After 15 years of hard work, researchers at the Oral Health CRC at the University of Melbourne are confident that they have developed a vaccine that could signal the end of periodontitis.
Periodontitis, or severe gum disease, is caused by the build-up of a bacterium, called P. gingivalis, that is found in dental plaque on the tooth root in a small crevice between the tooth and the gum. Once this chronic disease takes hold it destroys gum tissue and bone supporting teeth, leading to tooth loss.
Moderate to severe periodontitis affects one in three adults and more than 50 percent of Australians over the age of 65. In fact, severe cases affect 10.5 to 12 percent of the global population, so a vaccine is much needed.
“It has a very high economic and social burden,” says University of Melbourne Laureate Professor Eric Reynolds.
The global economic impact of dental disease – of which periodontitis is a major component – is an estimated $442 billion per year.
“Periodontitis is widespread and destructive. We hold high hopes for this vaccine to improve quality of life for millions of people.”
What has also come out in the last 10 years is that severe forms of gingivitis are also linked to diabetes, cardiovascular diseases and cancers.
For many years the treatment for periodontitis has been the same – professional cleaning to remove the plaque, progressing to surgery and antibiotic regimes for more serious cases.
Professor Reynolds explains: “These methods are helpful, but in many cases the bacterium re-establishes in the dental plaque causing a microbiological imbalance so the disease continues,”
How does the vaccine work
Although there are many types of bacteria present in the biofilm that cause chronic periodontitis, there are a select few responsible for the problems caused by periodontitis.
One of these ‘select few’ is the bacterium P. gingivalis, which has been demonstrated to predict imminent clinical attachment loss. This bacterium is also referred to as a “keystone pathogen” because it initiates and then progresses the advancement of chronic periodontitis.
Most vaccines imitate infections, training the body to attack them. However, P. gingivalis secretes an enzyme that causes the immune system to attack itself, so this wasn’t going to work.
The new vaccine ingeniously works on two levels. It teaches the body to target the enzymes produced by P. gingivalis and trigger an immune response. This stops it attacking its own flesh and bone, therefore limiting the damage being caused. It then proceeds to create antibodies that can effectively neutralise the toxins produced by the bacterium.
“Periodontitis is widespread and destructive. We hold high hopes for this vaccine to improve quality of life for millions of people, it’s a huge global market,” says Professor Reynolds.
Findings already show that the vaccine is effective on mice and these have been published in the highly regarded Nature Vaccines journal.
“We’re so confident that we want to go straight into clinical trials with patients. We’ve done just about every animal. We’re now ready to go into humans.
Working alongside their commercial partner, the Commonwealth Serum Laboratories (CSL), the Melbourne University research team hope that the vaccine could begin human trials in 2018, and Professor Reynolds is hopeful it could be available before 2022.