Periodontitis-Induced Immune Reprogramming: Implications for Cancer Immunotherapy Response.

Area of Science:

• Immunology
• Oncology
• Periodontology

Background:

• Chronic periodontitis is a widespread inflammatory condition with systemic effects beyond the oral cavity.
• It involves low-grade inflammation, microbial imbalances, and cytokine release, impacting systemic immune homeostasis.
• Emerging evidence links periodontitis to altered responses in cancer immunotherapies, particularly checkpoint blockade.

Purpose of the Study:

• To review how periodontal inflammation drives systemic immune reprogramming.
• To investigate the potential impact of periodontal inflammation on immunotherapy effectiveness.

Main Methods:

• Synthesis of current research on molecular and cellular mechanisms connecting periodontitis and immune dysfunction.
• Focus on key signaling pathways like NF-κB, STAT3, and PD-1/PD-L1 in oral-systemic immunity.

Main Results:

• Periodontal inflammation alters innate and adaptive immunity, increasing pro-inflammatory mediators (IL-1β, IL-6, TNF-α).
• It affects T-cell responses, primes myeloid cells, potentially causing immune exhaustion and treatment resistance.
• Controlling periodontal inflammation may reduce systemic inflammation, but clinical data in immunotherapy patients is limited.

Conclusions:

• Periodontal health is a relevant factor in managing cancer immunotherapy.
• Further research integrating oral and systemic immunology is needed.
• Understanding the bidirectional relationship between periodontal inflammation and systemic immunity may reveal new personalized immunomodulation strategies.