Roles of PCSK9 in the Pathogenesis of Periodontal Disease

Proprotein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors are FDA-approved drugs recommended for high-risk patients with LDL-cholesterol (LDL-c) levels >= 70 mg/dl. Several studies have also investigated the relationship between PCSK9 and periodontitis. Specifically, studies have investigated the association between periodontitis and periodontal PCSK9 levels in humans, and periodontium status in PCSK9-knockout versus wild-type mice. While a positive association between periodontitis and periodontal PCSK9 levels has been noted, the findings on the comparison of periodontium status between PCSK9-knockout and wild-type mice have been inconsistent. Different methodologies among these studies may explain this discrepancy. Future experimental studies on the impact of pharmacological PCSK9 inhibition on periodontal status as well as observational studies comparing periodontium status between patients receiving PCSK9 inhibitors and those receiving other lipid-lowering drugs will shed light on the role of PCSK9 in periodontal health and disease.