Periodontal Pathogens Correlate with Rheumatoid Arthritis Disease Parameters: A Systematic Review Based on Clinical Studies

Background: Numerous studies have found higher levels of autoantibodies including anti citrullinated protein antibodies (ACPAs), anti-cyclic citrullinated peptides (aCCP), or rheumatoid factor (RF) against periodontal microorganisms in rheumatoid arthritis (RA). Objective: To evaluate the correlation between periodontal bacteria and RA disease parameters. Methods: We utilized PubMed, Scopus, ScienceDirect, and manual search databases up until March 2024 using PRISMA 2020 guidelines. The data were obtained from microbiological assays by RT-PCR/qPCR, sequencing, and serological testing of disease parameters (ACPA, aCCP, and RF) utilizing ELISA method. Results: A total of 1514 documents were discovered based on the inclusion criteria. Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella_9 were associated with elevated levels of ACPA/aCCP and RF in RA with periodontitis. A positive correlation was found between Peptococcus simiae, Aminipila butyrica, Leptotrichia spp., Leptotrichia wadei, and Neisseria bacilliformis with ACPA, and Treponema sp. canine oral taxon 087 with RF. Conclusions: This study found that several oral microorganisms correlate with elevated ACPA/aCCP and RF in RA with periodontitis. Future studies of the oral microbiome and the molecular mechanisms are anticipated to discover new therapies and diagnostic methods for periodontitis and RA.