Importantly, like RF, ESR correlates with arthritis (SJC28, TJC28, DAS28-ESR and pVAS) scores and inflammatory maker (TNF and MMP-3) levels in the RRP group as shown in Fig 7, indicating that Pg-LPS, which contributes to increasing ESR (Fig 3), may also be implicated in developing arthritis in the RRP group. Here, MMP3 is linked to Arthritis.