Immune responses and vaccination against periodontal infections.
BACKGROUND
The infectious aetiology of periodontitis is complex and no curative treatment modality exists. Palliative therapy is available.


OBJECTIVE
To review the evidence that active or passive immunization against periodontitis provides immune protection.


METHODS
PubMed (Medline), the National Institutes of Health, the Food and Drug Administration, and the Center for Disease Control electronic databases were searched to extrapolate information on immune responses to immunization against periodontitis.


RESULTS
Studies in non-human primate models using ligature-induced experimental periodontitis suggest that antibody responses by active immunization against Porphyromonas gingivalis can safely be induced, enhanced, and obtained over time. Immune responses to whole bacterial cell and purified protein preparations considered as vaccine candidates have been evaluated in different animal models demonstrating that there are several valid vaccine candidates. Data suggest that immunization reduces the rate and severity of bone loss. It is also, temporarily, possible to alter the composition of the subgingival microflora. Natural active immunization by therapeutic interventions results in antibody titre enhancement and potentially improves treatment outcomes. Passive immunization of humans using P. gingivalis monoclonal antibodies temporarily prevents colonization of P. gingivalis. Probiotic therapy may be an alternative approach. Regulatory and safety issues for human periodontal vaccine trials must be considered. Shared infectious aetiology between periodontitis and systemic diseases may enhance vaccine effort developments.


CONCLUSIONS
Proof of principle that active and passive immunization can induce protective antibody responses is given. The impact of natural immunization and passive immunization in humans should be explored and may, presently, be more feasible than active immunization studies.
Persson
G Rutger
GR
Department of Periodontology and Fixed Prosthodontics, Division of Oral Microbiology, University of Berne, Berne, Switzerland. rutger.persson@zmk.unibe.ch
D000818:Animals; D000907:Antibodies, Bacterial / Q000276:immunology; D000942:Antigens, Bacterial / Q000276:immunology*; D001428:Bacterial Vaccines; D001442:Bacteroides Infections / Q000276:immunology*; D002318:Cardiovascular Diseases / Q000276:immunology; D006801:Humans; D007116:Immunization, Passive; D023421:Models, Animal; D010518:Periodontitis / Q000276:immunology* / Q000382:microbiology* / Q000517:prevention & control; D016966:Porphyromonas gingivalis / Q000276:immunology*; D019936:Probiotics; D014611:Vaccination
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001428:Bacterial Vaccines