Symptoms of periodontitis and antibody responses to Porphyromonas gingivalis in juvenile idiopathic arthritis

Lauren Lange, Geoffrey M. Thiele, Courtney McCracken, Gabriel Wang, Lori A. Ponder, Sheila T. Angeles-Han, Kelly A. Rouster-Stevens, Aimee O. Hersh, Larry B. Vogler, John F. Bohnsack, Shelly Abramowicz, Ted R. Mikuls, Sampath Prahalad

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: The association between rheumatoid arthritis (RA) and periodontitis is well established. Some children with juvenile idiopathic arthritis (JIA) phenotypically resemble adults with RA, characterized by the presence of anti-cyclic citrullinated peptide (CCP) antibodies. We sought to investigate an association between CCP-positive JIA and symptoms of periodontitis and antibodies to oral microbiota. Methods: Antibodies to oral pathogens Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum were measured using ELISA in 71 children with CCP-positive JIA and 74 children with CCP-negative JIA. Oral health history was collected from 37 children with CCP-positive JIA and 121 children with CCP-negative JIA. T-tests, Chi-square tests, Mann-Whitney U tests, and multivariable regression were used to compare the groups. Results: Compared to those with CCP-negative JIA, children with CCP-positive JIA were more likely to be female, older and non-Caucasian. Anti-P. gingivalis (p <0.003) and anti-P. intermedia (p <0.008) IgG antibody titers were higher in the CCP-positive cohort. Differences in P. gingivalis antibody titers remained significant after adjusting for age (p = 0.007). Children with CCP-positive JIA more likely reported tender/bleeding gums (43% vs. 24%, p < 0.02) compared to children with CCP-negative JIA. After controlling for age at collection, the odds of having tender/bleeding gums were 2.2 times higher in the CCP-positive group compared (95% CI 0.98 - 4.83; p = 0.056). Conclusions: Children with CCP-positive JIA have higher antibody titers to P. gingivalis and more symptoms of poor oral health, supporting a possible role for periodontitis in the etiology of CCP-positive JIA.

Original languageEnglish (US)
Article number8
JournalPediatric Rheumatology
Issue number1
StatePublished - Feb 9 2016


  • Anti-citrullinated peptide antibody
  • Juvenile idiopathic arthritis
  • Periodontitis
  • Porphyromonas gingivalis
  • Prevotella intermedia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Rheumatology
  • Immunology and Allergy


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