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doi: 10.1016/S0140-6736(06)68433-X

The truth sits somewhere in the middle

The initiation of RA by inflammation characterized by an aberrant Th-17-dominated immune response, neutrophil activation, antigen citrullination, and anti-cyclic citrullinated peptide (CCP) production is exacerbated by microbial dysbiosis, the presence of oral pathobionts (e.g., Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans ), and periodontitis has been described (165167)

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