Gong Wentao, Yu Hairong, You Wei, Chen Zhen, Wang Yu, Liu Chao, Li Youxiang, Guan Sheng
Department of Neurointervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Ann Med. 2025 Dec;57(1):2451191. doi: 10.1080/07853890.2025.2451191. Epub 2025 Jan 13.
Intracranial aneurysms (IAs) are a significant clinical concern, with detection rates increasing due to advances in imaging technologies. However, precise mechanisms underlying their pathophysiology remain incompletely understood. Recent evidence suggests a pivotal role of oral microbiota dysbiosis, particularly periodontal pathogens, in systemic inflammation that may contribute to IA development and rupture.
This review aims to critically evaluate the association between oral microbiota dysbiosis and the pathogenesis of IAs, with a focus on the molecular and immunological mechanisms by which oral pathogens influence vascular pathology.
We conducted a comprehensive analysis of the literature regarding the impact of oral microbial dysbiosis on IA pathophysiology, emphasizing the role of specific pathogenic species, such as . The review explores how these pathogens may mediate chronic inflammation through hematogenous spread, gut microbiome alterations, and neuroinflammatory processes, leading to vascular remodeling and cerebrovascular instability.
The findings suggest that oral microbial dysbiosis, particularly the presence of pathogenic bacteria, is implicated in the systemic inflammatory response that exacerbates the structural integrity of the cerebrovascular wall. Chronic inflammatory states induced by oral pathogens contribute to extracellular matrix degradation, impaired vascular remodeling, and an increased susceptibility to IA rupture.
The findings highlight the importance of maintaining oral microbiota homeostasis as a potential therapeutic target for preventing IAs. Interventions aimed at restoring oral microbial balance may represent a novel strategy for reducing the burden of IA formation and rupture, highlighting the need for an integrated approach to oral health and IAs prevention.
颅内动脉瘤（IAs）是一个重大的临床问题，随着成像技术的进步，其检出率不断提高。然而，其病理生理学的确切机制仍未完全明了。最近的证据表明，口腔微生物群失调，尤其是牙周病原体，在可能导致颅内动脉瘤发生和破裂的全身炎症中起关键作用。
本综述旨在批判性地评估口腔微生物群失调与颅内动脉瘤发病机制之间的关联，重点关注口腔病原体影响血管病理的分子和免疫机制。
我们对有关口腔微生物失调对颅内动脉瘤病理生理学影响的文献进行了全面分析，强调了特定致病物种的作用，如 。该综述探讨了这些病原体如何通过血行播散、肠道微生物群改变和神经炎症过程介导慢性炎症，导致血管重塑和脑血管不稳定。
研究结果表明，口腔微生物失调，尤其是病原菌的存在，与加剧脑血管壁结构完整性的全身炎症反应有关。口腔病原体诱导的慢性炎症状态会导致细胞外基质降解、血管重塑受损以及颅内动脉瘤破裂易感性增加。
研究结果强调了维持口腔微生物群稳态作为预防颅内动脉瘤潜在治疗靶点的重要性。旨在恢复口腔微生物平衡的干预措施可能代表了一种减轻颅内动脉瘤形成和破裂负担的新策略，凸显了采取综合方法进行口腔健康和颅内动脉瘤预防的必要性。
