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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Microbial Immunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1504975
This article is part of the Research Topic Community Series in Unveiling Immunological Mechanisms of Periodontal Diseases, volume II View all 10 articles

The PerioGene North study reveals that periodontal inflammation and advanced jawbone loss in periodontitis associate with serum gingipain antibodies but not with systemic autoimmunity

Provisionally accepted
Elin Kindstedt Elin Kindstedt 1,2*Charlotte de Vries Charlotte de Vries 3Magnus Wänman Magnus Wänman 1Barbara Aleksandra Potempa Barbara Aleksandra Potempa 4Jan Potempa Jan Potempa 5Susanne Lindquist Susanne Lindquist 6Anders Esberg Anders Esberg 7Karin Lundberg Karin Lundberg 3Pernilla Lundberg Pernilla Lundberg 1
  • 1 Department of Odontology, Section for Molecular Periodontology, Umeå University, Umeå, Sweden
  • 2 Wallenberg Centre for Molecular Medicine, Faculty of Medicine, Umeå University, Umeå, Västerbotten, Sweden
  • 3 Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
  • 4 Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, Colorado, United States
  • 5 Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
  • 6 LipumAB, Umeå, Sweden
  • 7 Department of Odontology, Faculty of Medicine, Umeå University, Umea, Västerbotten, Sweden

The final, formatted version of the article will be published soon.

    Introduction: Periodontitis is associated with rheumatoid arthritis (RA). One hypothesis posits that this connection arises from the formation of autoantibodies against citrullinated proteins (ACPA) in inflamed gums, possibly triggered by Porphyromonas gingivalis. We previously demonstrated an increased antibody response to P. gingivalis arginine gingipains (anti-Rgp IgG), not only in individuals with severe periodontitis compared to controls, but in RA versus controls, with an association to ACPA. In the present study, we set out to further explore the relationship between anti-Rgp IgG, ACPA and periodontitis, including clinical periodontal parameters, in the large and well-characterized PerioGene North case-control study.We measured serum levels of anti-Rgp and ACPA IgG by enzyme-linked immunosorbent assay (ELISA), in 478 patients with periodontitis and 509 periodontally healthy controls within PerioGene North. Subsequently, anti-Rgp IgG levels and ACPA status were analysed in relation to periodontitis and clinical periodontal parameters.Results: Serum anti-Rgp IgG levels were elevated in cases versus controls (p< 0.001). However, receiver operating characteristic (ROC) curve analysis revealed that anti-Rgp IgG could not efficiently discriminate cases from controls (AUC= 0.63; 95% CI: 0.60 -0.66). Among cases, increased anti-Rgp IgG levels associated with high periodontal inflammation and advanced alveolar bone loss (p<0.001 for both). An ACPA response was detected in 15 (3.1%) cases and 6 (1.2%) controls (p=0.033), but no association to periodontitis was evident after adjustment for age and smoking and anti-Rgp IgG levels did not differ between ACPA-positive and ACPA-negative individuals.We show that anti-Rgp IgG identifies a subgroup of periodontitis patients with high degree of periodontal inflammation and advanced alveolar bone loss, but we do not find support for a link between periodontitis or anti-Rgp IgG and ACPA status in PerioGene North. Given the association between anti-Rgp and alveolar bone loss, the mechanistic role of gingipains in bone resorption should be experimentally explored.

    Keywords: Periodontitis, Alveolar Bone Loss, Periodontal inflammation, cysteine peptidase gingipain B, Anti-citrullinated protein antibodies

    Received: 01 Oct 2024; Accepted: 19 Dec 2024.

    Copyright: © 2024 Kindstedt, de Vries, Wänman, Aleksandra Potempa, Potempa, Lindquist, Esberg, Lundberg and Lundberg. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Elin Kindstedt, Department of Odontology, Section for Molecular Periodontology, Umeå University, Umeå, Sweden

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