Journal Article Review Ppublish 2 citations
PubMed: 38782605 DOI: 10.1002/rmv.2543
SARS-CoV-2, periodontal pathogens, and host factors: The trinity of oral post-acute sequelae of COVID-19.
Rev Med Virol 34(3):e2543
Authors: Joel Schwartz, Kristelle J Capistrano, Joseph Gluck, Armita Hezarkhani, Afsar R Naqvi
Affiliations
- Department of Oral Medicine and Diagnostic Sciences, University of Illinois Chicago, Chicago, Illinois, USA.
- Department of Periodontics, University of Illinois Chicago, Chicago, Illinois, USA.
- Department of Microbiology and Immunology, University of Illinois Chicago, Chicago, Illinois, USA.
Abstract
COVID-19 as a pan-epidemic is waning but there it is imperative to understand virus interaction with oral tissues and oral inflammatory diseases. We review periodontal disease (PD), a common inflammatory oral disease, as a driver of COVID-19 and oral post-acute-sequelae conditions (PASC). Oral PASC identifies with PD, loss of teeth, dysgeusia, xerostomia, sialolitis-sialolith, and mucositis. We contend that PD-associated oral microbial dysbiosis involving higher burden of periodontopathic bacteria provide an optimal microenvironment for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. These pathogens interact with oral epithelial cells activate molecular or biochemical pathways that promote viral adherence, entry, and persistence in the oral cavity. A repertoire of diverse molecules identifies this relationship including lipids, carbohydrates and enzymes. The S protein of SARS-CoV-2 binds to the ACE2 receptor and is activated by protease activity of host furin or TRMPSS2 that cleave S protein subunits to promote viral entry. However, PD pathogens provide additional enzymatic assistance mimicking furin and augment SARS-CoV-2 adherence by inducing viral entry receptors ACE2/TRMPSS, which are poorly expressed on oral epithelial cells. We discuss the mechanisms involving periodontopathogens and host factors that facilitate SARS-CoV-2 infection and immune resistance resulting in incomplete clearance and risk for 'long-haul' oral health issues characterising PASC. Finally, we suggest potential diagnostic markers and treatment avenues to mitigate oral PASC.
MeSH
Cells, Sars-Cov-2, Epithelial Cells, Furin, Covid-19, Viruses, Integration Host Factors, Severe Acute Respiratory Syndrome-Related Coronavirus, Infections, Virus Internalization, Virus Diseases, Oral Microbiome