Session Information
Session Title: Sjögren's Syndrome: Clinical Aspects
Session Type: Abstract Submissions (ACR)
Background/Purpose: We set out to examine peripheral blood antibody ELISA responses to common oral bacteria in primary Sjögren’s syndrome (pSS) to identify potential bacterial triggers linked to HLA-DR3 and anti-Ro/La antibodies. We also assessed the prevalence of periodontitis in relation to these antibody responses and in comparison to other patient groups.
Methods: Following Research Ethics Committee approval, 65 patients (64,female) with pSS according to American-European Criteria (mean age = 61 years; 59/65 with anti-Ro/La antibodies; 2 smokers, 22 ex-smokers), 47 female patients with rheumatoid arthritis (RA) (mean age = 59; 46 anti-CCP positive; 8 smokers, 16 ex-smokers), 35 patients with osteoarthritis (OA) (mean age = 58 years; 2 smokers, 17 ex-smokers) and 41 people (28 female, mean age = 53) previously recruited to a therapeutic study in non-smokers with periodontitis (1), participated in this study. Sonicated whole bacteria lysates from 10 common oral bacteria were used as substrates for an in-house ELISA of anti-bacterial responses. Oral periodontal status was assessed using standard approaches according to the American Academy of Periodontology/Centres for Disease Control criteria.
Results: Periodontitis was identified in 20/42 patients with pSS who took part in this component of the study, 22/35 patients with RA and 17/30 patients with OA (not significant). RA patients were more likely than pSS to be current smokers (p=0.01). ELISA responses to P. gingivalis, P. denticola, P. intermedia and S. sanguis were significantly higher in patients with RA and periodontitis than in OA controls. P. denticola and S. mutans had greater responses in pSS patients than in OA controls. C. showae, E. faecalis and A. actinomycetemcomitans were particularly associated with the periodontitis group and F. nucleatum and C. gingivalishad no apparent associations with any groups.
Conclusion: Previous studies of the frequency of periodontitis in pSS have yielded conflicting results. This study did not identify an increased overall frequency of periodontitis in pSS although additional data analyses are planned. Periodontitis has been linked to active RA and Porphyromonas gingivalis has been proposed to play a central role in relation to anti-CCP antibody responses (2). Prevotella intermedia has also been identified by microbiome analysis (3) to be of potential interest in RA. Our data in RA patients supports these findings. Furthermore we have identified bacterial responses of potential interest in pSS such as to P. denticola and S. mutans. Oral microbiome analysis in pSS is now indicated to identify further bacteria of interest to direct research in this area.
- Chapple IL et al. J Clin Periodontol 2012; 39:62-72.
- De Pablo P et al. Ann Rheum Dis 2013; Mar 16.
- Scher JU et al. Arth Rheum 2012; 64:3083-94.
Acknowledgements: We thank the following for their assistance: Yanina Sevastsyanovich, Faye Morris, Ian Henderson, Farrah Ali and John Butcher. We thank Queen Elizabeth Hospital Charities for funding this work.
Disclosure:
B. Lugonja,
None;
M. Milward,
None;
D. Pearson,
None;
T. Dietrich,
None;
I. Chapple,
None;
J. Hamburger,
None;
F. Barone,
None;
S. Rauz,
None;
L. Yeo,
None;
A. Povedo-Gallego,
None;
G. Williams,
None;
P. de Pablo,
None;
A. Richards,
None;
C. D. Buckley,
None;
D. Scheel-Toellner,
None;
S. J. Bowman,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/antibody-responses-to-oral-bacteria-in-patients-with-primary-sjogrens-syndrome-and-comparison-with-rheumatoid-arthritis-and-periodontitis/