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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.

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