as compared to the control group. Moreover, an increased presence of Veillonella bacteria was detected on the tongue coatings of those affected by RA.

The research team’s findings highlight a link between the oral cavity’s microbiome and RA, as certain bacteria, along with other genera, contribute to the body’s inflammatory response. In particular, the study reinforces prior research on Prevotella bacteria, which can lead to chronic inflammation and have been identified in the gut microbiome of RA patients or those with risk factors. The researchers note that this microbial imbalance, or dysbiosis, often improves with RA treatment.

Scientists have long suspected that microorganisms may play a role in triggering or causing autoimmune diseases like RA. The potential connection between periodontal disease, alterations in the oral and intestinal microbiomes, and RA has been a subject of ongoing investigation. Numerous studies suggest that specific oral bacteria, predominantly anaerobic types, may be critical in the development of RA.

A study from 2009 emphasized the presence of three distinct anaerobic bacterial species in the mouth, which have also been detected in the synovial fluid of individuals with RA. Subsequent research has suggested a connection between antibodies against specific bacteria linked to periodontitis and the development of RA.

From a scientific standpoint, it is likely that these bacteria generate proteins that trigger the ACPA antibody cascade, subsequently contributing to the body’s inflammatory reaction.

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