Dysbiotic subgingival microbial communities in periodontally healthy patients with rheumatoid arthritis

OBJECTIVES: Studies that demonstrate an association between rheumatoid arthritis (RA) and dysbiotic oral microbiomes are often confounded by the presence of extensive periodontitis in these individuals. Therefore, the present investigation sought to investigate the role of RA in modulating the periodontal microbiome by comparing periodontally healthy individuals with and without RA.

METHODS: Subgingival plaque was collected from was collected periodontally healthy individuals (22 with and 19 without RA), and 16S gene sequenced on the Ilumina MiSeq platform. Bacterial biodiversity and co-occurrence patterns were examined using the QIIME and PhyloToAST pipelines.

RESULTS: The subgingival microbiomes differed significantly based on both community membership and as well as the abundance of lineages, with 41.9% of the community differing in abundance and 19% in membership. In contrast to the sparse and predominantly congeneric co-occurrence networks seen in controls, RA subjects revealed a highly connected grid containing a large inter-generic hub anchored by known periodontal pathogens. Predictive metagenomic analysis (PICRUSt) demonstrated that arachidonic acid and ester lipid metabolism pathways might partly explain the robustness of this clustering. As expected from a periodontally healthy cohort, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were not significantly different between groups, however, Cryptobacterium curtum, another organism capable of producing large amounts of citrulline, emerged as a robust discriminant of the microbiome in individuals with RA.

CONCLUSIONS: Our data demonstrates that the oral microbiome in RA is enriched for inflammophilic and citrulline producing organisms, which may play a role in the production of autoantigenic citrullinated peptides in RA. This article is protected by copyright. All rights reserved.