Activated antimicrobial peptides due to periodontal bacteria in synovial fluid - The link between psoriatic arthritis and periodontitis?

Background: The impact of periodontal disease on systemic conditions has not been fully identified yet. Literature shows that the incidence of psoriatic arthritis in psoriasis-patients is higher in presence of periodontitis. To this day, it is not fully clear which pathophysiological mechanism lies behind this correlation. The missing link between these diseases might be the activation of antimicrobial peptides (AMPs) due to DNAs of periodontal bacteria in synovial fluid.

Hypothesis: Periodontitis is not only a local inflammation but effects systemic conditions as well. We assume that periodontitis is an important risk factor for the development of psoriatic arthritis in patients with psoriasis due to the increase of AMPs triggered by elevated periodontal bacteria DNAs in synovial fluid.

Conclusion: Systemic inflammation caused by periodontitis, the circulation of inflammatory proteins and the increase of potential pathogenic bacteria in the blood stream as well as in synovial fluid might trigger the over-expression of several immunological factors as AMPs and activate immune cells in all parts of the body.