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The RAPD group had been randomised to receive intensive non\u2010surgical periodontal therapy (PMPR) or oral hygiene alone and reviewed at 3 and 6\u2009months in our previously reported study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Subgingival microbial dysbiosis, as evidenced by higher species richness, alpha\u2010diversity and higher levels of known and putative periodontal pathobionts, was evident at baseline in RAnoPD, RAPD and PDnoRA. Higher serum antibodies to oral pathogens were recorded in RAPD. PMPR restored host\u2013microbial homeostasis in RAPD within 3\u2009months. Significant decreases in serum antibodies to microbial antigens and clinical measures of RA activity were seen after 3 and 6\u2009months in the PMPR group but not controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We demonstrate a mutualistic influence of RA and PD, beginning with RA\u2010induced dysbiosis of the periodontal microbiome, progressing to periodontal inflammation and culminating in PD\u2010driven exacerbation of systemic inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.70063","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:38:52Z","timestamp":1764740332000},"page":"466-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Dysbiosis\u2010Mediated Inflammation: A Pathophysiological Link Between Rheumatoid Arthritis and Periodontitis"],"prefix":"10.1111","volume":"53","author":[{"given":"Isabel","family":"Lopez\u2010Oliva","sequence":"first","affiliation":[{"name":"Institute of Dentistry, Barts and the London School of Medicine and Dentistry Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2697-7082","authenticated-orcid":false,"given":"Iain L.","family":"Chapple","sequence":"additional","affiliation":[{"name":"Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences University of Birmingham  Birmingham UK"},{"name":"NIHR Birmingham Biomedical Research Centre in Inflammation  Birmingham UK"},{"name":"Birmingham Dental Hospital, Birmingham Community Healthcare NHS Foundation Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Paropkari","sequence":"additional","affiliation":[{"name":"Clear Labs, Inc.  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Pablo","sequence":"additional","affiliation":[{"name":"Research Into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, College of Medical and Dental Sciences University of Birmingham  Birmingham UK"},{"name":"Department of Rheumatology Sandwell and West Birmingham NHS Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Raza","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre in Inflammation  Birmingham UK"},{"name":"Research Into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, College of Medical and Dental Sciences University of Birmingham  Birmingham UK"},{"name":"Department of Rheumatology Sandwell and West Birmingham NHS Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Filer","sequence":"additional","affiliation":[{"name":"NIHR Birmingham Biomedical Research Centre in Inflammation  Birmingham UK"},{"name":"Research Into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, College of Medical and Dental Sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-7645","authenticated-orcid":false,"given":"Thomas","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences University of Birmingham  Birmingham UK"},{"name":"NIHR Birmingham Biomedical Research Centre in Inflammation  Birmingham UK"},{"name":"Birmingham Dental Hospital, Birmingham Community Healthcare NHS Foundation Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Grant","sequence":"additional","affiliation":[{"name":"Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences University of Birmingham  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