Periodontal pathogen sialometabolic activity in periodontitis

Periodontitis is a common bacterially induced inflammatory condition that damages the tooth-supporting apparatus and negatively impacts the systemic health. It affects over 700 million people worldwide with an estimated economic burden totaling to $442 billion annually. A bacterial triad in the subgingival niche comprising of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia is very influential in the development of periodontitis. Significantly, all these three pathogens produce a sialidase enzyme that can cleave terminal sialic acid residue from host-derived sialoglycoproteins, such as present on the surface of oral epithelial cells and in saliva and gingival crevicular fluid. This ability to release and utilize sialic acid from host glycoproteins is crucial for their growth and immune evasion and survival strategies. In addition, sialic acid cleavage can cause immune dysfunction and disruption of tissue integrity and thus exacerbate periodontal inflammation in various ways. Here, we propose that inhibition of pathogen-derived sialidase activity with sialidase-targeting pharmacological drugs may be an attractive adjunct therapy in the treatment of periodontitis.