Paper Connects the Dots on Systemic Diseases and Oral Health

A principal pathogen that drives periodontitis may be the root cause of other systemic diseases. In this new paper, researchers provide a comprehensive update of Porphyromonas gingivalis-related systemic diseases, including atherosclerosis, cancer, and Alzheimer’s disease. Findings from the research article, “Porphyromonas gingivalis and Its Systemic Impact: Current Status,” appear in Pathogens.

Research suggests periodontitis as a potential risk factor for several systemic diseases. Unlike other research papers that focus on the relationship between P. gingivalis and one specific disease, this investigation delivers an update of the literature on P. gingivalis-related systemic diseases, as well as the internal mechanisms. The findings provide a more comprehensive understanding of the pathogen and its relationship with systemic diseases.

Previous studies report P. gingivalis may drive the development of Alzheimer’s disease and other systemic diseases, including Type 2 diabetes. The pathogen is also linked to cancer, depression, and adverse pregnancy outcomes. This review supports those findings, providing additional evidence showing direct and indirect links between  P. gingivalis and several chronic diseases, including atherosclerotic cardiovascular diseases, myocardial infarction, abdominal aortic aneurysms, hypertension, pancreatic and esophageal cancer, oral squamous cell carcinoma, chronic obstructive pulmonary disease, and nonalcoholic fatty liver disease, as well as respiratory diseases, such as pneumonia.

Mark Cannon, DDS, MS, a professor in the Department of Otolaryngology, Division of Dentistry at Northwestern University’s Feinberg School of Medicine in Chicago, explains P. gingivalis opens the gate for all the other microbes, as the pathogen has the unique capability of penetrating the epithelial cell and epigenetically releasing the tight junctions between the cells that form the barrier to microbial invasion. P. gingivalis and other microbes can then invade the rest of the body through daily activities such as toothbrushing, chewing, and flossing. It also negatively affects the immune system and the body’s defensive cells, such as macrophages. 

Cannon explains this key pathogen slowly propagates and spreads, degrading the host’s immune system. “Once the body has been exposed to repeated bacteremias and microbes in the lymph tissue fluids, chronic inflammation wreaks havoc on the host’s health. The human body under constant assault overreacts, with metabolic syndrome (including weight gain, diabetes, and hypertension) and rheumatoid arthritis,” he notes. 

While clinicians can suggest therapeutic approaches to reduce the pathogenic load, work is also progressing on a vaccine against P. gingivalis —a development that could potentially have far-reaching consequences for oral and systemic health.