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Polymicrobial communities in periodontal disease: Their quasi‐organismal nature and dialogue with the host

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Hajishengallis, George, Lamont, Richard J.·2021·Periodontology 2000

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Abstract

In health, indigenous polymicrobial communities at mucosal surfaces maintain an ecological balance via both inter‐microbial and host‐microbial interactions that promote their own and the host's fitness, while preventing invasion by exogenous pathogens. However, genetic and acquired destabilizing factors (including immune deficiencies, immunoregulatory defects, smoking, diet, obesity, diabetes and other systemic diseases, and aging) may disrupt this homeostatic balance, leading to selective outgrowth of species with the potential for destructive inflammation. This process, known as dysbiosis, underlies the development of periodontitis in susceptible hosts. The pathogenic process is not linear but involves a positive‐feedback loop between dysbiosis and the host inflammatory response. The dysbiotic community is essentially a quasi‐organismal entity, where constituent organisms communicate via sophisticated physical and chemical signals and display functional specialization (eg, accessory pathogens, keystone pathogens, pathobionts), which enables polymicrobial synergy and dictates the community's pathogenic potential or nososymbiocity. In this review, we discuss early and recent studies in support of the polymicrobial synergy and dysbiosis model of periodontal disease pathogenesis. According to this concept, disease is not caused by individual “causative pathogens” but rather by reciprocally reinforced interactions between physically and metabolically integrated polymicrobial communities and a dysregulated host inflammatory response.

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Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases: Consensus report of the Joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA Europe)
Herrera, D., Sanz, M., Shapira, L., Brotons, C., Chapple, I., Frese, T., Graziani, F., Hobbs, F. D. R., Huck, O., Hummers, E., et al. (2023) · Journal of Clinical Periodontology · doi:10.1111/jcpe.13807 · Cited by 284

See all 281

Authors: Hajishengallis, G., & Lamont, R. J.
Venue: Periodontology 2000
Publisher: Wiley
Published: 2021-03-10
Volume: 86
Issue: 1
Pages: 210-230
ISSN: 0906-6713 (ISSN-L)
1600-0757
DOI: 10.1111/prd.12371
OpenAlex: W3134907435
Cited by: 281
References: 241
FWCI: 34.76
Type: journal article
Language: en
Open access: green

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Polymicrobial communities in periodontal disease: Their quasi‐organismal nature and dialogue with the host

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