Clinical and pathogenetic significance of the gingival microbiota in rheumatoid arthritis

Authors

  • O.V. Syniachenko Donetsk National Medical University, Lyman, Ukraine
  • M.V. Іermolaieva Donetsk National Medical University, Lyman, Ukraine
  • D.O. Gaviley Donetsk National Medical University, Lyman, Ukraine
  • K.V. Liventsova Donetsk National Medical University, Lyman, Ukraine
  • S.M. Verzilov Donetsk National Medical University, Lyman, Ukraine

DOI:

https://doi.org/10.22141/2312-413X.9.1.2021.228826

Keywords:

rheumatoid arthritis, gingiva, microbiota, etiology, pathogenesis

Abstract

Background. The trigger factors of the development of rheumatoid arthritis (RA) may be infections associated with the carriage in the oral cavity of Actinomycetes, Campylobacter, Mycoplasma, Porphyromonas, Transducers, Proteus, Selemons, Streptococci, and Fusobacteria, but their role in the disease pathogenesis requires clarification. In turn, the quantity of cases of comorbid infectious pathology significantly increases in RA. The purpose was to study the qualitative and quantitative composition of the oral microbiota in RA, to assess the role of individual bacteria in the pathogenetic structures of the disease. Materials and methods. There were examined 121 RA patients aged 18–76 years (on ave­rage 49 years old), among whom there were 19 % men and 81 % women. The duration from the first manifestation of the disease averaged 10 years. The frequency of seropositivity of RA for rheumatoid factor in the blood was 81 %, and for antibodies to cyclic citrullinated peptide — 75 %. I, II, and III degrees of disease activity were determined in 13, 45, and 42 % of cases, respectively, and the ratio of I, II, III, and IV stages of the pathological process was 1 : 5 : 5 : 3. To assess the number of aerobic and facultative anaerobic microorganisms growing on the gingival mucosa, the technique of sterile paper discs was used. The kits “Mikro-La-Test”, “Streptotest-16”, “Anaero-Test 23”, “Neferm Test 24” were used. Results. The vegetation of associations of aerobes on the gums was found in 96.7 % of patients, anaerobic bacteria — in 91.7 %, the number of which is closely related to clinical, laboratory, and X-ray signs of RA, while the integral landscape of the gingival microbiota is influenced by the severity of the comorbid chronic generalized periodontitis, which affects the presence of Moraxella, Sarcina, Streptococci, and Eubacteria in the oral cavity, moreover, the number of anaerobes reflects the degree of RA activity and bone mineral density, and in the pathogenetic constructions of individual signs of the disease (the nature of the articular syndrome and damage to the periarticular tissues), Aerococci, Candida, Clostridia, Megasphaera, Propionibacteria, Sarcina, Fusobacteria, and Eubacteria are involved. Conclusions. The obtained data dictate the need to develop new approaches to medical techno­logy for individual etiopathogenetic therapy of RA with comorbid periodontitis, to identify criteria that allow assessing the activity of the pathological process, predicting the nature of the course of the disease and the effectiveness of therapeutic measures.

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Published

2021-04-22

Issue

Section

Original Researches