Exposure to a Periodontal Pathogen Aggregatibacter Actinomycetemcomitans Is Associated with Increased SLE Severity

Harini Bagavant¹, Nina Wolska¹, Paulina Rybakowska¹, Magdalena Sroka¹, Astrid Rasmussen¹, Indra Adrianto¹, Felicia Qi², Courtney Montgomery¹, Kathy L. Sivils¹, Joel M. Guthridge³, Judith A. James¹, Joan T. Merrill¹ and Umesh Deshmukh¹, ¹Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, ²University of Oklahoma Health Sciences Center, Oklahoma City, OK, ³Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, OKC, OK

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: SLE and infection

Session Information

Date: Tuesday, November 7, 2017

Title: Systemic Lupus Erythematosus – Human Etiology and Pathogenesis Poster II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Infections are linked to morbidity in systemic lupus erythematosus (SLE). This study was undertaken to evaluate oral infections by dental plaque bacteria in SLE patients and the influence of this bacterial exposure on disease in patients and in lupus mice.

Methods: Circulating IgG antibodies against dental plaque bacteria identify exposure to the organism. In a pilot study, sera from 72 SLE patients in the Lupus Family Registry and Repository (LFRR) were tested for antibodies to 7 dental plaque bacteria by ELISA. Antibodies to Aggregatibacter actinomycetemcomitans (Aa) were measured in a confirmatory study of 587 patients from the Oklahoma Lupus Cohort and 75 healthy volunteers. Correlations between anti-Aa antibody titers and autoantibodies, complement levels, and clinical features of lupus were studied. NZM2328 lupus mice were infected orally with Aa and the effects on disease severity was evaluated.

Results: SLE patients show varying levels of serum antibodies to plaque bacteria. Of the antibodies tested, only anti-Aa antibody levels were significantly associated with anti-dsDNA titers, a hallmark of SLE. This association was confirmed in patients from the Oklahoma Lupus Cohort. Absorption of anti-Aa with Aa did not affect anti-dsDNA reactivity, indicating that this association was not solely due to cross-reactivity. An exploratory analysis of clinical variables showed that higher anti-Aa titers in SLE patients were associated with low C4 complement levels and increased disease activity as measured by SLEDAI and BILAG scores. In lupus mice, Aa activated histone reactive T cells and accelerated onset lupus nephritis.

Conclusion: Exposure to the periodontal pathogen, Aa, is associated with higher autoantibodies and increased disease activity in SLE patients. Evidence from mouse studies suggests that this worsening of disease may be driven by exacerbated auto-reactivity.

Disclosure: H. Bagavant, None; N. Wolska, None; P. Rybakowska, None; M. Sroka, None; A. Rasmussen, None; I. Adrianto, None; F. Qi, None; C. Montgomery, None; K. L. Sivils, None; J. M. Guthridge, None; J. A. James, None; J. T. Merrill, None; U. Deshmukh, None.

To cite this abstract in AMA style:

Bagavant H, Wolska N, Rybakowska P, Sroka M, Rasmussen A, Adrianto I, Qi F, Montgomery C, Sivils KL, Guthridge JM, James JA, Merrill JT, Deshmukh U. Exposure to a Periodontal Pathogen Aggregatibacter Actinomycetemcomitans Is Associated with Increased SLE Severity [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/exposure-to-a-periodontal-pathogen-aggregatibacter-actinomycetemcomitans-is-associated-with-increased-sle-severity/. Accessed .

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