Mucosal Vaccination Against Periodontal Disease: Current Status and Opportunities

Abstract

Approximately 9 out of 10 adults have some form of periodontal disease, an infection-induced inflammatory disease of the tooth-supporting tissues. The initial form, gingivitis, often remains asymptomatic, but this can evolve into periodontitis, which is typically associated with halitosis, oral pain or discomfort, and tooth loss. Furthermore, periodontitis may contribute to systemic disorders like cardiovascular disease and type 2 diabetes mellitus. Control options remain nonspecific, time-consuming, and costly; largely relying on the removal of dental plaque and calculus by mechanical debridement. However, while dental plaque bacteria trigger periodontal disease, it is the host-specific inflammatory response that acts as main driver of tissue destruction and disease progression. Therefore, periodontal disease control should aim to alter the host’s inflammatory response as well as to reduce the bacterial triggers. Vaccines may provide a potent adjunct to mechanical debridement for periodontal disease prevention and treatment. However, the immunopathogenic complexity and polymicrobial aspect of PD appear to complicate the development of periodontal vaccines. Moreover, a successful periodontal vaccine should induce protective immunity in the oral cavity, which proves difficult with traditional vaccination methods. Recent advances in mucosal vaccination may bridge the gap in periodontal vaccine development. In this review, we offer a comprehensive overview of mucosal vaccination strategies to induce protective immunity in the oral cavity for periodontal disease control. Furthermore, we highlight the need for additional research with appropriate and clinically relevant animal models. Finally, we discuss several opportunities in periodontal vaccine development such as multivalency, vaccine formulations, and delivery systems.

Grafting resveratrol onto mesoporous silica nanoparticles towards efficient sustainable immunoregulation and insulin resistance alleviation for diabetic periodontitis therapy

“…7 Therefore, clinicians only have to select conventional therapeutic strategies that involve three main steps: (1) glycemic control, (2) regular periodontal non-surgical treatment, and (3) antibiotic administration. 8,9 Although it has demonstrated a certain extent of efficacy in alleviating diabetic periodontitis (DP), 10 a plethora of related clinical trials have revealed no significant differences in the serum levels of key critical pro-inflammatory cytokines such as TNF-α and IL-6 before and after therapy. 11–13 In addition, related research studies have also claimed that this strategy played a limited role in alleviating the IR level of diabetes.…”

“…8,14 What's worse, antibiotic use is not routinely recommended due to the increased bacterial drug resistance which is detrimental to the human body. 9,15…”

“…8,14 What's worse, antibiotic use is not routinely recommended due to the increased bacterial drug resistance which is detrimental to the human body. 9,15 Periodontitis is caused by the confrontation between pathogenic microorganisms and various immune cells in the tissue. 16 Macrophages play a role in defending against bacterial infection, antigen presentation, and mobilization and serve as an efficient regulator of immune response homeostasis.…”

Pan-Genome Analysis of Oral Bacterial Pathogens to Predict a Potential Novel Multi-Epitopes Vaccine Candidate

“…Of these species, Treponema denticola , Aggregatibacter actinomycetemcomitans , P. gingiyalis , Tannerella forsythia , Campylobacter rectus and Fusobacterium nucleatum are associated with periodontitis [ 19 ]. No vaccine is currently licensed against periodontal disease; however, several efforts are underway to develop a vaccine [ 20 ]. Herein, reverse vaccinology was integrated with subtractive proteomics to prioritize potential vaccine candidates in the proteome of oral pathogens, especially P. gingivalis followed by epitopes mapping using immunoinformatic techniques.…”

Immortalised canine buccal epithelial cells’ CXCL8 secretion is affected by allergen extracts, Toll-like receptor ligands, IL-17A and calcitriol

“…In dogs this has been seen for house dust mite allergens and skin epithelial cells [ 10 , 11 ], but the effect of allergens on canine buccal epithelial cells has not yet been studied. Apart from antigen-specific tolerance, also pathogen-specific protective mucosal immune responses can be generated by vaccines that are administered onto the oral mucosa [ 12 – 14 ]. Recently, an oral Bordetella bronchiseptica vaccine has been developed for dogs which involves dripping the vaccine antigens onto the oral epithelium [ 15 ].…”