1
|
Yadalam PK, Kalaivani V, Fageeh HI, Ibraheem W, Al-Ahmari MM, Khan SS, Ahmed ZH, Abdulkarim HH, Baeshen HA, Balaji TM, Bhandi S, Raj AT, Patil S. Future Drug Targets in Periodontal Personalised Medicine-A Narrative Review. J Pers Med 2022; 12:371. [PMID: 35330371 PMCID: PMC8955099 DOI: 10.3390/jpm12030371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 02/08/2023] Open
Abstract
Periodontal disease is an infection-driven inflammatory disease characterized by the destruction of tooth-supporting tissues. The establishment of chronic inflammation will result in progressive destruction of bone and soft tissue changes. Severe periodontitis can lead to tooth loss. The disease has complex pathogenesis with an interplay between genetic, environmental, and host factors and pathogens. Effective management consists of plaque control and non-surgical interventions, along with adjuvant strategies to control inflammation and disrupt the pathogenic subgingival biofilms. Recent studies have examined novel approaches for managing periodontal diseases such as modulating microbial signaling mechanisms, tissue engineering, and molecular targeting of host inflammatory substances. Mounting evidence suggests the need to integrate omics-based approaches with traditional therapy to address the disease. This article discusses the various evolving and future drug targets, including proteomics, gene therapeutics, vaccines, and nanotechnology in personalized periodontal medicine for the effective management of periodontal diseases.
Collapse
Affiliation(s)
- Pradeep Kumar Yadalam
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602117, India;
| | - V. Kalaivani
- Department of Periodontics, SRM Kattankulathur Dental College & Hospital, SRM Nagar, Chennai 603203, India;
| | - Hammam Ibrahim Fageeh
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.I.F.); (W.I.)
| | - Wael Ibraheem
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.I.F.); (W.I.)
| | - Manea Musa. Al-Ahmari
- Department of Periodontics and Community Medical Science, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Samar Saeed Khan
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Zeeshan Heera Ahmed
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Hesham H. Abdulkarim
- Advanced Periodontal and Dental Implant Care, Missouri School of Dentistry and Oral Health, A. T. Still University, St. Louis, MO 63104, USA;
| | - Hosam Ali Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | | | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| |
Collapse
|
2
|
Sojod B, Pidorodeski Nagano C, Garcia Lopez GM, Zalcberg A, Dridi SM, Anagnostou F. Systemic Lupus Erythematosus and Periodontal Disease: A Complex Clinical and Biological Interplay. J Clin Med 2021; 10:jcm10091957. [PMID: 34063235 PMCID: PMC8125164 DOI: 10.3390/jcm10091957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
Reports on the association of periodontal disease (PD) with systemic lupus erythematosus (SLE) have regularly been published. PD is a set of chronic inflammatory conditions linked to a dysbiotic microbial biofilm, which affects the periodontal tissues, resulting eventually in their destruction and contributing to systemic inflammation. SLE is a multi-system chronic inflammatory autoimmune disease that has a wide range of clinical presentations, touching multiple organ systems. Many epidemiological studies have investigated the two-way relationship between PD and SLE, though their results are heterogeneous. SLE and PD are multifactorial conditions and many biological-based hypotheses suggest common physiopathological pathways between the two diseases, including genetics, microbiology, immunity, and environmental common risk factors. By focusing on recent clinical and translational research, this review aimed to discuss and give an overview of the relationship of SLE with PD, as well as looking at the similarities in the immune-pathological aspects and the possible mechanisms connecting the development and progression of both diseases.
Collapse
Affiliation(s)
- Bouchra Sojod
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Glenda Melissa Garcia Lopez
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | - Antoine Zalcberg
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Fani Anagnostou
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
- B3OA, CNRS UMR 7052-INSERM U1271, Université de Paris, 75010 Paris, France;
- Correspondence:
| |
Collapse
|
3
|
Gu Y, Han X. Toll-Like Receptor Signaling and Immune Regulatory Lymphocytes in Periodontal Disease. Int J Mol Sci 2020; 21:ijms21093329. [PMID: 32397173 PMCID: PMC7247565 DOI: 10.3390/ijms21093329] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/27/2022] Open
Abstract
Periodontitis is known to be initiated by periodontal microbiota derived from biofilm formation. The microbial dysbiotic changes in the biofilm trigger the host immune and inflammatory responses that can be both beneficial for the protection of the host from infection, and detrimental to the host, causing tissue destruction. During this process, recognition of Pathogen-Associated Molecular Patterns (PAMPs) by the host Pattern Recognition Receptors (PRRs) such as Toll-like receptors (TLRs) play an essential role in the host–microbe interaction and the subsequent innate as well as adaptive responses. If persistent, the adverse interaction triggered by the host immune response to the microorganisms associated with periodontal biofilms is a direct cause of periodontal inflammation and bone loss. A large number of T and B lymphocytes are infiltrated in the diseased gingival tissues, which can secrete inflammatory mediators and activate the osteolytic pathways, promoting periodontal inflammation and bone resorption. On the other hand, there is evidence showing that immune regulatory T and B cells are present in the diseased tissue and can be induced for the enhancement of their anti-inflammatory effects. Changes and distribution of the T/B lymphocytes phenotype seem to be a key determinant of the periodontal disease outcome, as the functional activities of these cells not only shape up the overall immune response pattern, but may directly regulate the osteoimmunological balance. Therefore, interventional strategies targeting TLR signaling and immune regulatory T/B cells may be a promising approach to rebalance the immune response and alleviate bone loss in periodontal disease. In this review, we will examine the etiological role of TLR signaling and immune cell osteoclastogenic activity in the pathogenesis of periodontitis. More importantly, the protective effects of immune regulatory lymphocytes, particularly the activation and functional role of IL-10 expressing regulatory B cells, will be discussed.
Collapse
Affiliation(s)
- Yingzhi Gu
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA;
| | - Xiaozhe Han
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA;
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
- Correspondence:
| |
Collapse
|
4
|
Shang L, Deng D, Buskermolen JK, Roffel S, Janus MM, Krom BP, Crielaard W, Gibbs S. Commensal and Pathogenic Biofilms Alter Toll-Like Receptor Signaling in Reconstructed Human Gingiva. Front Cell Infect Microbiol 2019; 9:282. [PMID: 31448244 PMCID: PMC6692492 DOI: 10.3389/fcimb.2019.00282] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/24/2019] [Indexed: 12/24/2022] Open
Abstract
The balance between the host and microbe is pivotal for oral health. A dysbiotic oral microbiome and the subsequent host inflammatory response are causes for the most common dental problems, such as periodontitis and caries. Classically, toll-like receptors (TLRs) are known to play important roles in host-microbe interactions by recognizing pathogens and activating innate immunity. However, emerging evidence suggests that commensals may also exploit TLRs to induce tolerance to the benefit of the host, especially in oral mucosa which is heavily colonized by abundant microbes. How TLRs and downstream signaling events are affected by different oral microbial communities to regulate host responses is still unknown. To compare such human host-microbe interactions in vitro, we exposed a reconstructed human gingiva (RHG) to commensal or pathogenic (gingivitis, cariogenic) multi-species oral biofilms cultured from human saliva. These biofilms contain in vivo like phylogenic numbers and typical bacterial genera. After 24 h biofilm exposure, TLR protein and gene expression of 84 TLR pathway related genes were investigated. Commensal and pathogenic biofilms differentially regulated TLR protein expression. Commensal biofilm up-regulated the transcription of a large group of key genes, which are involved in TLR signaling, including TLR7, the MyD88-dependent pathway (CD14, MyD88, TIRAP, TRAF6, IRAKs), MyD88-independent pathway (TAB1, TBK1, IRF3), and their downstream signaling pathways (NF-κB and MAPK pathways). In comparison, gingivitis biofilm activated fewer genes (e.g., TLR4) and cariogenic biofilm suppressed CD14, IRAK4, and IRF3 transcription. Fluorescence in situ hybridization staining showed the rRNA of the topically applied and invaded bacteria, and histology showed that the biofilms had no obvious detrimental effect on RHG morphology. These results show an important role of TLR signaling pathways in regulating host-microbe interactions: when a sterile gingival tissue is exposed to commensals, a strong immune activation occurs which may prime the host against potential challenges in order to maintain oral host-microbe homeostasis. In contrast, pathogenic biofilms stimulate a weaker immune response which might facilitate immune evasion thus enabling pathogens to penetrate undetected into the tissues.
Collapse
Affiliation(s)
- Lin Shang
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Dongmei Deng
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jeroen Kees Buskermolen
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sanne Roffel
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marleen Marga Janus
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bastiaan Philip Krom
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Wim Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Susan Gibbs
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
5
|
Andrade EF, Orlando DR, Araújo AMS, de Andrade JNBM, Azzi DV, de Lima RR, Lobo-Júnior AR, Pereira LJ. Can Resveratrol Treatment Control the Progression of Induced Periodontal Disease? A Systematic Review and Meta-Analysis of Preclinical Studies. Nutrients 2019; 11:E953. [PMID: 31035477 PMCID: PMC6566182 DOI: 10.3390/nu11050953] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 12/29/2022] Open
Abstract
Resveratrol is an anti-inflammatory compound found in several foods. Periodontal disease (PD) is associated to other systemic diseases, and inflammation may be responsible for the association. Consequently, controlling inflammation not only may benefit oral health but also may assist with the management of other chronic inflammatory conditions. We aimed to investigate the effects of resveratrol administration on PD control in preclinical studies. A systematic search was performed for scientific articles using both electronic databases and a manual search using combinations of the following keywords: "resveratrol" OR "3,5,4'-trihydroxystilbene" AND "periodontal disease" OR "periodontitis" OR "gingivitis". Only in vivo original studies investigating resveratrol treatment on experimental animal models of PD were selected. A quality assessment of the studies was performed using the Animal Research Reporting In Vivo Experiment (ARRIVE) guidelines, and the risk of bias was assessed using the Syrcle tool. The search returned 570 articles, and 11 matched the inclusion criteria. A meta-analysis showed that resveratrol treatment attenuated alveolar bone loss (τ2 = 0.0041; 95% CI: -0.14; -0.04). The ARRIVE criteria reported a good quality of studies in general (mean score 28.5 ± 2.5). However, five Syrcle domains indicated a high risk of bias or did not present information clearly. We concluded that, in preclinical studies, resveratrol treatment prevented PD progression.
Collapse
Affiliation(s)
- Eric Francelino Andrade
- Institute of Agricultural Sciences, Universidade dos Vales do Jequitinhonha e Mucuri-UFVJM, Rua Vereador João Narciso, n.º 1380⁻Bairro Cachoeira, Unaí, Minas Gerais 38610-000, Brazil.
| | - Débora Ribeiro Orlando
- Institute of Agricultural Sciences, Universidade dos Vales do Jequitinhonha e Mucuri-UFVJM, Rua Vereador João Narciso, n.º 1380⁻Bairro Cachoeira, Unaí, Minas Gerais 38610-000, Brazil.
| | - Amanda Melo Sant'Anna Araújo
- Institute of Agricultural Sciences, Universidade dos Vales do Jequitinhonha e Mucuri-UFVJM, Rua Vereador João Narciso, n.º 1380⁻Bairro Cachoeira, Unaí, Minas Gerais 38610-000, Brazil.
| | - James Newton Bizetto Meira de Andrade
- Institute of Agricultural Sciences, Universidade dos Vales do Jequitinhonha e Mucuri-UFVJM, Rua Vereador João Narciso, n.º 1380⁻Bairro Cachoeira, Unaí, Minas Gerais 38610-000, Brazil.
| | - Diana Vilela Azzi
- Department of Veterinary Medicine, Universidade Federal de Lavras-UFLA, Mail Box 3037, Lavras, Minas Gerais 37200-000, Brazil.
| | - Renato Ribeiro de Lima
- Department of Exact Sciences, Universidade Federal de Lavras-UFLA, Mail Box 3037, Lavras, Minas Gerais 37200-000, Brazil.
| | - Adalfredo Rocha Lobo-Júnior
- Institute of Agricultural Sciences, Universidade dos Vales do Jequitinhonha e Mucuri-UFVJM, Rua Vereador João Narciso, n.º 1380⁻Bairro Cachoeira, Unaí, Minas Gerais 38610-000, Brazil.
| | - Luciano José Pereira
- Department of Veterinary Medicine, Universidade Federal de Lavras-UFLA, Mail Box 3037, Lavras, Minas Gerais 37200-000, Brazil.
- Department of Health Sciences, Universidade Federal de Lavras-UFLA, Mail Box 3037, Lavras, Minas Gerais 37200-000, Brazil.
| |
Collapse
|
6
|
AlQallaf H, Hamada Y, Blanchard S, Shin D, Gregory R, Srinivasan M. Differential profiles of soluble and cellular toll like receptor (TLR)-2 and 4 in chronic periodontitis. PLoS One 2018; 13:e0200231. [PMID: 30571680 PMCID: PMC6301611 DOI: 10.1371/journal.pone.0200231] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/05/2018] [Indexed: 01/19/2023] Open
Abstract
Chronic periodontitis is a common inflammatory disease initiated by a complex microbial biofilm and mediated by the host response causing destruction of the supporting tissues of the teeth. Host recognition of pathogens is mediated by toll-like receptors (TLRs) that bind conserved molecular patterns shared by large groups of microorganisms. The oral epithelial cells respond to most periodontopathic bacteria via TLR-2 and TLR-4. In addition to the membrane-associated receptors, soluble forms of TLR-2 (sTLR-2) and TLR-4 (sTLR-4) have been identified and are thought to play a regulatory role by binding microbial ligands. sTLR-2 has been shown to arise from ectodomain shedding of the extracellular domain of the membrane receptor and sTLR-4 is thought to be an alternate spliced form. Many studies have previously reported the presence of elevated numbers of viable exfoliated epithelial cells in the saliva of patients with chronic periodontitis. The objective of this study was to investigate the potential value of salivary sTLR-2 and sTLR-4 together with the paired epithelial cell-associated TLR-2/4 mRNA as diagnostic markers for chronic periodontitis. Unstimulated whole saliva was collected after obtaining informed consent from 40 individuals with either periodontitis or gingivitis. The sTLR-2 and sTLR4 in saliva was measured by enzyme-linked immunosorbent assay. The TLR-2 and TLR-4 transcript in the epithelial cells in saliva was measured by real time polymerase chain reaction. While levels of sTLR-2 exhibited an inverse correlation, sTLR-4 positively correlated with clinical parameters in the gingivitis cohort. Interestingly, both correlations were lost in the periodontitis cohort indicating a dysregulated host response. On the other hand, while the sTLR-2 and the paired epithelial cell associated TLR-2 mRNA exhibited a direct correlation (r2 = 0.62), that of sTLR4 and TLR-4 mRNA exhibited an inverse correlation (r2 = 0.53) in the periodontitis cohort. Collectively, assessments of salivary sTLR2 and sTLR4 together with the respective transcripts in the epithelial cells could provide clinically relevant markers of disease progression from gingivitis to periodontitis.
Collapse
Affiliation(s)
- Hawra AlQallaf
- Department of Periodontics and Allied Dental Programs, School of Dentistry, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Yusuke Hamada
- Department of Periodontics and Allied Dental Programs, School of Dentistry, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Steven Blanchard
- Department of Periodontics and Allied Dental Programs, School of Dentistry, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Daniel Shin
- Department of Periodontics and Allied Dental Programs, School of Dentistry, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Richard Gregory
- Department of Biomedical and Applied Sciences, School of Dentistry, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Mythily Srinivasan
- Department of Oral Pathology, Medicine and Radiology, School of Dentistry, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| |
Collapse
|