Singhrao Sim K, Olsen Ingar
Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK.
Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
J Alzheimers Dis Rep. 2018 Dec 20;2(1):219-228. doi: 10.3233/ADR-180080.
Our research into Alzheimer's disease (AD) focuses on the oral cavity and the brain, from which key evaluations of prospective and retrospective population-based data have shown that chronic periodontal disease existing for ten-years or over doubles the risk for the sporadic form of AD. Furthermore, () mono-infections in established periodontal lesions, or introducing its lipopolysachharide (LPS), as demonstrated in studies, show hallmark pathology inclusive of extracellular amyloid plaques and phospho-tau bound neurofibrillary tangles with AD-like phenotype. Other studies have shown that if periodontitis remains untreated in human AD patients, cognitive decline ensues. This is a bi-directional relationship meaning that the converse is also true; treating periodontal disease in AD patients improves memory. Bacterial cultures and established oral biofilms generate vast numbers of microvesicles and outer membrane vesicles encase key virulence factors (LPS, gingipains, capsule, fimbriae) as though they are complete destructive "microbullets" when shed in the host. This provides additional arsenal to manipulate its entry into disparate organs, hijack phagocytosis, destroy tissues, and affect complement related genes while transducing the onset of proinflammatory signaling cascades. The resulting inflammatory mediators may be the cause of disease defining lesions and cognitive decline typical of clinical AD.
我们对阿尔茨海默病(AD)的研究聚焦于口腔和大脑,基于前瞻性和回顾性人群数据的关键评估表明,持续十年或更长时间的慢性牙周病会使散发性AD的风险增加一倍。此外,如研究所示,在已形成的牙周病变中存在单一感染,或引入其脂多糖(LPS),会表现出包括细胞外淀粉样斑块和与AD样表型相关的磷酸化tau蛋白结合神经原纤维缠结在内的典型病理特征。其他研究表明,如果人类AD患者的牙周炎得不到治疗,就会出现认知衰退。这是一种双向关系,也就是说反之亦然;治疗AD患者的牙周病可改善记忆力。细菌培养物和已形成的口腔生物膜会产生大量微泡,外膜囊泡包裹着关键毒力因子(LPS、牙龈蛋白酶、荚膜、菌毛),当它们在宿主体内脱落时,就像完全具有破坏性的“微型子弹”。这为其进入不同器官、劫持吞噬作用、破坏组织以及影响补体相关基因提供了额外手段,同时引发促炎信号级联反应。由此产生的炎症介质可能是临床AD典型的疾病定义性病变和认知衰退的原因。