Inflammasome targeting for periodontitis prevention is sex dependent

T Tomaz Alves (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) K Karen V. Swanson (Division of Infectious Diseases, School of Medicine, University of North Carolina) M Mustafa S. Girnary (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) M Marcelo Freire (Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego) K Kevin Moss (Department of Biostatistics and Health Data Science, School of Medicine, University of Indiana) K Kimon Divaris (Department of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina) J James Beck (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) P Pollyana Coelho Pessoa Santos (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) W W. June Brickey J John A. Wrobel (Lineberger Comprehensive Cancer Center, University of North Carolina) H Heidi Yeigi Min (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) M Manaal Syed (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) T Thiago Morelli (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) W William T. Seaman (National Institute of Dental and Craniofacial Research, National Institutes of Health) J John S. Preisser (Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina) D Di Hu (Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina) H Hannah Preisser (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) N Natalia Makhanova (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) C Cristiano Susin (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) N Nishma P. Vias (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina) M Maya Styner (Division of Endocrinology and Metabolism, School of Medicine, University of North Carolina) S Shaoping Zhang F Flavia Queiroz Pirih (Division of Regenerative and Reconstructive Sciences, School of Dentistry, University of California Los Angeles) J Jia Chang H Harvinder Singh Gill (Department of Chemical and Biomolecular Engineering, North Carolina State University) A Adam D. Lietzan (Department of Biomedical Sciences, Adams School of Dentistry, University of North Carolina) J Jennifer Webster-Cyriaque (National Institute of Dental and Craniofacial Research, National Institutes of Health) J Jenny P. Y. Ting (Lineberger Comprehensive Cancer Center, University of North Carolina) J Julie T. Marchesan (Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina)

Abstract

Inflammasome initiates inflammation via the maturation of interleukin-1 beta (IL-1β). Periodontitis is a prevalent, male-biased disease characterized by inflammation-driven bone loss, yet the mechanism(s) of this sex bias is unknown. This study explored whether enhanced inflammasome represents a causal mechanism for this bias. Analyses of three separate human studies (>6,200 samples) show that males have significantly higher IL-1β in the gingival crevicular fluid than females during health and periodontitis. This pattern is experimentally reproduced with different versions of the ligature-induced periodontitis mouse model where males show greater IL-1β secretion than females. The inflammasome drives bone resorption in males but not females as revealed by analyses of inflammasome gene-deletion mice. Pharmacologic treatment with a caspase-1/4 inhibitor reduces inflammatory cell infiltration, dampens osteoclastogenesis signaling (via the receptor activator of nuclear factor-kappa B pathway), and prevents bone resorption in males but not females during experimental periodontitis. While ovariectomized females show no change in their nonresponsiveness to caspase-1/4 inhibition, orchiectomized males no longer respond to the inhibition, suggesting the importance of an intact male reproductive system in the mediation of this inhibition. Thus, our study identifies inflammasome activation as causal for male-biased experimental periodontitis and supports sex-stratified studies to foster future advancement of inflammasome therapeutics in periodontics.

Article Details

Volume / Issue Vol. 122, Issue 44
Published November 04, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (29)

T

Tomaz Alves

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

K

Karen V. Swanson

Division of Infectious Diseases, School of Medicine, University of North Carolina

M

Mustafa S. Girnary

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

M

Marcelo Freire

Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego

K

Kevin Moss

Department of Biostatistics and Health Data Science, School of Medicine, University of Indiana

K

Kimon Divaris

Department of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina

J

James Beck

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

P

Pollyana Coelho Pessoa Santos

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

W

W. June Brickey

J

John A. Wrobel

Lineberger Comprehensive Cancer Center, University of North Carolina

H

Heidi Yeigi Min

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

M

Manaal Syed

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

T

Thiago Morelli

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

W

William T. Seaman

National Institute of Dental and Craniofacial Research, National Institutes of Health

J

John S. Preisser

Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina

D

Di Hu

Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina

H

Hannah Preisser

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

N

Natalia Makhanova

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

C

Cristiano Susin

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

N

Nishma P. Vias

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina

M

Maya Styner

Division of Endocrinology and Metabolism, School of Medicine, University of North Carolina

S

Shaoping Zhang

F

Flavia Queiroz Pirih

Division of Regenerative and Reconstructive Sciences, School of Dentistry, University of California Los Angeles

J

Jia Chang

H

Harvinder Singh Gill

Department of Chemical and Biomolecular Engineering, North Carolina State University

A

Adam D. Lietzan

Department of Biomedical Sciences, Adams School of Dentistry, University of North Carolina

J

Jennifer Webster-Cyriaque

National Institute of Dental and Craniofacial Research, National Institutes of Health

J

Jenny P. Y. Ting

Lineberger Comprehensive Cancer Center, University of North Carolina

J

Julie T. Marchesan

Department of Periodontology, Endodontics, and Dental Hygiene, Adams School of Dentistry, University of North Carolina