Virulent Porphyromonas gingivalis as the root cause of chronic inflammation‐a Chronic Oral Health Perspective

Abstract

AbstractOral health professionals are the forefront of preventing and treating not only dental and periodontal diseases, but also a growing list of systemic conditions associated with specific periodontal pathogens such as P. gingivalis (Pg). The oral‐systemic connection offers dental professionals an opportunity to positively influence patients’ overall health. Armed with the ability to transform its own environment and the entire periodontal microbiome, as well as modify the host response, the influence of Pg extends beyond the oral cavity. Beyond the neuroinflammatory effects discussed in this session it is capable of both releasing complex virulence factors/toxins and translocating and invading distant tissues and organs and is involved in the pathogenesis of systemic diseases including cardiovascular disease, atherosclerosis, hypertension, myocarditis, and myocardial infarction. This periodontal pathogen also impacts autoimmune diseases including rheumatoid arthritis; neurodegenerative diseases such as Alzheimer’s disease and AD‐related brain atrophy; several cancers‐oral, esophageal, and pancreatic; and metabolic diseases such as diabetes mellitus. Pg by limiting the complement cascade and restraining leukocyte death by activating and exploiting the C5a‐receptor signaling pathway. Another viable conduit in systemic dysbiosis and immune dysfunction is the translocation of Pg with its microbiome‐altering abilities and its coaggregation pathobiont actions found in the gut flora. Studies on murine models that introduced Pg into the gut demonstrated an altered intestinal microflora and increased manifestation or aggravation of liver disease, arthritis, including an increase in the production of proinflammatory cytokines observed at both the intestinal and extra‐intestinal levels. Dental professionals will most likely be one of the major healthcare delivery systems to bring a paradigm shift in healthcare and medicine using novel companion diagnostics and treatments to early screening and treatment of virulent Pg infections in the general population thereby greatly reducing the onset of multiple major systemic inflammatory driven chronic diseases. Dental professionals will most likely be one of the major healthcare delivery systems to bring a paradigm shift in healthcare and medicine by using novel companion diagnostics and treatments to early screening and treatment of virulent Pg infections in the general population thereby greatly reducing the onset of multiple major systemic inflammatory driven chronic diseases.