CTLA-4 and targeted immunotherapy-a key link in the systemic influence of periodontitis: a mini review

Cytotoxic T Lymphocyte Associated Protein 4 is a T cell-associated receptor that serves as an immune checkpoint molecule, downregulating immunosurveillance and propagating immune homeostasis. Periodontitis influences the serum levels of CTLA-4, which in turn alters the T cell activation pathways, PD-1 pathways, and CD80 activation, which has a key role in antigen presentation and implicates the B cell-mediated antibody response in periodontitis. In contrast, this elevation in CTLA-4 affects various other systemic immuno-inflammatory disorders, predominantly cancer and the efficacy of its immunotherapy. In the current article, an extensive literature review is conducted to elicit the link between the elevation of CTLA-4 in periodontitis and its possible influence on systemic immune-inflammatory disorders and their related targeted immune therapies. After investigation, CTLA-4 and its molecular therapy were found to have a crucial role in altering cancer pathogenesis, immunotherapy, and the pathogenesis of autoimmune disorders. The current article elaborates on the immuno-inflammatory pathways, molecular links, and plausible mechanisms linking periodontitis-associated CTLA-4 elevation and CTLA-4-based molecular therapy, specifically focusing on cancer immunotherapy.