A vaccine against dental caries - An overview

Dental caries continues to be a costly and prevalent oral disease. Research efforts towards developing a well tolerated and effective vaccine against dental caries were initiated following the demonstration of a specific bact erial aetiology for this disease. The cariogenic mutans streptococci are th e principal bacteria causing this disease. Specific immune defence against these bacteria is provided mainly by secretory immunoglobulin (Ig) A antibo dies present in saliva, which are generated by the common mucosal immune sy stem. Progress in the development of a vaccine against dental caries has in creased due to both advancements in molecular biology and our understanding of the mucosal immune system and mucosal vaccines. Advancements in molecul ar biology have facilitated the cloning and functional characterisation of virulence factors of the mutans streptococci, including the cell-surface fi brillar proteins, which mediate adherence to the tooth surface, and the glu cosyltransferase enzymes, which synthesise adhesive glucans and allow micro bial accumulation on the teeth. Current strategies for immunisation against dental caries are using these v irulence factors as key antigens and incorporating them into novel mucosal vaccine systems and delivering them with or without adjuvants to mucosal Ig A inductive sites. The most popular routes of mucosal immunisation are via the oral or nasal route, The mucosal immune system is functional in newborn infants, who develop salivary IgA antibodies as they become colonised by o ral micro-organisms. Mucosal immunisation strategies result in the inductio n of salivary IgA antibody responses and pose fewer problems than parentera l injection of antigen. Therefore, mucosal immunisation of infants prior to the appearance of their first teeth may be a well tolerated and effective way to induce immunity against the colonisation of teeth by mutans streptoc occi and protection against subsequent dental caries. The purpose of this a rticle is to provide an overview of the recent progress on the development of a vaccine against infection by Streptococcus mutans for the prevention o f dental caries, with emphasis on the mucosal immune system and vaccine des ign.