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  • Tooth decay : how genetics and epigenetics could pave the way for a vaccine revolution
    Publication . Bouaita, Ines; Manso, Ana Cristina; Mascarenhas, Paulo; Peixoto, André
    Introduction: Dental caries has long been considered as a disease primarily linked to individual behaviours and modifiable environmental factors, such as poor oral hygiene, excessive sugar consumption or insufficient exposure to fluoride. However, recent research reveals a far more complex reality, in which genetic, epigenetic and microbiological factors interact with social, behavioural and biological determinants to modulate individual susceptibility over time. Development: Polymorphisms in genes involved in enamel development (AMELX, ENAM, TUFT1), salivary function (AQP5, MUC7) or immune response (DEFB1, TLR2) have been associated with reduced resistance to cariogenic bacteria such as Streptococcus mutans (S. mutans). In addition, variants in genes related to taste perception (TAS1R2, TAS1R3, GNAT3) may increase sensitivity to sweet tastes and reinforce sweet food preferences, thereby amplifying behavioural risk factors. It is also important to note that genetic effects may vary depending on gender and dental topography, influencing not only susceptibility to caries but also the strength and nature of immune responses. Nevertheless, genetic predisposition alone is not sufficient to explain the development of the disease. Early environmental exposures such as socioeconomic inequality, unbalanced diet, low fluoride availability, mode of delivery, infant feeding practices, antibiotic use or tobacco smoke can significantly influence risk via epigenetic mechanisms such as DNA methylation and microRNA-mediated regulation of gene expression. Conclusions: In this multifactorial context, shaped by both inherited and modifiable biological vulnerabilities, vaccination against S. mutans appears to be a promising complementary strategy. Preclinical data support the potential of recombinant, DNA-based and plant-derived platforms. However, important challenges remain, particularly regarding mucosal immunity, long-term safety, population-wide feasibility, and the integration of such vaccines into personalised preventive approaches.
    2025-08-08Dissertação de mestrado Acesso aberto Ver mais