The Association between Periodontal Disease and Obesity: Roles of the Dysbiotic Microbiome and Inflammation

(Ahmed Hashim)

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Abstract

Periodontal disease and obesity are highly prevalent conditions in the developed and developing countries, and recent studies have suggested their association. However, it is not clear whether this association is due to common risk factors or there are underlying molecular and cellular mechanisms linking both conditions. The keystone-pathogen hypothesis holds that administration of the periodontal pathogen Porphyromonas gingivalis in the oral cavity of murine models led to low colonisation but transformed the health-associated (symbiotic) microbiota to a disease-causing (dysbiotic) state. This shift causes qualitative and quantitative changes in the oral microbiome and breakdown of the host’s homeostatic balance and initiation of periodontitis (Hajishengallis et al., 2011). The second hypothesis suggests the link between periodontitis and obesity is largely based on the oral cavity–gut microbiome connection. Administration of P. gingivalis in rodent models altered the composition of the gut microbiome from one of health to disease. These changes resulted in impaired gut barrier function, endotoxemia and inflammation of the liver and adipose tissue (Arimatsu et al., 2014); (Nakajima et al., 2015). This review aims to discuss and assess the available literature in regard to both hypotheses, and the potential mechanisms that are necessary for linking both diseases. In the author’s opinion, the available literature partly supports the mechanistic link between obesity and periodontitis through a dysbiotic microbiome and inflammation. This warrant-targeted research to identify the common pathogenic bacteria or other keystone pathogens that drive dysbiosis and orchestrate inflammatory disease for the development of novel diagnostics and treatment modalities.

KEYWORDS
Dysbiosis, keystone-pathogen, microbiome, obesity, periodontitis, symbiosis

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References

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