Can oral infection be a risk factor for Alzheimer's disease?
Can oral infection be a risk factor for Alzheimer's disease?
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DOI：
10.3402/jom.v7.29143
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发表时间：
2015
影响因子：
4.5
通讯作者：
Singhrao SK
中科院分区：
文献类型：
--
作者：
Olsen I;Singhrao SK
阿尔茨海默氏病（AD）是一种长寿的祸害，将在未来消耗公共卫生预算的巨大资源。目前，对于这种最常见的人类痴呆症形式，还没有诊断生物标志物和/或治疗方法。AD可以是早期家族性发作，也可以是散发性伴迟发性。除了两个主要标志，β淀粉样蛋白和神经纤维缠结，炎症是AD神经病理学的特征。炎症可由局部中枢神经系统损伤和/或外周感染引起。AD脑中疑似存在多种微生物，包括细菌（主要是口腔和非口腔密螺旋体属）、病毒（单纯疱疹I型）和酵母菌（念珠菌属）。牙周病原体和非口腔密螺旋体属细菌之间的因果关系已经通过淀粉样蛋白β和炎症联系提出。牙周炎是一种外周性口腔感染，由于每天短暂的细菌感染，它可以为大脑提供完整的细菌和毒力因子以及炎症介质。如果遗传风险因素与大脑中的环境风险因素相遇，就会表现出疾病，其中神经认知可能受到影响，导致痴呆症的发展。为了实现发现AD的诊断生物标志物和可能的预防性治疗的目标，最初需要解决导致其发病机制的病因学难题。因此，这篇综述将口腔感染作为迟发性AD（LOAD）的合理病因。
Alzheimer's disease (AD) is a scourge of longevity that will drain enormous resources from public health budgets in the future. Currently, there is no diagnostic biomarker and/or treatment for this most common form of dementia in humans. AD can be of early familial-onset or sporadic with a late-onset. Apart from the two main hallmarks, amyloid-beta and neurofibrillary tangles, inflammation is a characteristic feature of AD neuropathology. Inflammation may be caused by a local central nervous system insult and/or by peripheral infections. Numerous microorganisms are suspected in AD brains ranging from bacteria (mainly oral and non-oral Treponema species), viruses (herpes simplex type I), and yeasts (Candida species). A causal relationship between periodontal pathogens and non-oral Treponema species of bacteria has been proposed via the amyloid-beta and inflammatory links. Periodontitis constitutes a peripheral oral infection that can provide the brain with intact bacteria and virulence factors and inflammatory mediators due to daily, transient bacteremias. If and when genetic risk factors meet environmental risk factors in the brain, disease is expressed, in which neurocognition may be impacted, leading to the development of dementia. To achieve the goal of finding a diagnostic biomarker and possible prophylactic treatment for AD, there is an initial need to solve the etiological puzzle contributing to its pathogenesis. This review therefore addresses oral infection as the plausible etiology of late-onset AD (LOAD).