Protein Citrullination: The Link Between Rheumatoid Arthritis and Periodontitis?

  • M. J. de Smit
  • J. Westra
  • W. Nesse
  • A. Vissink
  • A. J. van Winkelhoff
  • E. Brouwer


Autoimmunity to citrullinated proteins is very specific for rheumatoid arthritis and is considered to be of pathogenic significance. Porphyromonas gingivalis, a major pathogen in gum disease (periodontitis), is hypothesized to play a role in the pathogenesis of rheumatoid arthritis by its unique ability to citrullinate endogenous and host proteins. The immune system in patients with a periodontal infection with Porphyromonas gingivalis is exposed to citrullinated antigens that might become systemic immunogens, eventually leading to rheumatoid arthritis.


Rheumatoid arthritis Periodontitis Porphyromonas gingivalis Protein citrullination 


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • M. J. de Smit
    • 1
  • J. Westra
    • 2
  • W. Nesse
    • 3
  • A. Vissink
    • 3
  • A. J. van Winkelhoff
    • 1
    • 4
  • E. Brouwer
    • 2
  1. 1.Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of GroningenGroningenThe Netherlands
  2. 2.Department of Rheumatology and Clinical ImmunologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
  3. 3.Department of Oral and Maxillofacial SurgeryUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
  4. 4.Department of Medical MicrobiologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands

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