Immunization Strategies Against Dental Caries

Dental caries remains a prevalent global health challenge, driven primarily by Streptococcus mutans and related streptococci that colonise the tooth surface and form acidogenic biofilms. Immunization strategies aim to disrupt colonisation, neutralise key virulence factors and elicit protective mucosal and systemic responses. Active approaches have focussed on subunit vaccines delivering purified antigens such as protein antigen c or glucosyltransferases, often formulated with adjuvants that target innate receptors to boost immunogenicity. Innovative adjuvant platforms include engineered flagellin derivatives and pH-responsive nanoparticles designed to enhance antigen delivery to lymphoid tissues. Passive strategies exploit preformed antibodies—either humanised or heterologous immunoglobulins—to inhibit microbial adhesion and biofilm formation. Together, these approaches seek to combine robust IgA-mediated mucosal defence with systemic IgG responses to achieve long-lasting protection and reduce reliance on conventional restorative treatments.

Research from Nature Portfolio

A second-generation fusion of bacterial flagellin and protein antigen c was engineered to reduce inflammatory potential while preserving antigen-specific immunity. By removing hypervariable domains from flagellin, the construct retained TLR5 activation sufficient to promote mucosal IgA and systemic IgG responses without eliciting excessive pro-inflammatory cytokines. In rodent challenge models, this design conferred equivalent prophylaxis against caries to its predecessor but with markedly fewer side effects, underscoring the importance of adjuvant fine-tuning. In a complementary passive immunization study, fully human antigen-binding fragments were selected by phage display against surface adhesins of S. mutans and S. sobrinus. These Fabs bound with high affinity, inhibited sucrose-dependent biofilm formation in vitro and prevented lesion development in an animal model. This work highlights the feasibility of topical or dietary application of recombinant antibody fragments as a non-invasive caries prevention strategy.

Immunization Strategies Against Dental Caries publication trend

The graph below shows the total number of articles in immunization strategies against dental caries across all publications each year (not limited to Nature Index journals).

Technical terms

Subunit vaccine: A vaccine containing purified antigenic components rather than whole organisms, aimed at reducing reactogenicity while eliciting targeted immune responses.

Adjuvant: A substance formulated with vaccine antigens to enhance and shape the immune response, often by stimulating innate immune receptors.

Mucosal immunity: Immune protection at mucosal surfaces, mediated chiefly by secretory immunoglobulin A (IgA) to prevent pathogen adherence and invasion.

Passive immunization: Administration of preformed antibodies to confer immediate, short-term protection without inducing host adaptive immunity.

Antigen-binding fragment (Fab): A recombinant antibody fragment comprising the variable regions of heavy and light chains, responsible for specific antigen recognition and binding.

References

1. A Nanoparticle-Based Anticaries Vaccine Enhances the Persistent Immune Response To Inhibit Streptococcus mutans and Prevent Caries. Microbiology Spectrum (2023).
2. Second-generation Flagellin-rPAc Fusion Protein, KFD2-rPAc, Shows High Protective Efficacy against Dental Caries with Low Potential Side Effects. Scientific Reports (2017).
3. Synthetic antigen-binding fragments (Fabs) against S. mutans and S. sobrinus inhibit caries formation. Scientific Reports (2018).
4. Potential of goats’ milk from Aceh hybrid and Etawa goats in producing specific anti-S. mutans antibodies as candidate antibodies for caries immunotherapy. F1000Research (2023).