Can Better Management of Periodontal Disease Delay the Onset and Progression of Alzheimer's Disease?
Can Better Management of Periodontal Disease Delay the Onset and Progression of Alzheimer's Disease?
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DOI：
10.3233/jad-170046
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发表时间：
2017-01-01
影响因子：
4
通讯作者：
Singhrao, Sim K.
中科院分区：
文献类型：
--
作者：
Harding, Alice;Robinson, Sarita;Singhrao, Sim K.
牙周病和阿尔茨海默病（AD）之间存在风险因素关系，通过牙齿脱落和牙科干预后记忆力的改善。这将来自本土口腔牙周病原体的微生物贡献与慢性疾病（如AD）的表现联系起来。在这里，我们使用牙龈卟啉单胞菌感染来说明其对心理健康的影响。牙龈卟啉单胞菌感染，在其主要的龈下生态位，可导致多微生物协同作用和生态失调。生态失调描述了口腔中选定共生体在主要关键病原体（例如牙龈卟啉单胞菌）周围共聚集以获得更大毒力后的驻留。最初的过程涉及牙龈卟啉单胞菌干扰健康牙龈中中性粒细胞介导的先天免疫应答，然后下调适应性免疫细胞分化和发育以侵入，随后建立新的生态失调细菌群落。免疫反应通过牙齿脱落引起的饮食调整在总体上和功能上影响宿主。对口腔感染牙龈卟啉单胞菌的动物的研究证实，这种细菌可以迁移到远处的器官部位（大脑），并导致外周和脑内炎症，损害血管和微血管的完整性。在另一项研究中，牙龈卟啉单胞菌感染通过改变神经胶质细胞亮/暗分子钟活动引起睡眠模式紊乱，这反过来又会影响危险相关分子模式的清除，例如淀粉样蛋白-β，通过胶质淋巴系统。由于牙龈卟啉单胞菌可以迁移到大脑，并调节器官特异性炎症先天性和适应性免疫反应，本文探讨了更好地管理本土牙周细菌是否可以延迟/预防痴呆症的发作和/或进展。
A risk factor relationship exists between periodontal disease and Alzheimer's disease (AD) via tooth loss, and improved memory following dental intervention. This links the microbial contribution from indigenous oral periodontal pathogens to the manifestation of chronic conditions, such as AD. Here, we use Porphyromonas gingivalis infection to illustrate its effect on mental health. P. gingivalis infection, in its primary sub-gingival niche, can cause polymicrobial synergy and dysbiosis. Dysbiosis describes the residency of select commensals from the oral cavity following co-aggregation around the dominant keystone pathogen, such as P. gingivalis, to gain greater virulence. The initial process involves P. gingivalis disturbing neutrophil mediated innate immune responses in the healthy gingivae and then downregulating adaptive immune cell differentiation and development to invade, and subsequently, establish new dysbiotic bacterial communities. Immune responses affect the host in general and functionally via dietary adjustments caused by tooth loss. Studies from animals orally infected with P. gingivalis confirm this bacterium can transmigrate to distant organ sites (the brain) and contribute toward peripheral and intracerebral inflammation, and compromise vascular and microvascular integrity. In another study, P. gingivalis infection caused sleep pattern disturbances by altering glial cell light/dark molecular clock activity, and this, in turn, can affect the clearance of danger associated molecular patterns, such as amyloid-beta, via the glymphatic system. Since P. gingivalis can transmigrate to the brain and modulate organ-specific inflammatory innate and adaptive immune responses, this paper explores whether better management of indigenous periodontal bacteria could delay/prevent the onset and/or progression of dementia.