Mucosal vaccination against periodontal disease : unexploited potential for veterinary and human oral medicine

Periodontal disease is one of the most prevalent diseases in humans, dogs, and cats, imposing a significant burden on human and animal health. Control options remain nonspecific, time-consuming, and costly; largely relying on the removal of dental plaque and calculus by mechanical debridement. However, while this reduces the formation of a disease-triggering dysbiotic biofilm, it does not directly affect the latent dysregulated inflammatory cascade in susceptible hosts. Consequently, mechanical debridement requires constant repetition and provides variable prognoses. This has led to the indiscriminate use of antibiotics as an adjunct therapy. This injudicious use of antibiotics is alarming, especially considering the ubiquity of periodontal disease and the systemic administration of antibiotics, as this contributes to the emergence and spread of world-wide antimicrobial resistance. Periodontal vaccines may be a better adjunct therapy to control periodontal disease, by reducing the bacterial triggers and altering the host’s inflammatory response. However, the immunopathogenic complexity and polymicrobial aspect of this disease complicate the development of periodontal vaccines. Moreover, a successful periodontal vaccine should induce protective immunity in the oral cavity, which proves difficult with traditional vaccination methods. We aim to provide unique insights into mucosal vaccination strategies to induce protective immunity in the oral cavity for periodontal disease control. Furthermore, we discuss our current efforts to create a modular, self-amplifying mRNA vaccine platform with a microneedle-mediated delivery to the buccal tissues. Our approach offers a flexible platform for periodontal vaccines and may lead to veterinary and human medical applications due to interspecies similarities in periodontal disease.

Publication year:2022

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