Abstract:
The extensive studies on Filifactor alocis (Fa) show a positive association with
periodontitis, demonstrating elevated Fa levels compared to traditional periodontal
pathogens in severe disease. Periodontitis is a chronic multifactorial disease
induced by a dysbiotic microbiota in a susceptible host whilst diabetes is an
established risk factor for periodontitis. Diabetes has been shown to alter the
subgingival microbiota into distinct microbial communities which favours the
shift towards disease. It is these very distinct subgingival microbiota that are
believed to contribute to the high prevalence and severity of periodontitis in
diabetic patients. This dysbiotic microbiota constitute traditional periodontal
pathogens which include among others the red complex triad (Porphyromonas
gingivalis, Treponema denticola, Tannerella forsythia), Aggregatibacter
actinomycetemcomitans, the orange complex (Fusobacterium nucleatum,
Prevotella intermedia etc.) and other emerging pathogens such as Fa that were
previously unrecognised as role players in the pathogenesis of periodontitis. Fa is
an asaccharolytic anaerobic gram-positive rod (AAGPR) currently considered to be
one of the potential drivers of periodontitis progression and worsening through its
unique virulence characteristics. Various mechanisms through which Fa contributes
to the pathogenesis and severity of periodontitis have been reported. The
mechanisms involved in the bidirectional relationship between periodontitis and
diabetes are continuously being explored in order to enhance individualised
preventative and management approaches in affected patients. This review aims to
report on this emerging periodontal pathogen and its capacity to influence
dysbiosis within a complex subgingival microbial community; including its potential
role in the bidirectional relationship between diabetes and periodontitis. This review
will highlight Fa as a potential prognostic indicator for disease worsening, which
will help improve management protocols for periodontitis and diabetes.
