Introduction
The oral pathogen
Porphyromonas gingivalis
is not only associated with periodontitis but also with systemic diseases elsewhere in the body. The mechanisms by which
P. gingivalis
travels from the oral cavity to other organs in the body are largely unknown. This review describes the four putative mechanisms supported by experimental evidence, which enable translocation of
P. gingivalis
over the oral mucosa, endothelial barriers and subsequent dissemination into the bloodstream.
Mechanisms
The first mechanism: proteolytic enzymes secreted by
P. gingivalis
degrade adhesion molecules between tissue cells, and the extracellular matrix. This weakens the structural integrity of the mucosa and allows
P
.
gingivalis
to penetrate the tissue. The second is transcytosis: bacteria actively enter tissue cells and transfer to the next layer or the extracellular space. By travelling from cell to cell,
P. gingivalis
reaches deeper structures. Thirdly, professional phagocytes take up
P. gingivalis
and travel to the bloodstream where
P. gingivalis
is released. Lastly,
P. gingivalis
can adhere to the hyphae forming Candida albicans. These hyphae can penetrate the mucosal tissue, which may allow
P. gingivalis
to reach deeper structures.
Conclusion
More research could elucidate targets to inhibit
P. gingivalis
dissemination and prevent the onset of various systemic diseases.
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