Exemplifying PAMP-bMV functionality; the aforementioned P. gingivalis associated proteases such as gingipains, can exploit the vesicle’s ability to readily translocate into systemic circulation, and their translocation to the liver has been found to induce local insulin resistance in mice, as demonstrated by a decrease in protein kinase B (Akt) phosphorylation25 (Figure 4). This evidence concerns the gene AKT1 and Insulin resistance.