Lion's Pride Volume 13 (Spring 2020) Volume 13 (Spring 2020) | Page 61

PERIODONTAL VACCINE
Patricia Wells & Wakasa Peabody
DHYG 331: Dental Hygiene Research II
What Are Vaccines & How Do They Work?
o A vaccine solution is introduced into the body
containing killed or weakened microbes so that
they don’t cause disease
o The immune system confronts and clears these
harmless microbes from our body quickly
o This acquired immunity is the process of tricking
your body into resisting further encounters with
that particular microbe (21)
(How do vaccines work?, n.d.)
What Is Periodontal Disease &
What Bacteria Are Involved?
Bacterial infection causing gradual break down of
periodontal tissue, tooth and bone
(The stages of periodontal disease, n.d.)
o Multiple bacteria have been identified as
contributing pathogens to periodontal disease
o Research has identified Porphyromonas gingivalis
(P. gingivalis) as the keystone pathogen for the
vaccine to target (4)
(P. gingivalis and dysbiosis, n.d.)
P. Gingivalis interfering with the healthy symbiotic bacteria in the mouth
o About 10% of the global population has periodontal disease
o Periodontitis is a leading cause of tooth loss
o P. gingivalis also adversely affects other parts of the body, and facilitates more severe conditions
‣ Heart attack
‣ Stroke
‣ Cardiovascular disease
‣ Premature and low birth weight babies
‣ Diabetes
‣ Some types of cancer (10)
o Worldwide, $442 billion for treatment of dental
disease (17)
o 160 million Americans suffer from periodontal
disease
o The annual cost of periodontitis treatment in the
United States of America is $41 billion (14)
(Mode of action of P. gingivalis, n.d.)
Why Is It a Big Deal?
Periodontal Vaccine: What You Need to Know
o Research determining P. gingivalis bacteria as a primary cause of periodontitis has made the idea of a vaccine
in conjunction with traditional dental treatment a tangible solution to the global problem of periodontal disease
o It will reduce global economic burden
o It will reduce other known health risks
o Multiple vaccine manufacturing companies have shown interest
in producing a periodontal vaccine (17)
o Clinical human trials are still underway
o The earliest target date for public use has been estimated for the year of 2022 (17)
Progression from healthy gums to severe periodontitis
(More advanced inflammation, n.d.)
(Advanced periodontal disease, n.d.)
Treatment today vs. Potential benefits of a periodontal vaccine
(Prospect of vaccination, n.d.)
A successful periodontal vaccines will:
1. Treat the cause
2. Reduce cost of treatment
3. Reduce relapse
P. gingivalis
(P. gingivalis, n.d.)
(Therapeutic dental vaccine, n.d.)
(Periodontal images, n.d.)
Gaps in the Current Knowledge
o The efficacy found in animal trials has not been
established on human subjects
o The manner in which P. gingivalis causes
periodontitis is not well identified
o P. gingivalis in one of multiple pathogens in
periodontitis. It remains unclear what % of cases
would be effectively treated by targeting this
singular pathogen (5, 10, 16)
Limitations of Theories & Points of View
o Some people have P. gingivalis, but never
develop periodontitis (4)
o Research still being developed in the best
method of targeting antibodies or changing cells
genetically (3)
o Animal histology is very different from human’s
so outcomes can be difficult to predict
Areas for Further Research
o The efficacy of any vaccine is yet to be
determined on human subjects
o The pathogenesis of periodontitis induced by P.
gingivalis needs to be investigated
o The potency of targeting P. gingivalis as a
singular pathogen remains to be established
Areas of Controversy
o No human trials have been completed
References
1. [Advanced periodontal disease]. (n.d.). Retrieved from https://www.efp.org/images/patients/periodontitis/advanced-periodontaldisease.jpg
2. Chen, H. A., Johnson, B. D., Sims, T. J., Darveau, R. P., Monda, B. J., Whitney, C. W., … Page, R. C. (1991). Humoral immune
responses to Porphyromonas gingivalis before and following therapy in rapidly progressive periodontitis patients. Journal of
Periodontology, 62(12), 781-791. doi:10.1902/jop.1991.62.12.781
3. George, T. V., George, A. K., John, S., & Thomas, A. (2015). Periodontal vaccine: A therapeutic modality on the horizon? The Saudi
Journal for Dental Research, 6(2), 73-78. doi:10.1016/j.sjdr.2014.08.002
4. Hajishengallis, G., Darveau, R. P., & Curtis, M. A. (2012). The keystone-pathogen hypothesis. Nature reviews. Microbiology,
10(10), 717–725. doi:10.1038/nrmicro2873
5. Huang, N., Shimomura, E., Yin G., Tran, C., Sato, A., Steiner, A., … Gibson III, F. C. (2018). Immunization with cell‐free‐generated
vaccine protects from Porphyromonas gingivalis‐induced alveolar bone loss. Journal of Clinical Periodontology, 46(2), 197-
205. doi: 10.1111/jcpe.13047
6. [How do vaccines work?]. (n.d.). Retrieved from https://advancelocal-adapter-imageuploads.s3.amazonaws.com/image.mlive.com/home/mlive-media/width2048/img/mlive_statewide_river_candidates/photo/howvaccines-workjpg-4124fe097a13d163.jpg
7. Li, N., & Collyer, C. A. (2011). Gingipains from Porphyromonas gingivalis - Complex domain structures confer diverse functions.
European Journal of Microbiology & Immunology, 1(1), 41–58. doi:10.1556/EuJMI.1.2011.1.7
8. [Mode of action of P. gingivalis]. (n.d.). Retrieved from https://www.frontiersin.org/files/Articles/125567/fimmu-06-00045-
HTML/image_m/fimmu-06-00045-g001.jpg
9. [More advanced inflammation]. (n.d.). Retrieved from https://www.efp.org/images/patients/periodontitis/more-advancedinflammation.jpg
10. O'Brien-Simpson, N. M., Holden, J. A., Lenzo, J. C., Tan, Y., Brammar, G. C., Walsh, K. A., … Reynolds, E. C. (2016). A
therapeutic Porphyromonas gingivalis gingipain vaccine induces neutralising IgG1 antibodies that protect against experimental
periodontitis. NPJ Vaccines, 1, 16022. doi:10.1038/npjvaccines.2016.22
11. [P. gingivalis]. (n.d.). Retrieved from https://nutritionreview.org/wp-content/uploads/2013/09/Porphyromonas-gingivalis2.jpg
12. [P. gingivalis and dysbiosis]. (n.d.). Retrieved from https://pmj.bmj.com/content/93/1103/560#
13. [Periodontal images]. (n.d.). Retrieved from https://www.atsu.edu/faculty/chamberlain/mosdoh/images/Periodontal_Images.jpg
14. Periodontitis. (2016). Perio Vac X. Retrieved May 28, 2019, from http://www.periovacx.com/
15. [Prospect of vaccination]. (n.d.). Retrieved from http://www.periovacx.com/images/today-future.png
16. Puth, S., Hong, S. H., Na, H. S., Lee, H. H., Lee, Y. S., Kim, S. Y., … Lee, S. E. (2019). A built-in adjuvant-engineered mucosal
vaccine against dysbiotic periodontal diseases. Mucosal Immunology, 12(2), 565-579. doi:10.1038/s41385-018-0104-6
17. Say goodbye to periodontitis. (2017). DHAA-Dental Hygienists Association of Australia. Retrieved from
https://dhaa.info/periodontitis-vaccine/
18. [Therapeutic dental vaccine]. (n.d.). Retrieved from https://speciality.medicaldialogues.in/wp-content/uploads/2016/12/therapeuticdental-vaccine.jpg
19. [The stages of periodontal disease]. (n.d.). Retrieved from http://www.periovacx.com/images/periodontitis1.jpg
20. What is Periodontitis? (n.d.). European Federation of Periodontology. Retrieved from https://www.efp.org/patients/what-isperiodontitis.html
21. What is a vaccine? (2008). National Institute of Allergy and Infectious Diseases. Retrieved from
https://www.niaid.nih.gov/research/what-vaccine
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