# Periodontal Disease and Its Association with Porphyromonas gingivalis: Current Understanding of Microbial Dysbiosis, Immunopathology and Immune Evasion

## TL;DR

This review explains how the bacteria Porphyromonas gingivalis causes periodontal disease by disrupting the immune system and evading detection.

## Contribution

The paper highlights new insights into immune evasion by P. gingivalis and its role in the progression of periodontal disease.

## Key findings

- P. gingivalis is a keystone pathogen that drives immune dysregulation in periodontal disease.
- The pathogen alternates between immune activation and suppression, contributing to the relapsing nature of the disease.
- Correcting immune evasion mechanisms could lead to better therapeutic strategies for periodontal disease.

## Abstract

Porphyromonas gingivalis is described as a keystone pathogen associated with periodontal disease (PD), which exhibits enhanced representation upon microbial dysbiosis in such a chronic inflammatory disease. This oral pathogen drives and contributes to a dysregulated immune response, resulting in stages of aggressive destructive immune activation and inflammation punctuated by immune suppression, which underlies the relapsing–remitting nature of this disease. The understanding of key mechanisms and balance between protective innate, adaptive immune responses and dysregulated responses, linked to changes in the oral mucosal microbial environment, will afford researchers the potential to manipulate oral mucosal environments for clinical benefit. This review focuses on the dynamic interactions between the oral pathogen P. gingivalis and the immune system with an emphasis on immune evasion and how the potential correction of these mechanisms may benefit future therapeutic interventions, leading to the successful treatment of PD.