Filifactor alocis: An emerging pathogen in periodontitis
DOI:
https://doi.org/10.24265/kiru.2026.v23n3.06Keywords:
Bacteria; Virulence Factors; Diagnosis; Periodontitis; TreatmentAbstract
Filifactor alocis is an emerging Gram-positive rod closely associated with periodontitis. Its presence in periodontal lesions promotes coaggregation with red complex bacteria, such as Porphyromonas gingivalis. Furthermore, it possesses various virulence factors—notably oxidative stress resistance, cellular adhesion and invasion, and the production of enzymes and toxins—which confer high aggressiveness to this microorganism within the gingival sulcus. Clinically, F. alocis is frequently identified in the periodontal pockets of patients with periodontitis and peri-implantitis, whereas it remains undetected in healthy tissues; for this reason, it has been proposed as a biomarker for periodontal disease. Due to its fastidious nutritional requirements, isolation via traditional microbiological culture is complex; thus, molecular techniques constitute the standard diagnostic method. This review describes these aspects, along with other relevant factors, to further elucidate the biological and pathogenic characteristics of this microorganism.
Downloads
References
Faisal RH, Ali AO. Increased bacterial load of Filifactor alocis in deep periodontal pockets discriminate between periodontitis stage 3 and 4. Front Oral Health. 2025;6:1543030. doi:10.3389/froh.2025.1543030.
Ramos Perfecto D, Moromi Nakata H, Martínez Cadillo E. Porphyromonas gingivalis: patógeno predominante en la periodontitis crónica. Odontol Sanmarquina. 2011;14(1):34-8. doi: 10.15381/os.v14i1.2907
Ramos Perfecto D, Ávila Campos MJ, Levano Torres V. Treponema denticola: patógeno en procesos periodontales y pulpares. Odontol Sanmarquina 2012;15(2):38-41. doi: 10.15381/os.v15i2.2046
Ramos-Perfecto D. Tannerella forsythia: patógeno importante en la periodontitis, integrante del complejo rojo. Odontol Sanmarquina. 2020;23(3):253-9. doi: 10.15381/os.v23i3.18400
Corona-Martínez J, Pérez-Soto E, Sánchez-Monroy V. Identificación molecular de bacterias en salud y enfermedad periodontal. Rev Odont Mex. 2019;23(1):23-30. doi: 10.22201/fo.1870199xp.2019.23.1.70010
Aruni AW, Mishra A, Dou Y, Chioma O, Hamilton BN, Fletcher HM. Filifactor alocis: a new emerging periodontal pathogen. Microbes Infect. 2015;17(7):517 530. doi:10.1016/j.micinf.2015.03.006.
Aja E, Mangar M, Fletcher HM, Mishra A. Filifactor alocis: recent insights and advances. J Dent Res. 2021;100(8):790 797. doi:10.1177/00220345211004856.
Schlafer S, Riep B, Griffen AL, Petrich A, Hübner J, Berning M, Friedmann A, Göbel UB, Moter A. Filifactor alocis--involvement in periodontal biofilms. BMC Microbiol. 2010 Mar 1;10:66. doi: 10.1186/1471-2180-10-66.
Sarduy-Bermúdez L, Veitia-Cabarrocas F, Rodríguez-Felipe M. Patógenos fuertemente asociados a las periodontitis. Un análisis de su virulencia. Medisur. 2025;23(1):e4578.
Manenzhe SC, Koutras S, Zwane NB, Masilana AI and Shangase SL. The impact of Filifactor alocis on the severity of periodontitis among diabetic and non-diabetic patients: a narrative review. Front Dent Med.2024;5:1408839. doi: 10.3389/fdmed.2024.1408839.
Goswami D, Dewanjee P, Deka A, Kanungo R, Talukdar PM, Borah MS. Effects of Non-surgical Periodontal Therapy on Porphyromonas gingivalis and Filifactor alocis in Chronic Periodontitis Patients With Type 2 Diabetes Mellitus: A Clinico-Microbiological Study. Cureus. 2025;10;17(11):e96524. doi: 10.7759/cureus.96524
Wisutep P, Kamolvit W, Chongtrakool P, Jitmuang A. Brain abscess mimicking acute stroke syndrome caused by dual Filifactor alocis and Porphyromonas gingivalis infections: A case report. Anaerobe. 2022;75:102535. doi: 10.1016/j.anaerobe.2022.102535.
Hishiya N, Uno K, Amano M, Asada K, Masui K, Ishida Y, et al. Filifactor alocis brain abscess identified by 16S ribosomal RNA gene sequencing: A case report. J Infect Chemother. 2020 Feb;26(2):305-307. doi: 10.1016/j.jiac.2019.09.013.
Tan KT, Boan P, Heath CH. Pleural empyema caused by Filifactor alocis in a man with periodontitis. Intern Med J. 2024;54(3):516-517. doi: 10.1111/imj.16353.
Garcia-Castañeda Z, Vargas-Zuñiga L, Luna-Gomez J, Cabral-Romero C, Hernandez-Delgadillo R, Sanchez-Najera R, et al. Filifactor alocis in endodontic infections. Int J Appl Dent Sci. 2021;7(3):224-227. doi: 10.22271/oral.2021.v7.i3d.1303
Swethaa P, Afzana BF, Sadasivan A, Nilima TS, GirijaVallaban C, Vijayakumar S. Filifactor alocis: a deleterious intruder into the oral cavity and its effect on periodontal status. IP Int J Periodontol Implantol.
;10(1):9 16. doi: https://doi.org/10.18231/j.ijpi.2025.003.
Cato EP, Moore LV, Moore WE. Fusobacterium alocis sp. nov. y Fusobacterium sulci sp. nov. del surco gingival humano. Int J Syst Evol Microbiol. 1985;35:475-477. doi:10.1099/00207713-35-4-475
Jalava J, Eerola E. Phylogenetic analysis of Fusobacterium alocis and Fusobacterium sulci based on 16S rRNA gene sequences: proposal of Filifactor alocis comb. nov. Int J Syst Bacteriol. 1999;49(Pt 4):1375 1379. doi:10.1099/00207713-49-4-1375.
Borsanelli AC, Athayde FRF, Saraiva JR, Silva TA, Mendes JG, Zanetti ES, et al. Fusobacterium necrophorum predominates in the microbiota of mandibular dental abscess in Blastocerus dichotomus. Pesq Vet Bras. 2024;44:e07362. doi:10.1590/1678-5150-pvb-7362
Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25(2):134-44. doi: 10.1111/j.1600-051x.1998.tb02419.x
Abdulkareem AA, Gul SS, Abdulbaqi HR, Sha AM, Preshaw PM. Assessing Evidence to Include Filifactor alocis as a Novel Candidate in Socransky's Complexes. Mol Oral Microbiol. 2026;41(3):117-130. doi: 10.1111/omi.70018.
Aruni AW, Roy F, Fletcher HM. Filifactor alocis has virulence attributes that can enhance its persistence under oxidative stress conditions and mediate invasion of epithelial cells by porphyromonas gingivalis. Infect Immun. 2011;79(10):3872-86. doi: 10.1128/IAI.05631-11.
Kensara A, Saito H, Mongodin EF, Masri R. Microbiological profile of peri implantitis: analyses of peri implant microbiome. J Prosthodont. 2023;32(8):702 710. doi:10.1111/jopr.13620.
Di Spirito F, Giordano F, Di Palo MP, D'Ambrosio F, Scognamiglio B, Sangiovanni G, Caggiano M, Gasparro R. Microbiota of Peri-Implant Healthy Tissues, Peri-Implant Mucositis, and Peri-Implantitis: A Comprehensive Review. Microorganisms. 2024;12(6):1137. doi: 10.3390/microorganisms12061137.
Ozuna H, Snider I, Belibasakis GN, Oscarsson J, Johansson A, Uriarte SM. Aggregatibacter actinomycetemcomitans and Filifactor alocis: two exotoxin producing oral pathogens. Front Oral Health. 2022;3:981343. doi:10.3389/froh.2022.981343.
Razooqi Z, Khzam N, L’Hostis M, Belibasakis GN, Johansson A, Oscarsson J. Prevalence of the oral pathogen Filifactor alocis and its FtxA toxin related to clinical parameters and presence of Aggregatibacter actinomycetemcomitans. Front Cell Infect Microbiol. 2025; 14:1501028. doi:10.3389/fcimb.2024.1501028.
Razooqi Z, Bao K, Yabrag A, Ullah N, Sitaram RT, Lindholm M, et al. Filifactor alocis FtxA blocks inflammation and apoptosis pathways in monocytic cells. Front Cell Infect Microbiol. 2026;16:1745721. doi: 10.3389/fcimb.2026.1745721
Jusko M, Miedziak B, Ermert D, Magda M, King BC, Bielecka E, et al. FACIN, a Double-Edged Sword of the Emerging Periodontal Pathogen Filifactor alocis: A Metabolic Enzyme Moonlighting as a Complement Inhibitor. J Immunol. 2016;197(8):3245-3259. doi: 10.4049/jimmunol.1600739.
Uematsu H, Sato N, Hossain MZ, Ikeda T, Hoshino E. Degradation of arginine and other amino acids by butyrate-producing asaccharolytic anaerobic Gram-positive rods in periodontal pockets. Arch Oral Biol. 2003;48(6):423-9. doi: 10.1016/s0003-9969(03)00031-1
Armstrong CL, Miralda I, Neff AC, Tian S, Vashishta A, Perez L, et al. Filifactor alocis Promotes Neutrophil Degranulation and Chemotactic Activity. Infect Immun. 2016;84(12):3423-3433. doi: 10.1128/IAI.00496-16.
Armstrong CL, Klaes CK, Vashishta A, Lamont RJ, Uriarte SM. Filifactor alocis manipulates human neutrophils affecting their ability to release neutrophil extracellular traps induced by PMA. Innate Immun. 2018;24(4):210-220. doi: 10.1177/1753425918767507.
Kim HY, Lim Y, An SJ, Choi BK. Characterization and immunostimulatory activity of extracellular vesicles from Filifactor alocis. Mol Oral Microbiol. 2020;35(1):1-9. doi: 10.1111/omi.12272.
Moffatt CE, Whitmore SE, Griffen AL, Leys EJ, Lamont RJ. Filifactor alocis interactions with gingival epithelial cells. Mol Oral Microbiol. 2011;26(6):365-73. doi: 10.1111/j.2041-1014.2011.00624.x.
Poorana K, Lavanya N, Rekha MJ, Maheaswari R. Identification of Filifactor Alocis in Periodontal Biofilms using Polymerase Chain Reaction Technique: A Cross-Sectional Study. J Pharm Bioallied Sci. 2024;16(Suppl 5):S4381-S4386. doi: 10.4103/jpbs.jpbs_625_24.
Fragkioudakis I, Konstantopoulos G, Kottaridi C, Batas L, Sakellari D. Quantitative real-time PCR detection of Porphyromonas gingivalis and Filifactor alocis in peri-implantitis. J Med Microbiol. 2025;74(11):002091. doi: 10.1099/jmm.0.002091.
Romero-Martínez R, Maher A, Àlvarez G, Figueiredo R, León R, Arredondo A. Whole Genome Sequencing and Phenotypic Analysis of Antibiotic Resistance in Filifactor alocis Isolates. Antibiotics (Basel). 2023;12(6):1059. doi: 10.3390/antibiotics12061059.
Inubushi J, Liang K. Update on minocycline in vitro activity against odontogenic bacteria. J Infect Chemother. 2020;26(12):1334-1337. doi: 10.1016/j.jiac.2020.08.015.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Donald Ramos Perfecto , Jorge Eladio Pascual Ñaupay , Víctor Narciso Lévano Torres

This work is licensed under a Creative Commons Attribution 4.0 International License.
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) posterior al proceso de aprobación del manuscrito, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada.












