{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:13:22Z","timestamp":1792462402555,"version":"4.5.0"},"reference-count":80,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u2018Deutsche Forschungsgemeinschaft\u2019 (DFG, German Research Foundation) Collaborative Research Centre","award":["SFB1739"],"award-info":[{"award-number":["SFB1739"]}]},{"award":["SFB1739"],"award-info":[{"award-number":["SFB1739"]}],"id":[{"id":"https:\/\/ror.org\/018mejw64","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Porphyromonas gingivalis is a Gram-negative, anaerobic keystone pathogen strongly implicated in the pathogenesis of periodontitis. Its pathogenicity is mediated through virulence factors, such as lipopolysaccharides (PG-LPS), which have been reported to display conflicting results regarding structural composition and immunogenicity. Objectives: This scoping review investigates how PG-LPS modulates host immunity and contributes to advanced periodontitis, with emphasis on its structural composition, divergent immunogenic properties, and the possible regulatory factors underlying these observations. Furthermore, PG-LPS interactions with periodontal tissues and associations with outer membrane vesicles (OMV) are examined. Materials and Methods: A structured literature search was conducted in PubMed following the PRISMA-ScR guidelines and PCC frameworks. Results: Structural heterogeneity, especially within the lipid A moiety of PG-LPS, accounts for previously inconsistent findings regarding its immunogenicity. Minor alterations in lipid A composition through enzymatic dephosphorylation or deacylation profoundly affect Toll-like receptor (TLR) engagement, antimicrobial resistance, and cytokine induction, and contribute to the biogenesis of OMVs. Environmental factors such as hemin availability and temperature influence enzymatic activity, resulting in lipid A isoforms that act as TLR4 agonists, antagonists, or remain immunologically inert. This structural plasticity mediates dynamic immune modulation that fosters polymicrobial dysbiosis and perpetuates non-resolving inflammation, leading to progressive tissue destruction, while concurrently contributing to the systemic inflammatory burden. Conclusions: Lipid A heterogeneity represents a central adaptive strategy potentially linking environmental cues and the bioenergetic status of P. gingivalis to immunomodulative properties. Verification of in vivo lipid A structural shifts in clinical isolates could inform novel therapeutic approaches targeting P. gingivalis-mediated inflammation.<\/jats:p>","DOI":"10.3390\/antibiotics15090886","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:24:02Z","timestamp":1788945842000},"page":"886","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Role of Porphyromonas gingivalis Lipopolysaccharide (PG-LPS) in Advanced Periodontitis\u2014A Scoping Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-8301","authenticated-orcid":false,"given":"Tim","family":"Klomp","sequence":"first","affiliation":[{"name":"Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westf\u00e4lische Technische Hochschule University Hospital, 52074 Aachen, Germany"},{"name":"Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westf\u00e4lische Technische Hochschule University Hospital, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7801-040X","authenticated-orcid":false,"given":"Andreas","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westf\u00e4lische Technische Hochschule University Hospital, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2577-5294","authenticated-orcid":false,"given":"Georg","family":"Conrads","sequence":"additional","affiliation":[{"name":"Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westf\u00e4lische Technische Hochschule University Hospital, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","first-page":"S40","article-title":"Prevalence of the periodontal status in Germany: Results of the 6th German Oral Health Study (DMS \u2022 6)","volume":"56","author":"Eickholz","year":"2025","journal-title":"Quintessence Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/jcpe.12352","article-title":"Changes in prevalence of periodontitis in two German population-based studies","volume":"42","author":"Kocher","year":"2015","journal-title":"J. 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