Evaluation of Antimicrobial Peptides in Saliva as Potential Therapeutic Agents Against Oral Pathogens in Pakistan

Abstract

Background: Maintaining optimal oral health is essential for overall well-being; however, conditions such as dental caries and gingivitis remain prevalent in Pakistan and are further worsened by increasing antibiotic resistance. Objective: To evaluate the antimicrobial properties of salivary peptides as potential therapeutic agents against common oral pathogens in Pakistan. Methodology: A one-year cross-sectional study was conducted in Lahore, Pakistan, at Sharif Medical and Dental College and Akhter Saeed Medical and Dental College, involving 384 participants aged 18-65 years. High-performance liquid chromatography (HPLC) was used to isolate antimicrobial peptides (AMPs) from oral swabs and saliva samples. Using the enzyme-linked immunosorbent test (ELISA), the minimum inhibitory concentration (MIC) of histatin, defensin, and cathelicidin against Streptococcus mutans and Candida albicans was determined. T-tests and other statistical analyses were used to assess the significance of the results across demographic variables. Results: There were 210 men (54.69%) and 174 women (45.31%) in the participation group. A total of 298 individuals (77.60%) did not smoke, while 221 participants (57.56%) said they brushed their teeth every day. Moreover, 198 individuals (51.56%) had oral infections with S. mutans alone, 71 participants (18.49%) had oral pathogens with C. albicans alone, and 52 people (13.54%) had both. Histatin of 8.09 ± 2.13 µg/mL, defensin of 7.83 ± 2.31 µg/mL, and cathelicidin of 6.19 ± 1.57 µg/mL were the MIC values for salivary AMPs against S. mutans . MIC values for histatin, defensin, and cathelicidin against C. albicans were 10.57 ± 1.82 µg/mL, 9.01 ± 2.03 µg/mL, and 7.42 ± 1.73 µg/mL, respectively. Males had higher MIC values than females, and there were significant variations according to smoking status (p < 0.05) and age (p < 0.05), suggesting that smokers had lower AMP effectiveness. Conclusion: Salivary AMPs, particularly histatin, defensin, and cathelicidin, demonstrate strong potential as therapeutic alternatives against oral infections such as dental caries and gingivitis, suggesting a promising strategy to mitigate antibiotic resistance in Pakistan. Further research is needed to explore their application in clinical practice.