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gingivalis synergistically regulates three core pathways via the TLR4/NF-B signaling pathway: (1) iron metabolism imbalance (upregulation of TFRC and NCOA4 expression leading to intracellular iron overload), (2) lipid metabolism reprogramming (enhanced ACSL4 and LPCAT3 activity promoting polyunsaturated fatty acid phospholipid accumulation), (3) antioxidant defense collapse (downregulation of SLC7A11 and GPX4 triggering glutathione depletion and impaired lipid peroxide clearance)

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This observation reflects a severe permeability defect in the paracellular barrier mechanisms

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It has already been proven that synergy and drug combinations are a winning strategy in fighting multidrug-resistant bacteria and might help protect the existing drugs through antibiotic adjuvants