Scientists have discovered that the same bugs that cause gum infections also trigger the crippling condition that blights the lives of hundreds of thousands of Britons.
The discovery adds to growing evidence that rheumatoid arthritis (RA) is linked with dental health.
Professor Felipe Andrade, of Johns Hopkins University in the US who carried out the new study, said: “This is like putting together the last few pieces of a complicated jigsaw puzzle that has been worked on for many years.”
His researchers said the new findings, published in the journal Science Translational Medicine, have important implications for prevention and treatment of rheumatoid arthritis in the future.
Study leader Dr Maximilian Konig, now at Massachusetts General Hospital, said: “This research may be the closest we have come to uncovering the root cause of RA.”
Rheumatoid arthritis is caused when the immune system malfunctions and attacks cells, making joints stiff and painful.
Last night, research bodies in the UK welcomed the new study’s findings connecting a specific gum infection to RA.
Natalie Carter, head of research liaison and evaluation, Arthritis Research UK: “There have been various studies over the years exploring the link between arthritis and oral health, which have demonstrated that gum disease is more common, and often more severe, for people living with rheumatoid arthritis.
"This research is interesting as it suggests a specific type of bacteria can trigger this condition for some people.
“Arthritis Research UK are currently funding research to understand how changes to the bacteria in the mouth and gut can cause the immune system to attack the body’s own tissues, causing rheumatoid arthritis.
“Understanding this relationship could lead to the development of new diagnostic tests and targeted therapies for the condition, helping more people push back the limits of arthritis.”
During the last decade, studies have focused on a bacterium known as ‘Porphyromonas gingivalis’, found in patients with gum disease.
But Prof Andrade’s team failed to corroborate this so began searching for alternative drivers behind the condition.
And they concluded that the common feature in gum disease and in many patients with RA was actually a different infection - called ‘Aggregatibacter actinomycetemcomitans’.
This bug in turn sparks the production of certain proteins, which are suspected of activating problems in the immune system - leading directly to RA.
The team found a process that had been observed in the joints of RA patients was also apparent in samples of gum disease.
Prof Andrade said this process happened naturally in everyone as a way to regulate the function of proteins. But in people with RA, it became overactive, resulting in the abnormal accumulation of chemicals.
This in turn lead to the production of antibodies against these proteins that created inflammation and attacked a person’s own tissues, the hallmark of RA.
As part of the research, the team used 196 samples from a large study of patients with RA. They found that almost half (92) had evidence of the gum infection.
More strikingly, exposure to the infection was a major factor in susceptibility to RA.
Professor Andrade said more research was now needed on the evolution of the bug, meaning that one day “perhaps we could prevent rather than just intervene.”
He added that treatments with steroids, immunotherapy drugs and physical therapy help some by reducing or slowing the devastating joint deformities, but not in all patients.
As a result, the exploration of alternative treatment options was also necessary.
Ms Carter, from Arthritis Research UK, said further studies on the relationship between gum bacteria and RA would continue.
She added: “We have invested significantly in the last two years on understanding the impact of bacteria on arthritis, and now fund more than £6million worth of this type of research, including collaborations with exceptional scientists all over the world.”
http://www.express.co.uk/life-style/health/744004/Gum-disease-rheumatoid-arthritis-brushing-teeth-joint-pain
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