Maheshwari Priya, Eslick Guy D
The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
J Alzheimers Dis. 2015;43(3):957-66. doi: 10.3233/JAD-140621.
The possibility of an infectious etiology for Alzheimer's disease (AD) has been repeatedly postulated over the past three decades. We provide the first meta-analysis to address the relationship between bacterial infection and AD. Studies examining the association between AD and spirochetal bacteria or Chlamydophila pneumoniae (Cpn) were identified through a systematic search of the databases MEDLINE, EMBASE, PubMed, and Google Scholar. Data combined from 25 relevant, primarily case-control studies demonstrated a statistically significant association between AD and detectable evidence of infection of either bacterial group. We found over a ten-fold increased occurrence of AD when there is detectable evidence of spirochetal infection (OR: 10.61; 95% CI: 3.38-33.29) and over a four-fold increased occurrence of AD in a conservative risk estimate (OR: 4.45; 95% CI: 2.33-8.52). We found over a five-fold increased occurrence of AD with Cpn infection (OR: 5.66; 95% CI: 1.83-17.51). This study shows a strongly positive association between bacterial infection and AD. Further detailed investigation of the role of bacterial infection is warranted.
在过去三十年里，阿尔茨海默病（AD）存在感染性病因的可能性已被多次提出。我们进行了首次荟萃分析，以探讨细菌感染与AD之间的关系。通过系统检索MEDLINE、EMBASE、PubMed和谷歌学术等数据库，确定了研究AD与螺旋体细菌或肺炎衣原体（Cpn）之间关联的研究。对25项相关的主要病例对照研究的数据进行合并分析后发现，AD与这两种细菌感染的可检测证据之间存在统计学上的显著关联。我们发现，当有螺旋体感染的可检测证据时，AD的发生率增加了十倍以上（比值比：10.61；95%置信区间：3.38 - 33.29），在保守的风险估计中，AD的发生率增加了四倍以上（比值比：4.45；95%置信区间：2.33 - 8.52）。我们还发现，Cpn感染时AD的发生率增加了五倍以上（比值比：5.66；95%置信区间：1.83 - 17.51）。这项研究表明细菌感染与AD之间存在强正相关。有必要对细菌感染的作用进行进一步详细研究。
