Association between anti-Porphyromonas gingivalis antibody, anti-citrullinated protein antibodies, and rheumatoid arthritis

A meta-analysis

Zusammenhang zwischen Anti-Porphyromonas-gingivalis-Antikörpern, Anti-citrulliniertes-Protein-Antikörpern und rheumatoider Arthritis

Eine Metaanalyse

Abstract

Objective

The aim of this study was to determine the relationship between anti-Porphyromonas gingivalis (anti-P. gingivalis) antibody levels and rheumatoid arthritis (RA) and its correlation with anti-citrullinated protein antibodies (ACPA).

Methods

We performed a meta-analysis of studies comparing (a) anti-P. gingivalis antibody levels in RA patients and healthy controls and (b) the correlation coefficients between the anti-P. gingivalis antibody levels and ACPA in RA patients.

Results

The study included 14 articles with 3829 RA patients and 1239 controls. Our meta-analysis showed that anti-P. gingivalis antibody levels were significantly higher in the RA group than in the control group (standardized mean difference [SMD] = 0.630, 95% CI = 0.272–0.989, p = 0.001). Subgroup analysis revealed that RA patients had significantly elevated anti-P. gingivalis antibody levels compared with healthy controls, but not compared with the non-RA control group and also not between different sample sizes. Anti-P. gingivalis antibody levels were significantly higher in the RA group than in the control group in the age-/sex-matched population, but not in the unmatched population. Anti-P. gingivalis antibody levels were significantly higher in the ACPA-positive group than in the ACPA-negative group (SMD = 0.322, 95% CI = 0.164–0.480, p = 6.4 × 10−5). Meta-analysis of the correlation coefficients showed a significant positive correlation between anti-P. gingivalis antibody levels and ACPA (correlation coefficient = 0.147, 95% CI = 0.033–0.258, p = 0.012).

Conclusion

Our meta-analysis demonstrated that anti-P. gingivalis antibody levels were significantly higher in patients with RA and they were positively correlated with ACPA.

Zusammenfassung

Ziel

Ziel der Studie war es, die Assoziation vom Anti-Porphyromonas-gingivalis-Antikörper-Spiegeln (Anti-P.-gingivalis-AK) und rheumatoider Arthritis (RA) sowie deren Korrelation mit Anti-citrulliniertes-Protein-Antikörpern (ACPA) zu ermitteln.

Methoden

Es erfolgte eine Metaanalyse von Studien, die zum einen die Anti-P.-gingivalis-AK-Spiegel bei RA-Patienten und gesunden Kontrollen verglichen und zum anderen die Korrelationskoeffizienten zwischen Anti-P.-gingivalis-AK-Spiegeln und ACPA bei RA-Patienten untersuchten.

Ergebnisse

Die Studie umfasste 14 Beiträge mit 3829 RA-Patienten und 1239 Kontrollen. Die vorliegende Metaanalyse zeigte, dass die Anti-P.-gingivalis-AK-Spiegel in der RA-Gruppe signifikant höher waren als in der Kontrollgruppe (standardisierte Mittelwertdifferenz, SMD: 0,630; 95%-Konfidenzintervall, 95%-KI: 0,272–0,989; p = 0,001). Die Subgruppenanalyse ergab, dass RA-Patienten im Vergleich zu gesunden Kontrollen signifikant erhöhte Anti-P. gingivalis-AK-Spiegel aufwiesen, nicht aber gegenüber der Kontrollgruppe ohne RA und auch nicht im Vergleich zwischen verschiedenen Stichprobengrößen. Die Anti-P.-gingivalis-AK-Spiegel waren in der RA-Gruppe signifikant höher als in der Kontrollgruppe in der nach Alter und Geschlecht gematchten Population, nicht aber in der ungematchten Population. In der ACPA-positiven Gruppe waren die Anti-P.-gingivalis-AK-Spiegel signifikant höher als in der ACPA-negativen Gruppe (SMD: 0,322; 95%-KI: 0,164–0,480; p = 6,4 × 10−5). Die Metaanalyse der Korrelationskoeffizienten zeigte eine signifikante positive Korrelation zwischen den Anti-P.-gingivalis-AK-Spiegeln und ACPA (Korrelationskoeffizient: 0,147; 95% -KI: 0,033–0,258; p = 0,012).

Schlussfolgerung

Die vorliegende Metaanalyse zeigte, dass die Anti-P.-gingivalis-AK-Spiegel bei RA-Patienten signifikant höher und mit APCA positiv korreliert waren.

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Funding

This study was supported in part by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health and Welfare, Republic of Korea (HI15C2958).

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Correspondence to Y. H. Lee MD, PhD.

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Conflict of interest

S.-C. Bae and Y.H. Lee declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Bae, S., Lee, Y.H. Association between anti-Porphyromonas gingivalis antibody, anti-citrullinated protein antibodies, and rheumatoid arthritis. Z Rheumatol 77, 522–532 (2018). https://doi.org/10.1007/s00393-017-0328-y

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Keywords

  • Anti-Pgingivalis antibody
  • Anti-citrullinated protein antibodies
  • Rheumatoid arthritis

Schlüsselwörter

  • Anti-Porphyromonas-gingivalis-Antikörper
  • Anti-citrulliniertes-Protein-Antikörper
  • Rheumatoide Arthritis