Mucosal Vaccines for Dental Diseases

The host immune system has significant potential for intervention or interference in periodontal infection. Many periodontitis patients exhibit a humoral immune response during the course of their spontaneous infection. Many of those who are seronegative convert to seropositivity following routine periodontal therapy. The antibodies, however, may have relatively low avidity and capacity to opsonize. Immunization studies demonstrate that immunization can reduce pathogenic subgingival flora, even in the presence of ligatures, and high levels of specific antibody titers can alter the progression of periodontal tissue destruction. It has also been demonstrated that T-cell and B-cell osteoclastogenic functions may contribute to bone resorption and inflammation in experimental periodontal diseases. Systematic evaluation of both mucosal and systemic vaccines is necessary. Inductive sites usually are in close association with antigen-handling cells such as M cells, macrophages, and dendritic cells. Initial stimulation of mucosal Ig-producing B cells occurs in the organized mucosa-associated lymphoreticular tissue (MALT), particularly the Peyer's patches. Effector cells migrate from these inductive sites from the peripheral blood to exocrine tissues throughout the body. Studies show that there are preferential pathways for migration of effector cells from MALT as opposed to more distal sites of the mucosal immune system such as the urogenital tract.