Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Nov;57(11):1526-1545.
doi: 10.1111/iej.14125. Epub 2024 Aug 1.

The immune landscape in apical periodontitis: From mechanism to therapy

Yuan-Hao Wen  1 , Yu-Xiu Lin  1   2 , Lu Zhou  1   2 , Chen Lin  3 , Lu Zhang  1   2
Affiliations
Review

The immune landscape in apical periodontitis: From mechanism to therapy

Yuan-Hao Wen et al. Int Endod J. 2024 Nov.

Abstract

Apical periodontitis (AP) is featured by a persistent inflammatory response and alveolar bone resorption initiated by microorganisms, posing risks to both dental and systemic health. Nonsurgical endodontic treatment is the recommended treatment plan for AP with a high success rate, but in some cases, periapical lesions may persist despite standard endodontic treatment. Better comprehension of the AP inflammatory microenvironment can help develop adjunct therapies to improve the outcome of endodontic treatment. This review presents an overview of the immune landscape in AP, elucidating how microbial invasion triggers host immune activation and shapes the inflammatory microenvironment, ultimately impacting bone homeostasis. The destructive effect of excessive immune activation on periapical tissues is emphasized. This review aimed to systematically discuss the immunological basis of AP, the inflammatory bone resorption and the immune cell network in AP, thereby providing insights into potential immunotherapeutic strategies such as targeted therapy, antioxidant therapy, adoptive cell therapy and cytokine therapy to mitigate AP-associated tissue destruction.

Keywords: apical periodontitis; bone homeostasis; immune response; immunotherapy.

PubMed Disclaimer

References

REFERENCES

    1. Abe, T. & Barber, G.N. (2014) Cytosolic‐DNA‐mediated, STING‐dependent proinflammatory gene induction necessitates canonical NF‐κB activation through TBK1. Journal of Virology, 88, 5328–5341. Available from: https://doi.org/10.1128/JVI.00037‐14
    1. Allihaibi, M., Niazi, S.A., Farzadi, S., Austin, R., Ideo, F., Cotti, E. et al. (2023) Prevalence of apical periodontitis in patients with autoimmune diseases: a case‐control study. International Endodontic Journal, 56, 573–583. Available from: https://doi.org/10.1111/iej.13902
    1. Altaie, A.M., Mohammad, M.G., Madkour, M.I., Shakartalla, S.B., Jayakumar, M.N., K G, A.R. et al. (2023) The essential role of 17‐Octadecynoic acid in the pathogenesis of periapical abscesses. Journal of Endodontics, 49, 169–177.e3. Available from: https://doi.org/10.1016/j.joen.2022.12.002
    1. Asano, T., Okamoto, K., Nakai, Y., Tsutsumi, M., Muro, R., Suematsu, A. et al. (2019) Soluble RANKL is physiologically dispensable but accelerates tumour metastasis to bone. Nature Metabolism, 1, 868–875. Available from: https://doi.org/10.1038/s42255‐019‐0104‐1
    1. Azuma, M.M., Samuel, R.O., Gomes‐Filho, J.E., Dezan‐Junior, E. & Cintra, L.T.A. (2014) The role of IL‐6 on apical periodontitis: a systematic review. International Endodontic Journal, 47, 615–621. Available from: https://doi.org/10.1111/iej.12196

MeSH terms

LinkOut - more resources