{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:46:15Z","timestamp":1783467975019,"version":"3.55.0"},"reference-count":114,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T00:00:00Z","timestamp":1710547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Rheumatoid arthritis (RA) is a chronic, autoimmune disease with a complex outset. Besides the genetic susceptibility in its pathogenesis, various environmental factors also participate. Of these, in recent years, there have been increasing reports of the involvement of bacteria in the disease\u2019s outset and development, especially gut microbiota and oral pathogens. Most recent reports about bacteria participation in RA pathogenesis focus on Prevotella copri and Porphyromonas gingivalis. There are also reports about the involvement of respiratory and urinary tract pathogens. The exact mechanisms leading to RA development used by bacteria are not well known; however, some mechanisms by which bacteria can interact with the immune system are known and can potentially lead to RA development. The aim of this study is to provide a comprehensive review of the potential bacteria participating in RA development and the mechanism involved in that process.<\/jats:p>","DOI":"10.3390\/ijms25063386","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T05:14:07Z","timestamp":1710738847000},"page":"3386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Infectious and Commensal Bacteria in Rheumatoid Arthritis\u2014Role in the Outset and Progression of the Disease"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5873-4678","authenticated-orcid":false,"given":"Aleksandra","family":"Korzeniowska","sequence":"first","affiliation":[{"name":"Department of Physiopathology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1410-4287","authenticated-orcid":false,"given":"Ewa","family":"Bryl","sequence":"additional","affiliation":[{"name":"Department of Physiopathology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1159\/000493390","article-title":"Rheumatoid Arthritis: A Brief Overview of the Treatment","volume":"27","author":"Bullock","year":"2018","journal-title":"Med. Princ. Pract."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"iv4","DOI":"10.1093\/rheumatology\/kel313","article-title":"The Heart and Cardiovascular Manifestations in Rheumatoid Arthritis","volume":"45","author":"Voskuyl","year":"2006","journal-title":"Rheumatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"R984","DOI":"10.1186\/ar1775","article-title":"Rheumatoid Arthritis Is an Independent Risk Factor for Multi-Vessel Coronary Artery Disease: A Case Control Study","volume":"7","author":"Warrington","year":"2005","journal-title":"Arthritis Res. Ther."},{"key":"ref_4","first-page":"e22367","article-title":"Rheumatoid Arthritis and Associated Lung Diseases: A Comprehensive Review","volume":"14","author":"Azam","year":"2022","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kochi, M., Kohagura, K., Shiohira, Y., Iseki, K., and Ohya, Y. (2016). Inflammation as a Risk of Developing Chronic Kidney Disease in Rheumatoid Arthritis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0160225"},{"key":"ref_6","first-page":"3","article-title":"Genetic and Environmental Risk Factors for Rheumatoid Arthritis. Best Pract","volume":"31","author":"Deane","year":"2017","journal-title":"Res. Clin. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1172\/JCI110127","article-title":"Elevated Levels of Antibodies to Epstein-Barr Virus Antigens in Sera and Synovial Fluids of Patients with Rheumatoid Arthritis","volume":"67","author":"Alspaugh","year":"1981","journal-title":"J. Clin. Investig."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.ejr.2019.03.003","article-title":"Elevated Cytomegalovirus and Epstein-Barr Virus Burden in Rheumatoid Arthritis: A True Pathogenic Role or Just a Coincidence","volume":"41","author":"Bassyouni","year":"2019","journal-title":"Egypt. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/472978","article-title":"Human Cytomegalovirus and Autoimmune Disease","volume":"2014","author":"Halenius","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"63","DOI":"10.21608\/ejmm.2022.247208","article-title":"Molecular and Serological Study of Parvovirus B19 Infection among Rheumatoid Arthritis Patients at Menoufia University Hospital","volume":"31","author":"Elkhyat","year":"2022","journal-title":"Egypt. J. Med. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"867389","DOI":"10.1155\/2013\/867389","article-title":"Possible Role of Human Herpesvirus 6 as a Trigger of Autoimmune Disease","volume":"2013","author":"Broccolo","year":"2013","journal-title":"Sci. World J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1007\/s10067-020-05082-8","article-title":"Human Immunodeficiency Virus Infection (HIV)\u2013Associated Rheumatic Manifestations in Thepre- and Post-HAART Eras","volume":"39","author":"Vega","year":"2020","journal-title":"Clin. Rheumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.cellimm.2005.04.018","article-title":"The Role of Toll-like Receptor Signalling in the Pathogenesis of Arthritis","volume":"233","author":"Brentano","year":"2005","journal-title":"Cell. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"17126","DOI":"10.1038\/s41598-018-35473-6","article-title":"Variations in Oral Microbiome Profiles in Rheumatoid Arthritis and Osteoarthritis with Potential Biomarkers for Arthritis Screening","volume":"8","author":"Chen","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.autrev.2011.04.021","article-title":"An Overview on the Genetic of Rheumatoid Arthritis: A Never-Ending Story","volume":"10","author":"Perricone","year":"2011","journal-title":"Autoimmun. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.rdc.2017.04.003","article-title":"Human Leukocyte Antigen\u2013Disease Associations in Rheumatoid Arthritis","volume":"43","author":"Holoshitz","year":"2017","journal-title":"Rheum. Dis. Clin. N. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1053\/sarh.2002.32552","article-title":"Influence of Human Leukocyte Antigen-DRB1 on the Susceptibility and Severity of Rheumatoid Arthritis","volume":"31","author":"Hajeer","year":"2002","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.autrev.2013.08.002","article-title":"HLA Shared Epitope and ACPA: Just a Marker or an Active Player?","volume":"12","author":"Pratesi","year":"2013","journal-title":"Autoimmun. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"930112","DOI":"10.3389\/fimmu.2022.930112","article-title":"How RA Associated HLA-DR Molecules Contribute to the Development of Antibodies to Citrullinated Proteins: The Hapten Carrier Model","volume":"13","author":"Roudier","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.autrev.2018.02.014","article-title":"ACPA Mediates the Interplay between Innate and Adaptive Immunity in Rheumatoid Arthritis","volume":"17","author":"Dong","year":"2018","journal-title":"Autoimmun. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Sakkas, L.I., Daoussis, D., Liossis, S.-N., and Bogdanos, D.P. (2017). The Infectious Basis of ACPA-Positive Rheumatoid Arthritis. Front. Microbiol., 8.","DOI":"10.3389\/fmicb.2017.01853"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"655477","DOI":"10.3389\/fimmu.2021.655477","article-title":"A Tale of Two Immune Cells in Rheumatoid Arthritis: The Crosstalk Between Macrophages and T Cells in the Synovium","volume":"12","author":"Tu","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00281-009-0189-9","article-title":"Th17 Cytokines and Arthritis","volume":"32","author":"Lubberts","year":"2010","journal-title":"Semin. Immunopathol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.cyto.2014.10.006","article-title":"The Role of the Th17 Cytokines IL-17 and IL-22 in Rheumatoid Arthritis Pathogenesis and Developments in Cytokine Immunotherapy","volume":"74","author":"Roeleveld","year":"2015","journal-title":"Cytokine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1093\/rheumatology\/kep028","article-title":"Th17 and Regulatory T Cells: Rebalancing pro- and Anti-Inflammatory Forces in Autoimmune Arthritis","volume":"48","author":"Nistala","year":"2009","journal-title":"Rheumatology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/art.30093","article-title":"Th17 Cells, but Not Th1 Cells, from Patients with Early Rheumatoid Arthritis Are Potent Inducers of Matrix Metalloproteinases and Proinflammatory Cytokines upon Synovial Fibroblast Interaction, Including Autocrine interleukin-17A Production","volume":"63","author":"Asmawidjaja","year":"2011","journal-title":"Arthritis Rheum."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/1756-185X.12132","article-title":"Th17 Cells in Immunopathogenesis and Treatment of Rheumatoid Arthritis","volume":"16","author":"Azizi","year":"2013","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.autrev.2018.06.006","article-title":"Neutrophils: Novel Key Players in Rheumatoid Arthritis. Current and Future Therapeutic Targets","volume":"17","author":"Cecchi","year":"2018","journal-title":"Autoimmun. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.it.2013.09.001","article-title":"Immunomicrobial Pathogenesis of Periodontitis: Keystones, Pathobionts, and Host Response","volume":"35","author":"Hajishengallis","year":"2014","journal-title":"Trends Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00125-011-2342-y","article-title":"Periodontitis and Diabetes: A Two-Way Relationship","volume":"55","author":"Preshaw","year":"2012","journal-title":"Diabetologia"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Sedghi, L.M., Bacino, M., and Kapila, Y.L. (2021). Periodontal Disease: The Good, The Bad, and The Unknown. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.766944"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Wu, C., Yuan, Y., Liu, H., Li, S., Zhang, B., Chen, W., An, Z., Chen, S., Wu, Y., and Han, B. (2020). Epidemiologic Relationship between Periodontitis and Type 2 Diabetes Mellitus. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01180-w"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1114927","DOI":"10.3389\/fcvm.2023.1114927","article-title":"Periodontal Disease Is Associated with the Risk of Cardiovascular Disease Independent of Sex: A Meta-Analysis","volume":"10","author":"Leng","year":"2023","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s40496-018-0171-5","article-title":"Periodontitis and Respiratory Diseases: What Does the Recent Evidence Point To?","volume":"5","author":"Muthu","year":"2018","journal-title":"Curr. Oral Health Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/prd.12294","article-title":"Periodontal Disease and Adverse Pregnancy Outcomes","volume":"83","author":"Bobetsis","year":"2020","journal-title":"Periodontol. 2000"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1902\/jop.2008.070501","article-title":"Association Among Rheumatoid Arthritis, Oral Hygiene, and Periodontitis","volume":"79","author":"Pischon","year":"2008","journal-title":"J. Periodontol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3153","DOI":"10.1007\/s10067-021-05661-3","article-title":"Investigating the Relationship between the Severity of Periodontitis and Rheumatoid Arthritis: A Cross-Sectional Study","volume":"40","author":"Punceviciene","year":"2021","journal-title":"Clin. Rheumatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1038\/nrrheum.2009.28","article-title":"Periodontitis in Systemic Rheumatic Diseases","volume":"5","author":"Chapple","year":"2009","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3480","DOI":"10.4103\/jfmpc.jfmpc_759_19","article-title":"Red Complex: Polymicrobial Conglomerate in Oral Flora: A Review","volume":"8","author":"Mohanty","year":"2019","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.1902\/jop.2005.76.11-S.2066","article-title":"Periodontitis and Rheumatoid Arthritis: A Review","volume":"76","author":"Bartold","year":"2005","journal-title":"J. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4103\/jicdro.jicdro_10_17","article-title":"Role of Genetic in Periodontal Disease","volume":"9","author":"Wankhede","year":"2017","journal-title":"J. Int. Clin. Dent. Res. Organ."},{"key":"ref_42","first-page":"99","article-title":"Potential Mechanisms Linking Periodontitis to Rheumatoid Arthritis","volume":"21","author":"Lee","year":"2019","journal-title":"J. Int. Acad. Periodontol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1034\/j.1600-051X.1999.260203.x","article-title":"A \u201cCase Control\u201d Study on the R\u00f4le of HLA DR4 in Severe Periodontitis and Rapidly Progressive Periodontitis: Identification of Types and Subtypes Using Molecular Biology (PCR.SSO)","volume":"26","author":"Bonfil","year":"1999","journal-title":"J. Clin. Periodontol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"274","DOI":"10.5455\/msm.2012.24.274-276","article-title":"Smoking and Periodontal Disease","volume":"24","author":"Borojevic","year":"2012","journal-title":"Mater. Socio Medica"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"22279","DOI":"10.3390\/ijms151222279","article-title":"Smoking and Rheumatoid Arthritis","volume":"15","author":"Chang","year":"2014","journal-title":"Int. J. Mol. Sci."},{"key":"ref_46","first-page":"4835189","article-title":"Intestinal Dysbiosis and Rheumatoid Arthritis: A Link between Gut Microbiota and the Pathogenesis of Rheumatoid Arthritis","volume":"2017","year":"2017","journal-title":"J. Immunol. Res."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Luo, S., Li, W., Li, Q., Zhang, M., Wang, X., Wu, S., and Li, Y. (2023). Causal Effects of Gut Microbiota on the Risk of Periodontitis: A Two-Sample Mendelian Randomization Study. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1160993"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"De Molon, R.S., Rossa, C., Thurlings, R.M., Cirelli, J.A., and Koenders, M.I. (2019). Linkage of Periodontitis and Rheumatoid Arthritis: Current Evidence and Potential Biological Interactions. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20184541"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"259074","DOI":"10.1155\/2015\/259074","article-title":"Relationship between Periodontitis and Rheumatoid Arthritis: Review of the Literature","volume":"2015","author":"Melo","year":"2015","journal-title":"Mediators Inflamm."},{"key":"ref_50","first-page":"503754","article-title":"Periodontal Disease: Linking the Primary Inflammation to Bone Loss","volume":"2013","author":"Gigante","year":"2013","journal-title":"Clin. Dev. Immunol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s00296-019-04460-z","article-title":"Periodontal Disease and Influence of Periodontal Treatment on Disease Activity in Patients with Rheumatoid Arthritis and Spondyloarthritis","volume":"40","author":"Korman","year":"2020","journal-title":"Rheumatol. Int."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1002\/JPER.20-0295","article-title":"Novel and Known Periodontal Pathogens Residing in Gingival Crevicular Fluid Are Associated with Rheumatoid Arthritis","volume":"92","author":"Manoil","year":"2021","journal-title":"J. Periodontol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Li, Y., Guo, R., Oduro, P.K., Sun, T., Chen, H., Yi, Y., Zeng, W., Wang, Q., Leng, L., and Yang, L. (2022). The Relationship Between Porphyromonas Gingivalis and Rheumatoid Arthritis: A Meta-Analysis. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.956417"},{"key":"ref_54","first-page":"e4775","article-title":"The Influence of Porphyromonas Gingivalis Bacterium Causing Periodontal Disease on the Pathogenesis of Rheumatoid Arthritis: Systematic Review of Literature","volume":"11","author":"Kriauciunas","year":"2019","journal-title":"Cureus"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1136\/annrheumdis-2019-216919","article-title":"Bacterial Citrullinated Epitopes Generated by Porphyromonas Gingivalis Infection\u2014A Missing Link for ACPA Production","volume":"79","author":"Jenning","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Maresz, K.J., Hellvard, A., Sroka, A., Adamowicz, K., Bielecka, E., Koziel, J., Gawron, K., Mizgalska, D., Marcinska, K.A., and Benedyk, M. (2013). Porphyromonas Gingivalis Facilitates the Development and Progression of Destructive Arthritis through Its Unique Bacterial Peptidylarginine Deiminase (PAD). PLoS Pathog., 9.","DOI":"10.1371\/journal.ppat.1003627"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/BF00918681","article-title":"Rheumatoid Factor (RF) Distribution in Periodontal Disease","volume":"11","author":"The","year":"1991","journal-title":"J. Clin. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Maibom-Thomsen, S.L., Trier, N.H., Holm, B.E., Hansen, K.B., Rasmussen, M.I., Chailyan, A., Marcatili, P., H\u00f8jrup, P., and Houen, G. (2019). Immunoglobulin G Structure and Rheumatoid Factor Epitopes. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0217624"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1038\/sj.bdj.2018.217","article-title":"The Oral Microbiota\u2014A Mechanistic Role for Systemic Diseases","volume":"224","author":"Jia","year":"2018","journal-title":"Br. Dent. J."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1556\/EuJMI.1.2011.1.7","article-title":"Gingipains from Porphyromonas Gingivalis\u2014Complex Domain Structures Confer Diverse Functions","volume":"1","author":"Li","year":"2011","journal-title":"Eur. J. Microbiol. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1902\/jop.2003.74.1.111","article-title":"The Role of Gingipains in the Pathogenesis of Periodontal Disease","volume":"74","author":"Imamura","year":"2003","journal-title":"J. Periodontol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1183194","DOI":"10.3389\/fimmu.2023.1183194","article-title":"Antibodies against Porphyromonas Gingivalis in Serum and Saliva and Their Association with Rheumatoid Arthritis and Periodontitis. Data from Two Rheumatoid Arthritis Cohorts in Sweden","volume":"14","author":"Kastbom","year":"2023","journal-title":"Front. Immunol."},{"key":"ref_63","first-page":"522","article-title":"Association between Anti-Porphyromonas Gingivalis Antibody, Anti-Citrullinated Protein Antibodies, and Rheumatoid Arthritis: A Meta-Analysis. Z","volume":"77","author":"Bae","year":"2018","journal-title":"Rheumatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1136\/annrheumdis-2012-202726","article-title":"Heightened Immune Response to Autocitrullinated Porphyromonas Gingivalis Peptidylarginine Deiminase: A Potential Mechanism for Breaching Immunologic Tolerance in Rheumatoid Arthritis","volume":"73","author":"Quirke","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"R488","DOI":"10.1016\/j.cub.2011.05.039","article-title":"Toll-like Receptors","volume":"21","author":"Moresco","year":"2011","journal-title":"Curr. Biol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3109\/08830185.2010.529976","article-title":"Pathogen Recognition by the Innate Immune System","volume":"30","author":"Kumar","year":"2011","journal-title":"Int. Rev. Immunol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"3684","DOI":"10.1002\/art.24140","article-title":"Overexpression of Toll-like Receptors 3 and 4 in Synovial Tissue from Patients with Early Rheumatoid Arthritis: Toll-like Receptor Expression in Early and Longstanding Arthritis","volume":"58","author":"Ospelt","year":"2008","journal-title":"Arthritis Rheum."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1002\/art.21278","article-title":"The Expression of Toll-like Receptors 3 and 7 in Rheumatoid Arthritis Synovium Is Increased and Costimulation of Toll-like Receptors 3, 4, and 7\/8 Results in Synergistic Cytokine Production by Dendritic Cells","volume":"52","author":"Roelofs","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3856","DOI":"10.1002\/art.20678","article-title":"Expression of Toll-like Receptors 2 and 4 in Rheumatoid Synovial Tissue and Regulation by Proinflammatory Cytokines Interleukin-12 and Interleukin-18 via Interferon-\u03b3","volume":"50","author":"Radstake","year":"2004","journal-title":"Arthritis Rheum."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Gokyu, M., Kobayashi, H., Nanbara, H., Sudo, T., Ikeda, Y., Suda, T., and Izumi, Y. (2014). Thrombospondin-1 Production Is Enhanced by Porphyromonas Gingivalis Lipopolysaccharide in THP-1 Cells. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0115107"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/j.1365-2567.2009.03221.x","article-title":"Expression and Regulation of Interleukin-33 in Human Monocytes","volume":"130","author":"Nile","year":"2010","journal-title":"Immunology"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1600-0722.1997.tb00174.x","article-title":"Localized Juvenile Periodontitis and Actinobacillus Actinomycetemcomitans in a Brazilian Population","volume":"105","author":"Tinoco","year":"1997","journal-title":"Eur. J. Oral Sci."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Vega, B.A., Belinka, B.A., and Kachlany, S.C. (2019). Aggregatibacter Actinomycetemcomitans Leukotoxin (LtxA; Leukothera\u00ae): Mechanisms of Action and Therapeutic Applications. Toxins, 11.","DOI":"10.3390\/toxins11090489"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1111\/j.1574-6976.2010.00231.x","article-title":"RTX Proteins: A Highly Diverse Family Secreted by a Common Mechanism","volume":"34","author":"Bumba","year":"2010","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"369ra176","DOI":"10.1126\/scitranslmed.aaj1921","article-title":"Aggregatibacter Actinomycetemcomitans\u2013Induced Hypercitrullination Links Periodontal Infection to Autoimmunity in Rheumatoid Arthritis","volume":"8","author":"Konig","year":"2016","journal-title":"Sci. Transl. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1177\/00220345010800010901","article-title":"Immunodominant Region of Actinobacillus Actinomycetemcomitans 40-Kilodalton Heat Shock Protein in Patients with Rheumatoid Arthritis","volume":"80","author":"Yoshida","year":"2001","journal-title":"J. Dent. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1902\/jop.2012.110467","article-title":"Proinflammatory and Anti-Inflammatory Cytokines in Gingival Crevicular Fluid and Serum of Patients With Rheumatoid Arthritis and Patients With Chronic Periodontitis","volume":"84","author":"Cetinkaya","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1111\/1756-185X.13240","article-title":"Rheumatoid Arthritis and Periodontal Disease: What Are the Similarities and Differences?","volume":"20","author":"Li","year":"2017","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1111\/odi.13145","article-title":"Cytokines in Gingivocrevicular Fluid of Rheumatoid Arthritis Patients: A Review of the Literature","volume":"25","author":"Rahajoe","year":"2019","journal-title":"Oral Dis."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"S86","DOI":"10.1111\/j.1834-7819.2009.01146.x","article-title":"Non-surgical Management of Periodontal Disease","volume":"54","author":"Darby","year":"2009","journal-title":"Aust. Dent. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1177\/154405910508400312","article-title":"Short-Term Effects of Intensive Periodontal Therapy on Serum Inflammatory Markers and Cholesterol","volume":"84","author":"Nibali","year":"2005","journal-title":"J. Dent. Res."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"4975","DOI":"10.1007\/s00784-021-03807-w","article-title":"Non-Surgical Periodontal Treatment Improves Rheumatoid Arthritis Disease Activity: A Meta-Analysis","volume":"25","author":"Sun","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1093\/cid\/ciab568","article-title":"Bacterial and Viral Respiratory Tract Microbiota and Host Characteristics in Adults With Lower Respiratory Tract Infections: A Case-Control Study","volume":"74","author":"Haak","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1002\/art.34344","article-title":"Brief Report: Airways Abnormalities and Rheumatoid Arthritis\u2013Related Autoantibodies in Subjects without Arthritis: Early Injury or Initiating Site of Autoimmunity?","volume":"64","author":"Demoruelle","year":"2012","journal-title":"Arthritis Rheum."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Ishikawa, Y., and Terao, C. (2020). The Impact of Cigarette Smoking on Risk of Rheumatoid Arthritis: A Narrative Review. Cells, 9.","DOI":"10.3390\/cells9020475"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1002\/art.38066","article-title":"Sputum Autoantibodies in Patients With Established Rheumatoid Arthritis and Subjects at Risk of Future Clinically Apparent Disease","volume":"65","author":"Willis","year":"2013","journal-title":"Arthritis Rheum."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Scher, J.U., Joshua, V., Artacho, A., Abdollahi-Roodsaz, S., \u00d6ckinger, J., Kullberg, S., Sk\u00f6ld, M., Eklund, A., Grunewald, J., and Clemente, J.C. (2016). The Lung Microbiota in Early Rheumatoid Arthritis and Autoimmunity. Microbiome, 4.","DOI":"10.1186\/s40168-016-0206-x"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Opazo, M.C., Ortega-Rocha, E.M., Coronado-Arr\u00e1zola, I., Bonifaz, L.C., Boudin, H., Neunlist, M., Bueno, S.M., Kalergis, A.M., and Riedel, C.A. (2018). Intestinal Microbiota Influences Non-Intestinal Related Autoimmune Diseases. Front. Microbiol., 9.","DOI":"10.3389\/fmicb.2018.00432"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Hedar, A.M., Stradner, M.H., Roessler, A., and Goswami, N. (2021). Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10194427"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1146\/annurev-immunol-093019-112348","article-title":"Control of Immunity by the Microbiota","volume":"39","author":"Ansaldo","year":"2021","journal-title":"Annu. Rev. Immunol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.molmed.2020.04.001","article-title":"The Gut Microbiota: Emerging Evidence in Autoimmune Diseases","volume":"26","author":"Zhang","year":"2020","journal-title":"Trends Mol. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/j.1365-2567.2011.03522.x","article-title":"Interleukin-23: As a Drug Target for Autoimmune Inflammatory Diseases","volume":"135","author":"Tang","year":"2012","journal-title":"Immunology"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"e373","DOI":"10.1038\/emm.2017.172","article-title":"Bacterial Flagellin\u2014A Potent Immunomodulatory Agent","volume":"49","author":"Hajam","year":"2017","journal-title":"Exp. Mol. Med."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2750","DOI":"10.3389\/fimmu.2019.02750","article-title":"Induction of Intestinal Th17 Cells by Flagellins From Segmented Filamentous Bacteria","volume":"10","author":"Wang","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.immuni.2010.06.001","article-title":"Gut-Residing Segmented Filamentous Bacteria Drive Autoimmune Arthritis via T Helper 17 Cells","volume":"32","author":"Wu","year":"2010","journal-title":"Immunity"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1126\/science.1206095","article-title":"The Toll-Like Receptor 2 Pathway Establishes Colonization by a Commensal of the Human Microbiota","volume":"332","author":"Round","year":"2011","journal-title":"Science"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"e01202","DOI":"10.7554\/eLife.01202","article-title":"Expansion of Intestinal Prevotella Copri Correlates with Enhanced Susceptibility to Arthritis","volume":"2","author":"Scher","year":"2013","journal-title":"eLife"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1136\/annrheumdis-2018-214514","article-title":"Prevotella Copri in Individuals at Risk for Rheumatoid Arthritis","volume":"78","author":"Lesker","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1002\/art.40003","article-title":"Evidence of the Immune Relevance of Prevotella Copri, a Gut Microbe, in Patients With Rheumatoid Arthritis","volume":"69","author":"Pianta","year":"2017","journal-title":"Arthritis Rheumatol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"2646","DOI":"10.1002\/art.39783","article-title":"Dysbiosis Contributes to Arthritis Development via Activation of Autoreactive T Cells in the Intestine","volume":"68","author":"Maeda","year":"2016","journal-title":"Arthritis Rheumatol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"711788","DOI":"10.3389\/fphar.2021.711788","article-title":"Probiotic Supplementation for Rheumatoid Arthritis: A Promising Adjuvant Therapy in the Gut Microbiome Era","volume":"12","author":"Ferro","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Pan, H., Guo, R., Ju, Y., Wang, Q., Zhu, J., Xie, Y., Zheng, Y., Li, T., Liu, Z., and Lu, L. (2019). A Single Bacterium Restores the Microbiome Dysbiosis to Protect Bones from Destruction in a Rat Model of Rheumatoid Arthritis. Microbiome, 7.","DOI":"10.1186\/s40168-019-0719-1"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"41","DOI":"10.4103\/0974-1208.178638","article-title":"Lactobacillus Acidophilus Maintained Oxidative Stress from Reproductive Organs in Collagen-Induced Arthritic Rats","volume":"9","author":"Amdekar","year":"2016","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_104","first-page":"1","article-title":"Bacillus Coagulans: A Viable Adjunct Therapy for Relieving Symptoms of Rheumatoid Arthritis According to a Randomized, Controlled Trial. BMC Complement","volume":"10","author":"Mandel","year":"2010","journal-title":"Altern. Med."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1038\/s41579-020-0324-0","article-title":"Urinary Tract Infections: Microbial Pathogenesis, Host\u2013Pathogen Interactions and New Treatment Strategies","volume":"18","author":"Klein","year":"2020","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/S0140-6736(85)90352-6","article-title":"Antibodies to Proteus in Rheumatoid Arthritis","volume":"2","author":"Ebringer","year":"1985","journal-title":"Lancet"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1093\/rheumatology\/XXVII.suppl_2.90","article-title":"Antibodies to Proteus in rheumatoid arthritis","volume":"27","author":"Rogers","year":"1988","journal-title":"Br. J. Rheumatol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/S1286-4579(00)01303-4","article-title":"Molecular Mimicry between HLA-DR Alleles Associated with Rheumatoid Arthritis and Proteus Mirabilis as the Aetiological Basis for Autoimmunity","volume":"12","author":"Wilson","year":"2000","journal-title":"Microbes Infect."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1128\/IAI.67.6.2769-2775.1999","article-title":"Cross-Reactivity between the Rheumatoid Arthritis-Associated Motif EQKRAA and Structurally Related Sequences Found in Proteus Mirabilis","volume":"67","author":"Tiwana","year":"1999","journal-title":"Infect. Immun."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s10067-003-0847-6","article-title":"Antibacterial and Antipeptide Antibodies in Japanese and Finnish Patients with Rheumatoid Arthritis","volume":"23","author":"Rashid","year":"2004","journal-title":"Clin. Rheumatol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1093\/rheumatology\/kei036","article-title":"Elevated Levels of IgM and IgA Antibodies to Proteus Mirabilis and IgM Antibodies to Escherichia Coli Are Associated with Early Rheumatoid Factor (RF)-Positive Rheumatoid Arthritis","volume":"44","author":"Newkirk","year":"2005","journal-title":"Rheumatology"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s10067-003-0713-6","article-title":"Proteus Mirabilis and Rheumatoid Arthritis: No Association with the Disease","volume":"22","author":"Chandrashekara","year":"2003","journal-title":"Clin. Rheumatol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"8427","DOI":"10.2147\/IJGM.S333423","article-title":"Lower Urinary Tract Symptoms Among Females with Rheumatoid Arthritis: A Prospective Cross-Sectional Study","volume":"14","author":"Abushamma","year":"2021","journal-title":"Int. J. Gen. Med."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s10067-012-2129-7","article-title":"Urinary Tract Infections in Patients with Rheumatoid Arthritis","volume":"32","author":"Puntis","year":"2013","journal-title":"Clin. Rheumatol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/6\/3386\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:14:44Z","timestamp":1760105684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/6\/3386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,16]]},"references-count":114,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["ijms25063386"],"URL":"https:\/\/doi.org\/10.3390\/ijms25063386","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,16]]}}}