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Periodontal Pathogens Linked to Atherosclerosis in RA

WEDNESDAY, Nov. 18, 2020 -- For patients with rheumatoid arthritis (RA), immunoreactivity against Aggregatibacter actinomycetemcomitans serotype b (anti-Aa) and Aa leukotoxin A (anti-LtxA) is associated with atherosclerosis, according to a study published online Nov. 18 in Arthritis & Rheumatology.

Jon T. Giles, M.D., M.P.H., from the College of Physicians and Surgeons at Columbia University in New York City, and colleagues examined the contribution of periodontal pathogens to cardiovascular disease among 197 RA patients who underwent coronary artery calcification (CAC), carotid intima media thickness and plaque, and ankle-brachial index assessments. Sera were assayed for antibodies targeting periodontal pathogens: Porphyromonas gingivalis (anti-Pg), anti-Aa, and anti-LtxA; generalized linear models were used to explore the associations between these antibodies and measures of atherosclerosis.

The researchers found that anti-Pg, anti-Aa, and anti-LtxA were detected in 37, 21, and 43 percent of patients, respectively. The mean CAC score was 90 percent higher in those with anti-Aa and/or anti-LtxA versus those without either antibody after adjustment for relevant confounders and reported tooth loss. For those with anti-Aa and/or anti-LtxA, the adjusted odds of CAC ≥100 units were 2.23-fold higher than for those without either antibody. Significant associations were seen for anti-Aa and/or anti-LtxA seropositivity with all other assessed measures of atherosclerosis, apart from carotid plaque. Among those with anti-Aa and/or anti-LtxA, higher swollen joint count was associated with CAC.

"Further studies are needed to determine if eliminating exposure to this pathogen might modify the increase in cardiovascular disease known to be part of rheumatoid arthritis," Giles said in a statement.

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Posted: November 2020

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