Rheumatoid arthritis

Furthermore, the presence of A actinomycetemcomitans in the periodontal pocket is associated with high citrullination in the gingiva. The leukotoxin produced by A actinomycetemcomitans can directly stimulate neutrophils in PD, leading to the release of highly citrullinated components. Upon stable colonisation in the gingival sulcus, which is the natural space between the teeth and the surrounding gingival tissue, actinomycetes disrupt the healthy balance of the symbiotic bacterial community, a process known as microbial population transfer. This colonisation triggers the host’s innate immune system response, resulting in chronic inflammation. Actinomycetes possess mechanisms to evade phagocytes, bactericidal proteins, peptides, and reactive oxygen species, contributing to the perpetuation of chronic inflammation in the periodontal tissues

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