Abstract
NLRP3 (NOD-, LRR- and pyrin domain-containing protein 3) is an inflammasome associated with oral and general health. There is a bidirectional relationship between the oral cavity and systemic health. The primary reason for this situation is the similarity in pathways for chronic inflammatory diseases both in the oral cavity and systemically. Periodontal and periapical diseases are some of the most common inflammatory conditions in adults and are associated with bacterial infection and host inflammation. The pathogenesis of periodontal and periapical lesions is complex and multifactorial, and the host inflammatory response determines the progression and pattern of the diseases. Inflammasomes, innate immune system receptors and sensors, are the key components in the pathogenesis of the inflammatory conditions. They are reported to be responsible for the initiation of the inflammatory reaction, maturation of proinflammatory cytokines and pyroptosis. The NLRP3 inflammasome is a multi-protein complex that contributes to immune responses during infection or injury. NLRP3 is implicated in several diseases such as diabetes, rheumatoid arthritis, cardiovascular diseases, inflammatory bowel diseases, multiple sclerosis, and Alzheimer’s disease. There have been many recent advances in our knowledge concerning the essential role of NLRP3 inflammasome in periodontal and periapical inflammation. Therefore, the NLRP3 inflammasome may be a promising target for anti-inflammatory therapies. This paper will provide an overview of the role of NLRP3 inflammasome on periodontal and endodontic diseases with their links between systemic conditions, and presents a future perspective for the treatment of these inflammatory conditions.
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McCarty MF, Iloki Assanga SB, Lewis Lujan L et al (2020) Nutraceutical Strategies for Suppressing NLRP3 Inflammasome Activation: Pertinence to the Management of COVID-19 and Beyond. Nutrients 2020:13. doi: https://doi.org/10.3390/nu13010047
Zahid A, Li B, Kombe AJK et al (2019) Pharmacological Inhibitors of the NLRP3 Inflammasome. Front Immunol 10:2538. doi:https://doi.org/10.3389/fimmu.2019.02538
de Freitas Dutra V, Leal VNC, Fernandes FP et al (2022) Genetic contribution and functional impairment of inflammasome in sickle cell disease. Cytokine 149:155717. doi:https://doi.org/10.1016/j.cyto.2021.155717
Porritt RA, Zemmour D, Abe M et al (2021) NLRP3 Inflammasome Mediates Immune-Stromal Interactions in Vasculitis. Circ Res 129:183–200. doi: https://doi.org/10.1161/CIRCRESAHA.121.319153
Liu X, Wang J, Dou P et al (2021) The Ameliorative Effects of Arctiin and Arctigenin on the Oxidative Injury of Lung Induced by Silica via TLR-4/NLRP3/TGF-beta Signaling Pathway. Oxid Med Cell Longev 2021: 5598980. doi:https://doi.org/10.1155/2021/5598980
Shao H, Huang L, Duan S et al (2020) Glyburide attenuates ozone-induced pulmonary inflammation and injury by blocking the NLRP3 inflammasome. Environ Toxicol 35:831–839. doi:https://doi.org/10.1002/tox.22919
Cavalcante-Silva J, Koh TJ (2022) Targeting the NOD-Like Receptor Pyrin Domain Containing 3 Inflammasome to Improve Healing of Diabetic Wounds. Adv Wound Care (New Rochelle). doi:https://doi.org/10.1089/wound.2021.0148
Li N, Wang Y, Wang X et al (2022) Pathway network of pyroptosis and its potential inhibitors in acute kidney injury. Pharmacol Res 175:106033. doi:https://doi.org/10.1016/j.phrs.2021.106033
Bauer C, Duewell P, Mayer C et al (2010) Colitis induced in mice with dextran sulfate sodium (DSS) is mediated by the NLRP3 inflammasome. Gut 59:1192–1199. doi:https://doi.org/10.1136/gut.2009.197822
Zhang Z, Bai H, Ma X et al (2021) Blockade of the NLRP3/caspase-1 axis attenuates ketamine-induced hippocampus pyroptosis and cognitive impairment in neonatal rats. J Neuroinflammation 18:239. doi:https://doi.org/10.1186/s12974-021-02295-9
Du X, Que W, Hu X et al (2021) Oridonin Prolongs the Survival of Mouse Cardiac Allografts by Attenuating the NF-kappaB/NLRP3 Pathway. Front Immunol 12:719574. doi:https://doi.org/10.3389/fimmu.2021.719574
Könönen E, Gursoy M, Gursoy UK (2019) Periodontitis: A Multifaceted Disease of Tooth-Supporting Tissues. J Clin Med 8:1135. doi:https://doi.org/10.3390/jcm8081135
Okano T, Ashida H, Suzuki S, Shoji M, Nakayama K, Suzuki T (2018) Porphyromonas gingivalis triggers NLRP3-mediated inflammasome activation in macrophages in a bacterial gingipains-independent manner. Eur J Immunol 48:1965–1974. doi:https://doi.org/10.1002/eji.201847658
Cugini C, Ramasubbu N, Tsiagbe VK, Fine DH (2021) Dysbiosis From a Microbial and Host Perspective Relative to Oral Health and Disease. Front Microbiol 12:617485. doi:https://doi.org/10.3389/fmicb.2021.617485
Shibata K (2018) Historical aspects of studies on roles of the inflammasome in the pathogenesis of periodontal diseases. Mol Oral Microbiol 33:203–211. doi:https://doi.org/10.1111/omi.12217
Kelk P, Moghbel NS, Hirschfeld J et al (2022) Aggregatibacter actinomycetemcomitans Leukotoxin Activates the NLRP3 Inflammasome and Cell-to-Cell Communication. Pathogens 11:159. doi:https://doi.org/10.3390/pathogens11020159
de Alencar JB, Zacarias JMV, Tsuneto PY et al (2020) Influence of inflammasome NLRP3, and IL1B and IL2 gene polymorphisms in periodontitis susceptibility. PLoS One 15:e0227905. doi:https://doi.org/10.1371/journal.pone.0227905
Lamkanfi M, Dixit VM (2017) In Retrospect: The inflammasome turns 15. Nature 548:534–535. doi:https://doi.org/10.1038/548534a
Marchesan JT, Girnary MS, Moss K et al (2020) Role of inflammasomes in the pathogenesis of periodontal disease and therapeutics. Periodontol 2000. 82:93–114. doi:https://doi.org/10.1111/prd.12269
Galler KM, Weber M, Korkmaz Y, Widbiller M, Feuerer M (2021) Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues. Int J Mol Sci 22:1480. doi:https://doi.org/10.3390/ijms22031480
Jang JH, Shin HW, Lee JM, Lee HW, Kim EC, Park SH (2015) An Overview of Pathogen Recognition Receptors for Innate Immunity in Dental Pulp. Mediators Inflamm. 2015:794143. doi:https://doi.org/10.1155/2015/794143
Liu M, Chen L, Wu J, Lin Z, Huang S (2021) Long noncoding RNA MEG3 expressed in human dental pulp regulates LPS-Induced inflammation and odontogenic differentiation in pulpitis. Exp Cell Res 400:112495. doi:https://doi.org/10.1016/j.yexcr.2021.112495
Farges JC, Alliot-Licht B, Renard E, Ducret M, Gaudin A, Smith AJ, Cooper PR (2015) Dental Pulp Defence and Repair Mechanisms in Dental Caries. Mediators of inflammation, 2015, 230251. doi:https://doi.org/10.1155/2015/230251
Rechenberg DK, Galicia JC, Peters OA (2016) Biological Markers for Pulpal Inflammation: A Systematic Review. PloS one 11:e0167289. doi:https://doi.org/10.1371/journal.pone.0167289
Poudel B, Gurung P (2018) An update on cell intrinsic negative regulators of the NLRP3 inflammasome. J Leukoc Biol. doi:https://doi.org/10.1002/JLB.3MIR0917-350R
Kummer JA, Broekhuizen R, Everett H et al (2007) Inflammasome components NALP 1 and 3 show distinct but separate expression profiles in human tissues suggesting a site-specific role in the inflammatory response. J Histochem Cytochem 55:443–452. doi:https://doi.org/10.1369/jhc.6A7101.2006
Lee SI, Kang SK, Jung HJ, Chun YH, Kwon YD, Kim EC (2015) Muramyl dipeptide activates human beta defensin 2 and pro-inflammatory mediators through Toll-like receptors and NLRP3 inflammasomes in human dental pulp cells. Clin Oral Investig 19:1419–1428. doi:https://doi.org/10.1007/s00784-014-1361-8
Zhang A, Wang P, Ma X et al (2015) Mechanisms that lead to the regulation of NLRP3 inflammasome expression and activation in human dental pulp fibroblasts. Mol Immunol 66:253–262. doi:https://doi.org/10.1016/j.molimm.2015.03.009
Jiang W, Lv H, Wang H et al (2015) Activation of the NLRP3/caspase-1 inflammasome in human dental pulp tissue and human dental pulp fibroblasts. Cell Tissue Res 361:541–555. doi:https://doi.org/10.1007/s00441-015-2118-7
Wang D, Sun S, Xue Y et al (2021) MicroRNA-223 negatively regulates LPS-induced inflammatory responses by targeting NLRP3 in human dental pulp fibroblasts. Int Endod J 54:241–254. doi:https://doi.org/10.1111/iej.13413
Persoon IF, Crielaard W, Özok AR (2017) Prevalence and nature of fungi in root canal infections: a systematic review and meta-analysis. Int Endod J 50:1055–1066. doi:https://doi.org/10.1111/iej.12730
Cavalla F, Letra A, Silva RM, Garlet GP (2021) Determinants of Periodontal/Periapical Lesion Stability and Progression. J Dent Res 100:29–36. doi:https://doi.org/10.1177/0022034520952341
Ran S, Liu B, Gu S, Sun Z, Liang J (2017) Analysis of the expression of NLRP3 and AIM2 in periapical lesions with apical periodontitis and microbial analysis outside the apical segment of teeth. Arch Oral Biol 78:39–47. doi:https://doi.org/10.1016/j.archoralbio.2017.02.006
Paik S, Kim JK, Silwal P, Sasakawa C, Jo EK (2021) An update on the regulatory mechanisms of NLRP3 inflammasome activation. Cell Mol Immunol 18(5):1141–1160. doi:https://doi.org/10.1038/s41423-021-00670-3
Ran S, Huang J, Liu B, Gu S, Jiang W, Liang J (2021) Enterococcus Faecalis activates NLRP3 inflammasomes leading to increased interleukin-1 beta secretion and pyroptosis of THP-1 macrophages. Microb Pathog 154:104761. doi:https://doi.org/10.1016/j.micpath.2021.104761
Yoo YJ, Kim AR, Perinpanayagam H, Han SH, Kum KY (2020) Candida albicans Virulence Factors and Pathogenicity for Endodontic Infections. Microorganisms 8:1300. doi:https://doi.org/10.3390/microorganisms8091300
Guan X, Guan Y, Shi C et al (2020) Estrogen deficiency aggravates apical periodontitis by regulating NLRP3/caspase-1/IL-1β axis. Am J Transl Res 12:660–671
Şehirli A, Aksoy U, Koca-Ünsal RB, Sayıner S (2021) Role of NLRP3 inflammasome in COVID-19 and periodontitis: Possible protective effect of melatonin. Med Hypotheses 151:110588. doi:https://doi.org/10.1016/j.mehy.2021.110588
Ding S, Xu S, Ma Y, Liu G, Jang H, Fang J (2019) Modulatory Mechanisms of the NLRP3 Inflammasomes in Diabetes. Biomolecules 9:850. doi:https://doi.org/10.3390/biom9120850
Miura K, Kodama Y, Inokuchi S et al (2010) Toll-like receptor 9 promotes steatohepatitis by induction of interleukin-1beta in mice. Gastroenterology 139:323–34e7. doi:https://doi.org/10.1053/j.gastro.2010.03.052
Bradshaw EM, Raddassi K, Elyaman W et al (2009) Monocytes from patients with type 1 diabetes spontaneously secrete proinflammatory cytokines inducing Th17 cells. Journal of immunology (Baltimore, Md.: 1950). 183:4432–4439. doi:https://doi.org/10.4049/jimmunol.0900576
Kim JK, Jin HS, Suh HW, Jo EK (2017) Negative regulators and their mechanisms in NLRP3 inflammasome activation and signaling. Immunol cell biology 95:584–592. doi:https://doi.org/10.1038/icb.2017.23
Carlos D, Costa FR, Pereira CA et al (2017) Mitochondrial DNA activates the NLRP3 inflammasome and predisposes to type 1 diabetes in murine model. Front Immunol. doi:https://doi.org/10.3389/fimmu.2017.00164
Zhou R, Tardivel A, Thorens B et al (2009) Thioredoxin-interacting protein links oxidative stress to inflammasome activation. Nat Immunol 11:136–140. doi:https://doi.org/10.1038/ni.1831
Vandanmagsar B, Youm Y-H, Ravussin A et al (2011) The NLRP3 inflammasome instigates obesity-induced inflammation and insulin resistance. Nat Med 17:179–188. doi:https://doi.org/10.1038/nm.2279
Chapple IL, Genco R, Working group 2 of joint EFPAAPw (2013) Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodontol 40:106–112. doi:https://doi.org/10.1111/jcpe.12077
Arya S, Duhan J, Tewari S et al (2017) Healing of apical periodontitis after nonsurgical treatment in patients with type 2 diabetes. J Endod 43:1623–1627. doi:https://doi.org/10.1016/j.joen.2017.05.013
Smolen JS, Aletaha D, McInnes IB (2016) Rheumatoid arthritis. The Lancet 388:2023–2038. doi:https://doi.org/10.1016/s0140-6736(16)30173-8
Li Z, Guo J, Bi L (2020) Role of the NLRP3 inflammasome in autoimmune diseases. Biomedicine & Pharmacotherapy 130:110542. doi:https://doi.org/10.1016/j.biopha.2020.110542
de Torre-Minguela C, Mesa del Castillo P, Pelegrín P (2017) The NLRP3 and pyrin inflammasomes: Implications in the pathophysiology of autoinflammatory diseases. Front Immunol. doi:https://doi.org/10.3389/fimmu.2017.00043
Hashimoto H, Hashimoto S, Shimazaki Y (2022) Functional impairment and periodontitis in rheumatoid arthritis. Int Dent J. doi:https://doi.org/10.1016/j.identj.2022.01.002
Karataş E (2020) Association between rheumatoid arthritis and apical periodontitis: A cross-sectional study. Eur Endodontic J. doi:https://doi.org/10.14744/eej.2019.52824
Ceccarelli F, Saccucci M, Di Carlo G et al (2019) Periodontitis and Rheumatoid Arthritis: The Same Inflammatory Mediators? Mediators Inflamm. 2019:6034546. doi:https://doi.org/10.1155/2019/6034546
Pellegrini C, Martelli A, Antonioli L et al (2021) NLRP3 inflammasome in cardiovascular diseases: Pathophysiological and pharmacological implications. Med Res Rev 2021. 41:1890–1926. doi:https://doi.org/10.1002/med.21781
Schenkein HA, Papapanou PN, Genco R et al (2020) Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000. 83:90–106. doi:https://doi.org/10.1111/prd.12304
Ozmeric N, Bissada N, da Silva APB (2018) The Association between Inflammatory Bowel Disease and Periodontal Conditions: Is There a Common Bacterial Etiology? J Int Acad Periodontol 20:40–51
Zhang Y, Qiao D, Chen R, Zhu F, Gong J, Yan F (2021) The Association between Periodontitis and Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. BioMed research international. 2021:6692420. doi:https://doi.org/10.1155/2021/6692420
Zhen Y, Zhang H (2019) NLRP3 Inflammasome and Inflammatory Bowel Disease. Front Immunol 10:276. doi:https://doi.org/10.3389/fimmu.2019.00276
Abbasi-Oshaghi E, Mirzaei F, Pourjafar M (2019) NLRP3 inflammasome, oxidative stress, and apoptosis induced in the intestine and liver of rats treated with titanium dioxide nanoparticles: in vivo and in vitro study. Int J Nanomedicine 14:1919–1936
Zhao S, Chen F, Yin Q, Wang D, Han W, Zhang Y (2020) Reactive Oxygen Species Interact With NLRP3 Inflammasomes and Are Involved in the Inflammation of Sepsis: From Mechanism to Treatment of Progression. Front Physiol. 2020. 11:571810
Chen XT, Chen LL, Tan JY et al (2016) Th17 and Th1 Lymphocytes Are Correlated with Chronic Periodontitis. Immunol Invest 45:243–254. doi:https://doi.org/10.3109/08820139.2016.1138967
Gris D, Ye Z, Iocca HA et al (2010) NLRP3 plays a critical role in the development of experimental autoimmune encephalomyelitis by mediating th1 and th17 responses. J Immunol 185:974–981. doi:https://doi.org/10.4049/jimmunol.0904145
Keane RW, Dietrich WD, de Rivero Vaccari JP (2018) Inflammasome proteins as biomarkers of multiple sclerosis. Front Neurol. doi:https://doi.org/10.3389/fneur.2018.00135
Al-Ansari A (2021) Is there an association between multiple sclerosis and oral health? Evid Based Dent 22:44–45. doi:https://doi.org/10.1038/s41432-021-0159-1
Malhotra S, Costa C, Eixarch H et al (2020) NLRP3 inflammasome as prognostic factor and therapeutic target in primary progressive multiple sclerosis patients. Brain 143:1414–1430. doi:https://doi.org/10.1093/brain/awaa084
Gao SS, Chu CH, Young FYF (2020) Oral Health and Care for Elderly People with Alzheimer’s Disease. Int J Environ Res Public Health 17:5713. doi:https://doi.org/10.3390/ijerph17165713
Kaur D, Sharma V, Deshmukh R (2019) Activation of microglia and astrocytes: a roadway to neuroinflammation and Alzheimer’s disease. Inflammopharmacology 27:663–677. doi:https://doi.org/10.1007/s10787-019-00580-x
Severini C, Barbato C, Di Certo MG et al (2021) Alzheimer’s Disease: New Concepts on the Role of Autoimmunity and NLRP3 Inflammasome in the Pathogenesis of the Disease. Curr Neuropharmacol 19:498–512. doi:https://doi.org/10.2174/1570159X18666200621204546
Heneka MT (2017) Inflammasome activation and innate immunity in alzheimer’s disease. Brain Pathol 27:220–222. doi:https://doi.org/10.1111/bpa.12483
Zukowski P, Maciejczyk M, Waszkiel D (2018) Sources of free radicals and oxidative stress in the oral cavity. Arch Oral Biol 92:8–17. doi:https://doi.org/10.1016/j.archoralbio.2018.04.018
Choromańska M, Klimiuk A, Kostecka-Sochoń P et al (2017) Antioxidant Defence, Oxidative Stress and Oxidative Damage in Saliva, Plasma and Erythrocytes of Dementia Patients. Can Salivary AGE be a Marker of Dementia? Int J Mol Sci 18:2205. doi:https://doi.org/10.3390/ijms18102205
Ghassib I, Chen Z, Zhu J et al (2019) Use of IL-1 beta, IL-6, TNF-alpha, and MMP-8 biomarkers to distinguish peri-implant diseases: A systematic review and meta-analysis. Clin Implant Dent Relat Res 21:190–207. doi:https://doi.org/10.1111/cid.12694
Arbore G, West EE, Spolski R et al (2016) T helper 1 immunity requires complement-driven NLRP3 inflammasome activity in CD4(+) T cells. Science 352:1210. doi:https://doi.org/10.1126/science.aad1210
Higuchi K, Sm Z, Yamashita Y et al (2020) Initial periodontal treatment affects nucleotide-binding domain leucine-rich repeat-containing protein 3 inflammasome priming in peripheral blood mononuclear cells. Arch Oral Biol 110:104625. doi:https://doi.org/10.1016/j.archoralbio.2019.104625
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All authors contributed to the study conception. Periodontal diseases part was written by RBKÜ, endodontic diseases part was written by UA, NLRP3 inflammasome relations part was written by AÖŞ, draft review, language revision parts and drawing of the diagram in the figure were prepared by SS. All authors read and approved the final manuscript.
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Koca-Ünsal, R.B., Şehirli, A.Ö., Sayıner, S. et al. Relationship of NLRP3 inflammasome with periodontal, endodontic and related systemic diseases. Mol Biol Rep 49, 11123–11132 (2022). https://doi.org/10.1007/s11033-022-07894-0
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DOI: https://doi.org/10.1007/s11033-022-07894-0