Host-Pathogen Interactions in Periodontitis: An Integrative Interkingdom Perspective

Periodontitis is described as an infectious, inflammatory, non-communicable disease driven by host responses to dysbiotic shifts within complex subgingival communities. The subgingival microbiome forms an interkingdom ecosystem where bacteria, fungi, viruses, and archaea communicate to influence the inflammatory milieu, though the precise molecular mechanisms remain largely unknown.

The review focuses on functional imbalances within this polymicrobial milieu that alter the local environment and promote uncontrolled periodontal inflammation with tissue destruction, and it notes potential links to systemic conditions. Methods are described as a narrative synthesis aligned with a PRISMA extension, aiming to capture studies on interkingdom host–pathogen interactions at the gingival interface that contribute to dysbiosis and immune dysregulation.

Findings highlighted include fungi acting as opportunistic pathogens that can enhance biofilm virulence and amplify host responses, and roles for viruses and archaea in modulating bacterial metabolism through lysis, nutrient recycling, horizontal gene transfer, and interspecies hydrogen transfer. The review emphasizes interkingdom crosstalk as a driver of disrupted symbiosis, increased virulence factor production, and antibiotic resistance, advocating polymicrobial diagnostics and therapies that target interkingdom communication alongside mechanical treatment.