Pathogens and seropositive RA.

[Maz]

For anyone wondering how RA labs, such as anti-CCP and RF relate to infections, this study describes this connection as it relates to oral pathogens:

http://www.springerlink.com/content/u0308p11j2800205/

There is a common misconception that if one has seropositive RA then the disease is stictly “idiopathic” (no known cause) and “autoimmune” (errant self attack) and can’t possibly be due to an infection, e.g. oral pathogens, helicobacter pylori, Lyme, mycoplasma, etc. This study discusses how these lab markers, essentially antibodies, which are parameters used in diagnosis, are produced as a result of oral pathogens specifically.

In the case of anti-CCP (Anti-citrullinated protein antibodies), for instance, the common oral pathogen, P. Gingivalis, that causes gum disease, is now known to cause “citrullination” and that the human body reacts (in those genetically pre-disposed with certain genetic haplotypes) by producing antibodies in response.

So much is yet unknown about the ways in which bacteria drive the “autoimmune” process through antigenic response (by producing antibodies), but this British study demonstrates how pathogens create these auto-antibodies:

http://www.ncbi.nlm.nih.gov/pubmed/20506214

“Our findings demonstrate that among the oral bacterial pathogens tested, P gingivalis is unique in its ability to citrullinate proteins. We further show that P gingivalis rapidly generates citrullinated host peptides by proteolytic cleavage at Arg-X peptide bonds by arginine gingipains, followed by citrullination of carboxy-terminal arginines by bacterial PAD. Our results suggest a novel model where P gingivalis-mediated citrullination of bacterial and host proteins provides a molecular mechanism for generating antigens that drive the autoimmune response in RA.“

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