ArticleBMC musculoskeletal disorders2015
Smoking, Porphyromonas gingivalis and the immune response to citrullinated autoantigens before the clinical onset of rheumatoid arthritis in a Southern European nested case-control study.
Article in BMC musculoskeletal disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 25 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Autoantibodies as predictors of progression to rheumatoid arthritis: a systematic review and meta-analysis.RMD open · 2026Pooled it
- The Relationship Between Porphyromonas Gingivalis and Rheumatoid Arthritis: A Meta-Analysis.Frontiers in cellular and infection microbiology · 2022Pooled it
- Serum antibody levels against Porphyromonas gingivalis in patients with and without rheumatoid arthritis - a systematic review and meta-analysis.Clinical oral investigations · 2017Pooled it
- Relationship between periodontitis and systemic health conditions: a narrative review.Ewha medical journal · 2025Review
- Article
- Periodontitis and periodontopathic bacteria as risk factors for rheumatoid arthritis: A review of the last 10 years.The Japanese dental science review · 2023Review
- The Interaction Effect of Anti-RgpA and Anti-PPAD Antibody Titers: An Indicator for Rheumatoid Arthritis Diagnosis.Journal of clinical medicine · 2023Article
- Serum antibodies to periodontal pathogens prior to rheumatoid arthritis diagnosis: A case-control study.Seminars in arthritis and rheumatism · 2023Article
- Host and bacterial factors linking periodontitis and rheumatoid arthritis.Frontiers in immunology · 2022Review
- Periodontitis in First Degree-Relatives of Individuals With Rheumatoid Arthritis: A Short Narrative Review.Frontiers in oral health · 2022Review
- The Subgingival Plaque Microbiome, Systemic Antibodies Against Bacteria and Citrullinated Proteins Following Periodontal Therapy.Pathogens (Basel, Switzerland) · 2021Article
- Improving accuracy of self-reported diagnoses of rheumatoid arthritis in the French prospective E3N-EPIC cohort: a validation study.BMJ open · 2019Article
- Gums and joints: is there a connection? Part two: the biological link.British dental journal · 2019Review
- Rheumatoid Arthritis-Associated Mechanisms ofJournal of clinical medicine · 2019Review
- Periodontal Injection of Lipopolysaccharide Promotes Arthritis Development in Mice.Inflammation · 2019Article
- A cross-sectional investigation into the association betweenTherapeutic advances in musculoskeletal disease · 2019Article
- Polymorphisms inFrontiers in cellular and infection microbiology · 2018Article
- Association of Distinct Fine Specificities of Anti-Citrullinated Peptide Antibodies With Elevated Immune Responses to Prevotella intermedia in a Subgroup of Patients With Rheumatoid Arthritis and Periodontitis.Arthritis & rheumatology (Hoboken, N.J.) · 2017Article
- Molecular basis for increased susceptibility of Indigenous North Americans to seropositive rheumatoid arthritis.Annals of the rheumatic diseases · 2017Article
- Pre-symptomatic autoimmunity in rheumatoid arthritis: when does the disease start?Seminars in immunopathology · 2017Review
Corrections and comments
- Erratum issuedErratum to: Smoking, Porphyromonas gingivalis and the immune response to citrullinated autoantigens before the clinical onset of rheumatoid arthritis in a Southern European nested case-control study.2016 · Apazidou, Danae [corrected to Apatzidou, Danae]
Authors and funding
20 authors.
Funding
Abstract
backgroundAntibodies to citrullinated proteins (ACPA) occur years before RA diagnosis. Porphyromonas gingivalis expresses its own peptidylarginine deiminase (PPAD), and is a proposed aetiological factor for the ACPA response. Smoking is a risk factor for both ACPA-positive RA and periodontitis. We aimed to study the relation of these factors to the risk of RA in a prospective cohort.
methodsWe performed a nested case-control study by identifying pre-RA cases in four populations from the European Prospective Investigation into Cancer and nutrition, matched with three controls. Data on smoking and other covariates were obtained from baseline questionnaires. Antibodies to CCP2 and citrullinated peptides from α-enolase, fibrinogen, vimentin and PPAD were measured. Antibodies to arginine gingipain (RgpB) were used as a marker for P.gingivalis infection and validated in a separate cohort of healthy controls and subjects with periodontitis.
resultsWe studied 103 pre-RA cases. RA development was associated with several ACPA specificities, but not with antibodies to citrullinated PPAD peptides. Antibody levels to RgpB and PPAD peptides were higher in smokers but were not associated with risk of RA or with pre-RA autoimmunity. Former but not current smoking was associated with antibodies to α-enolase (OR 4.06; 95 % CI 1.02, 16.2 versus 0.54; 0.09-3.73) and fibrinogen peptides (OR 4.24; 95 % CI 1.2-14.96 versus 0.58; 0.13-2.70), and later development of RA (OR 2.48; 95 % CI 1.27-4.84 versus 1.57; 0.85-2.93), independent of smoking intensity.
conclusionsSmoking remains a risk factor for RA well before the clinical onset of disease. In this cohort, P.gingivalis is not associated with pre-RA autoimmunity or risk of RA in an early phase before disease-onset. Antibodies to PPAD peptides are not an early feature of ACPA ontogeny.
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