Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Vaccines against periodontitis: a forward-looking review

  • Choi, Jeom-Il (Department of Periodontology, Pusan National University School of Dentistry) ;
  • Seymour, Gregory J. (Faculty of Dentistry, University of Otago)
  • Received : 2010.05.01
  • Accepted : 2010.07.02
  • Published : 2010.08.31
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Abstract

Periodontal disease, as a polymicrobial disease, is globally endemic as well as being a global epidemic. It is the leading cause for tooth loss in the adult population and has been positively related to life-threatening systemic diseases such as atherosclerosis and diabetes. As a result, it is clear that more sophisticated therapeutic modalities need to be developed, which may include vaccines. Up to now, however, no periodontal vaccine trial has been successful in satisfying all the requirements; to prevent the colonization of a multiple pathogenic biofilm in the subgingival area, to elicit a high level of effector molecules such as immunoglobulin sufficient to opsonize and phagocytose the invading organisms, to suppress the induced alveolar bone loss, or to stimulate helper T-cell polarization that exerts cytokine functions optimal for protection against bacteria and tissue destruction. This article reviews all the vaccine trials so as to construct a more sophisticated strategy which may be relevant in the future. As an innovative strategy to circumvent these barriers, vaccine trials to stimulate antigen-specific T-cells polarized toward helper T-cells with a regulatory phenotype (Tregs, $CD_{4+}$, $CD_{25+}$, $FoxP_{3+}$) have also been introduced. Targeting not only a single pathogen, but polymicrobial organisms, and targeting not only periodontal disease, but also periodontal disease-triggered systemic disease could be a feasible goal.

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