hostmodulation

Hostmodulation, or host modulation therapy (HMT), is a therapeutic approach that aims to alter the body's inflammatory and immune responses to a challenge such as a bacterial biofilm, with the goal of limiting tissue destruction while maintaining host defense. In dentistry and periodontology, HMT is typically used as an adjunct to mechanical therapy to reduce inflammation-driven tissue breakdown in inflammatory periodontal diseases and to stabilize surrounding tissues.

Mechanisms focus on dampening excessive inflammatory mediators and proteolytic enzymes that degrade connective tissue, notably matrix metalloproteinases, cytokines, and prostaglandins. Subantimicrobial-dose doxycycline is the best-known systemic HMT; it inhibits MMP activity and exerts anti-inflammatory effects at doses with minimal antimicrobial action. Other strategies include non-antibiotic tetracycline derivatives, selective anti-inflammatory approaches, and therapies aimed at promoting resolution of inflammation, such as specialized pro-resolving mediators and omega-3 fatty acids. Local delivery systems targeting host factors have also been explored.

Clinical use of hostmodulation centers on chronic periodontitis and as an adjunct to scaling and root planing, with evidence suggesting modest improvements in probing depth reduction and clinical attachment level gain compared with mechanical therapy alone. It is not a substitute for thorough plaque control or mechanical debridement.

Limitations include variable patient response, potential safety concerns with long-term use, and issues related to antibiotic stewardship for antibiotic-based approaches. The term also encompasses emerging modalities that target resolution pathways, which continue to be evaluated in clinical research. See also periodontology, matrix metalloproteinases, subantimicrobial-dose doxycycline, and host response.