Host insulin resistance caused by Porphyromonas gingivalis-review of recent progresses

Abstract

Porphyromonas gingivalis (P. gingivalis) is a Gram-negative oral anaerobic bacterium that plays a key role in the pathogenesis of periodontitis. P. gingivalis expresses a variety of virulence factors that disrupt innate and adaptive immunity, allowing P. gingivalis to survive and multiply in the host and destroy periodontal tissue. In addition to periodontal disease, P.gingivalis is also associated with systemic diseases, of which insulin resistance is an important pathological basis. P. gingivalis causes a systemic inflammatory response, disrupts insulin signaling pathways, induces pancreatic β-cell hypofunction and reduced numbers, and causes decreased insulin sensitivity leading to insulin resistance (IR). In this paper, we systematically review the studies on the mechanism of insulin resistance induced by P. gingivalis, discuss the association between P. gingivalis and systemic diseases based on insulin resistance, and finally propose relevant therapeutic approaches. Overall, through a systematic review of the mechanisms related to systemic diseases caused by P. gingivalis through insulin resistance, we hope to provide new insights for future basic research and clinical interventions for related systemic diseases.

Association of Urine (pH < 5.5) with Community Periodontal Index (CPI) and the Number of Remaining Teeth in Korean Adults: A Cross-Sectional Study Using Data from Korea National Health and Nutrition Examination Survey 2016–2018

“…It manifests in various outcomes, including a combination of metabolic disorders, lipotoxicity, glucotoxicity, and inflammation [26]. As such, it is associated with the pathophysiologic mechanisms of insulin resistance in the development of Mets, cardiovascular disease, and inflammation [14].…”

“…Among the various bacteria that contribute to periodontitis, virulence factors of Porphyromonas gingivalis have been suggested to be the main cause of tooth loss [13]. Through multiple virulence factors, the bacterium interferes with the host's immune system, triggers an inflammatory response, and induces insulin resistance [14]. Notably, oral inflammation is correlated with systemic diseases, such as diabetes, non-alcoholic fatty liver disease, and cardiovascular diseases [15].…”

Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients

“…P. gingivalis is strongly associated with severe periodontitis [14] and peri-implantitis lesions [15] and may play a role in the etiology of oral, oropharyngeal, and esophageal cancer [16]. Extraoral dissemination of P. gingivalis has been linked to adverse disruption of the gut microbiome [17], development of acute infections at various body sites [18], and the etiopathogenesis of atherosclerosis, rheumatoid arthritis, diabetes mellitus, respiratory diseases, and Alzheimer's disease [19][20][21][22][23][24][25][26].…”