Vaccines for periodontal disease: a new hope?

Recent recognition of the importance of periodontal disease and its impact on the perpetuation and management of systemic diseases calls for a global effort to control periodontal disease. With the advent of advanced molecular diagnostic techniques, a better understanding of the role of specific pathogens and the contributory role of the host immune response in the initiation and progression of periodontal disease has been possible. However, successful vaccine development that fully utilizes the current level of understanding has not yet occurred for human use. This article reviews the various trials undertaken to develop a vaccine against periodontal disease, so as to construct a more sophisticated design which may be relevant in the future. Periodontal disease as a multifactorial and polymicrobial disease requires a vaccine design targeting multiple pathogenic species. As an innovative strategy, vaccine trials to stimulate antigen-specific T-cells polarized towards helper T-cells with a regulatory phenotype have been introduced. Conjugate and recombinant vaccines, immune regulation with coinfecting microorganisms within the biofilm and vaccine regimens like commonly shared antigens by selected periodontopathogenic species are new avenues that are being explored. The role of RecA protein and osteoprotegerin-ligand cannot be overlooked. 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.

KEYWORDS: Vaccination, Periodontitis, Immune response, DNA vaccine.