<i>Porphyromonas gingivalis</i> experimentally induces periodontis and an anti-CCP2-associated arthritis in the rat.

Abstract

Association between periodontal disease (PD) and rheumatoid arthritis (RA) has been extensively described, but direct evidence of causal involvement of PD in RA is missing. We investigated the priming role of oral <i>Porphyromonas gingivalis</i> (<i>P. gingivalis</i>) in PD and subsequent RA and we assessed biomarkers of bone resorption and arthritis development in rats. Lewis rats were orally exposed to either <i>P. gingivalis</i>, <i>Prevotella intermedia</i> or control gel for 1 month and then followed for 8 months. The onset and development of PD was assessed by serology, gingivitis severity and micro-CT (µCT). We investigated arthritis development using circulating proinflammatory markers, anticyclic citrullinated peptide (CCP), anticitrullinated protein antibody (ACPA), ankle histology and µCT. PD was only observed in the <i>P. gingivalis</i> treated rats, as early as 1 month postexposure. Joint and systemic inflammation were detected only in the <i>P. gingivalis</i> group after 4 and 8 months. At 8 months, inflammatory cell infiltrate was observed in ankle joints and paralleled cortical erosions and overall cortical bone reduction. Furthermore, anti-CCP2 correlated with local and systemic bone loss. In our long-term study, PD induced by oral exposure to <i>P. gingivalis</i> triggered seropositive arthritis, with systemic inflammation and bone erosions. This is the first in vivo demonstration of arthritis induced by oral priming with <i>P. gingivalis</i>.