Mycobacterium tuberculosis: a new hitchhiker in the etiopathogenesis of periodontitis

Mycobacterium tuberculosis: a new hitchhiker in the etiopathogenesis of periodontitis ArunSundar MohanaSundaram School of Pharmacy, Sathyabama Institute of Science and Technology, Chennai, Tamilnadu Namra Vinay Gohil Medical College Baroda and SSG Hospital Vadodara, Gujarat Maudlyn O. Etekochay Winterset Edge, Ingham Road, Owings Mills, Maryland Premalkumar Patel Mount Sinai Medical Center, Alton Road, Miami Beach, Florida, USA Swathi Gurajala College of Applied Medical Sciences in Jubail, Imam Abdulrahman bin Faisal University, Saudi Arabia Shanmugarajan Thukani Sathanantham School of Pharmaceutical Sciences, Vels Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, Tamilnadu Mugisha Nsengiyumva Public Health and Scientific Research Center, Kigali, Rwanda Santosh Kumar Karnavati School of Dentistry Karnavati University Gandhinagar Gujarat, India Talha Bin Emran Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh

Periodontitis, a chronic inflammatory disease of the gums affects both the ligament and alveolar bone. A severe form of periodontal disease affects a strikingly high number of one billion adults globally. The disease permutes both the soft and hard tissues of the oral cavity leading to localized and systemic diseases. Periodontitis has a deleterious impact on systemic health causing diabetes, cardiovascular diseases (CVD), and other disease. The cause of the enhanced inflammatory process is due to dysbiosis and an unregulated immune response. Innate immune response and T cells trigger uninhibited cytokine release causing an unwarranted inflammatory response. The RANK- RANKL interaction between osteoblasts, immune cells, and progenitor osteoclasts results in the maturation of osteoclasts, which promote bone resorption. It is well established that dysbiosis of the oral cavity has been implicated in periodontitis. But emerging reports suggest that the pulmonary pathogen, Mycobacterium tuberculosis (Mtb), causes extrapulmonary diseases such as periodontitis. Many clinical case reports advocate the involvement of Mtb in periodontitis, which poses a threat with the surge of tuberculosis in HIV and other immunocompromised individuals. Fostering a better understanding of the mechanism, causative agents and control on inflammatory response is imperative in the prevention and treatment of periodontitis.
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