Biological Control of Cariogenic Bactria and Periodontal Pathogens by Antimicrobial Peptides

2.1. AMP Against Cariogenic Bacteria

Bacteriocins have been explored as alternatives to antibiotics for combating cariogenic species. For instance, the lantibiotic nisin has shown effectiveness in vitro against mono-species biofilms of Streptococcus mutans [6]. However, when nisin was tested against a three-species biofilm composed of S. oralis, S. gordonii, and A. naeslundii, no significant antibiofilm activity was observed, and its antimicrobial effect was only moderate.[9].

In contrast, promising results have been reported using the iron-free form of lactoferrin on dual-species biofilms formed on saliva-coated surfaces. Lactoferrin significantly reduced the biofilm formed by S. gordonii and Fusobacterium nucleatum, as well as that formed by S. gordonii and Porphyromonas gingivalis [10]. Furthermore, a peptide known as 1018 nearly completely eliminated biofilm formation from supragingival plaque samples cultured in vitro [11]. These findings suggest that antimicrobial peptides (AMPs) could be a promising approach for controlling cariogenic biofilms.

2.2. AMP Against Periodontal Pathogens

Periodontitis is an inflammatory disease of the periodontium with polymicrobial aetiology and commonly seen in oral cancer patients. [12,13,14,15,16].Some antimicrobial peptides (AMPs) may help prevent the attachment and development of microorganisms related to periodontal disease into a biofilm. Nisin, which has already been shown to inhibit oral streptococci, was found to suppress the growth of both early and late colonizers in saliva-derived biofilms formed in vitro [17]. Among the late colonizers studied, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Aggregatibacter actinomycetemcomitans were particularly sensitive to nisin. Furthermore, when cultured in the presence of nisin, multispecies biofilms showed a reduction in biomass and thickness. Notably, the effect of nisin on oral epithelial cells was evaluated in vitro, and no toxicity was observed at concentrations that displayed antimicrobial and ant biofilm activities.[17].

A characteristic of periodontal diseases is the inflammation that is common to all of them. The potential of AMPs as a strategy against these dysbiotic states partly stems from their immunomodulatory activities. Lactoferrin, which has been proposed for caries prevention, has also demonstrated significant anti-inflammatory effects due to its ability to sequester bacterial lipopolysaccharides [18]. In fact, lactoferrin is a component of several products designed for oral health maintenance, with beneficial effects confirmed in multiple clinical trials.[19].

A key concern during the development of engineered phages is their potential impact on the oral microbiome. Although these phages are genetically modified, they are designed to specifically target only pathogenic bacteria that contribute to disease states, such as those associated with tumor progression. This is achieved by using selective gene-editing tools that limit infection by pathogenic species like Fusobacterium nucleatum while leaving commensal bacteria unharmed [20].

Despite their potential, several challenges must be addressed before phage-based strategies can be fully integrated into clinical practice. Significant hurdles to the widespread adoption of phage therapy include phage resistance, immune system clearance, and regulatory barriers. Additionally, the complex interactions between bacteriophages, host immunity require further investigation to optimize both therapeutic efficacy and safety. Advancing research on bacteriophages in the context of oral diseases could revolutionize current treatment paradigms, offering more targeted, efficient, and patient-friendly alternatives to conventional therapies. By harnessing the natural specificity and adaptability of bacteriophages, clinicians and researchers can develop innovative approaches to combat oral diseases, ultimately improving patient care and clinical outcomes.

In conclusion, AMPs denote a promising avenue for combating infectious diseases and addressing the growing issue of antibiotic resistance. These small molecules, derived from natural sources, have shown potent antimicrobial activity against a wide range of pathogens, including bacteria, fungi, and even some viruses. Continued research and innovation in this field will pave the way for new and effective strategies in combating infections and improving patient outcomes. In conclusion, antimicrobial peptides against pathogens of oral infectious diseases offer a compelling solution to the global challenge of antimicrobial resistance. Through further advancements and collaborations between researchers, healthcare professionals, and industry partners, we can harness the power of these naturally occurring molecules to develop innovative therapies that effectively combat infections and enhance human health.