Treating Gum Disease With Immunotherapy: Is this A Game Changer?
“Treatment for periodontal disease (PD) has always focused on targeting bacteria, but bacteria don’t actually cause the disease. Rather, they trigger PD by activating the immune system, which leads to inflammation and bone loss around teeth,”
– Science Daily
Sfeir’s idea was to contain the immune system response and move the composition of bacteria, which, therefore, could prevent the disease from occurring or halt its progress at any rate.
Preventing Periodontal Disease via Immunotherapy
This was not a job to do alone, however, so Charles Sfeir teamed up with Professor Steven Little, the chair of the Department of Chemical and Petroleum Engineering in the Swanson School of Engineering. He needed an expert to develop and deliver micro-particles for the sustained release of CCL2.
“The potential for engineered systems to interact with the immune system of the periodontal space is tremendous and represents a completely different way to treat disease as compared to what is being done clinically now,” said Little. “This collaboration with Dr. Sfeir is further evidence of the exciting future for these kinds of technologies.”
– University of Pittsburgh. “Immunotherapy for gum disease? Study in mice shows promise.”
It all started with tying a strand of silk around the molar of a mouse, apparently.
Immunotherapy Gunning For Gum Disease & A Study In Mice
The study, originally published in Proceedings of the National Academy of Sciences, revealed that the delivery of micro-particles containing the immune-modulating compound CCL2 to the gums is a game changer for treating periodontal disease. The shown effects were inhibited bone loss and expedited bone repair in mice with PD. The silk around the mouse molar accumulates bacteria, induces inflammation and rapidly causes bone degradation around the teeth in just 4 days.
“To see whether CCL2 could prevent PD or treat actively progressing disease, the researchers treated the animals with the microparticles at the same time as silk placement or four days afterwards. They also examined if CCL2 would impact disease that was resolving on its own by treating mice with microparticles at the same time as they removed the silk. In all three scenarios, CCL2 therapy helped prevent or treat PD by reducing bone loss and improving bone repair.”
– Materials provided by University of Pittsburgh. Originally written by Asher Jones.
What is CCL2?
“C-C motif ligand 2 (CCL2), also known as monocytic chemotactic protein 1 (MCP-1), is an integral chemotactic factor which recruits macrophages for the immune response. Together with its receptors (e.g., CCR2, ACKR1, and ACKR2), they exert noticeable influences on various diseases of different systems. “
– PMC.NCBI.gov
The beneficial effect in the treatment upon the mice was largely to do with changes in the macrophages, the white blood cells which kill microorganisms, get rid of dead cells and stimulate further immune cells. In periodontal disease most macrophages are inflammatory M1 type but the treatment via CCL2 shifted them to the M2 anti-inflammatory type. In addition, the injection of microparticles altered the oral microbiome, which reduced the bacterial volume and especially lowered the amount of those bacterium linked to periodontal disease.
“Periodontal disease (PD) is an extremely widespread inflammatory disease that impacts many patients to varying degrees of severity,” said Sfeir. “This research is exciting because it has the potential to impact so many people.”
Sfeir sees CCL2 immunotherapy as an adjunct to the more conventional bacteria focused treatments currently occurring in dental clinics around the globe. His assessment is that the majority of folk who get a dental cleaning get the result they and their dentist are looking for. The inflammation goes away and the bacteria eliminated. There are, however, a smaller group of patients who do not see relief in this way and bone loss continues. Sfeir is convinced that CCL2 immunotherapy will provide healing solutions for this group of unfortunates.
“But a small fraction of patients, even though they have regular cleanings and maintain meticulous oral hygiene, they still have bone destruction. For this aggressive PD, we don’t yet have a good therapy. This is where we think modulating the immune system with something like CCL2 would really help.”
Is treating gum disease with immunotherapy a game changer, or just hype? It is early days for this exciting breakthrough for immunotherapy in the periodontal space and predicting the future is rarely an exact science in these matters. What we do know is that gum disease is a major problem for humanity and new effective treatments are of critical importance in getting on top of the issue.
The Stages Of Gum Disease
Gum disease is a global scourge affecting large parts of the population. In its more advanced periodontal disease form it causes tooth loss and is directly linked to very serious degenerative health conditions. It is estimated by the World Health Organization (WHO) that around 19% of the global population suffers from the more serious form of periodontal disease. The early stages of gum disease if left unchecked progress to the more serious manifestation. It is recommended that we all pay close attention to the health of our gums and teeth for very good reason.
Gingivitis
Indicators of this earliest form of gum disease include: red swollen gums that are more inclined to bleed following brushing or flossing.
Periodontitis (Mild)
Bad bacteria has managed to get beneath your gums, which will begin to impact the supporting bone. Pockets may form from your gums pulling away from teeth. Plaque hides in these pockets avoiding the best intentions of brushing and flossing.
Periodontitis (Moderate)
The erosion of the ligaments begins if untreated. Bad breath and pus may manifest inside your mouth. This stage can be painful.
Periodontitis (Advanced)
The loosening of your teeth intensifies and the falling out may begin. Bone loss worsens. You are in serious danger of the infections spreading beyond your oral region down into the major organs and surrounding tissues of your body. This is a red flashing light warning of imminent extreme danger to your health.
– Cleveland Clinic
Treating gum disease with immunotherapy appears to offer an exciting new way to tackle a pervasive and much more serious health issue than was previously realised. Oral health care may yet have another scientifically tested and proven means of combatting periodontal disease for the benefit of us all.
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