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Leira Y, Vivancos J, Diz P, Martín Á, Carasol M, Frank A. The association between periodontitis and cerebrovascular disease, and dementia. Scientific report of the working group of the Spanish Society of Periodontology and the Spanish Society of Neurology. Neurologia 2024; 39:302-311. [PMID: 38224833 DOI: 10.1016/j.nrleng.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/03/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVE This article reviews the scientific evidence on the relationship between periodontitis and neurological disease, and particularly cerebrovascular disease and dementia. We also issue a series of recommendations regarding the prevention and management of periodontitis and these neurological diseases at dental clinics and neurology units. DEVELOPMENT In response to a series of questions proposed by the SEPA-SEN working group, a literature search was performed, with no restrictions on study design, to identify the most relevant articles on the association between periodontitis and cerebrovascular disease and dementia from the perspectives of epidemiology, treatment, and the biological mechanisms involved in these associations. CONCLUSIONS Periodontitis increases the risk of ischaemic stroke and Alzheimer dementia. Recurrent bacterial infections and increased low-grade systemic inflammation seem to be possible biological mechanisms underlying this association. Limited evidence suggests that various oral health interventions can reduce the future risk of cerebrovascular disease and dementia.
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Affiliation(s)
- Y Leira
- Unidad de Periodoncia, Facultad de Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Grupo de Investigación en Neuroenvejecimiento, Laboratorio de Investigación en Neurociencias Clínicas (LINC), Instituto de Investigación Sanitaria de Santiago (IDIS), Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain.
| | - J Vivancos
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Servicio de Neurología, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - P Diz
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Unidad de Pacientes Especiales, Facultad de Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Á Martín
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Servicio de Neurología, Hospital Universitario de La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Carasol
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Grupo de Investigación en Etiología y Terapéutica de Enfermedades Periodontales y Periimplantarias, Universidad Complutense de Madrid, Madrid, Spain
| | - A Frank
- Grupo de Trabajo de la Sociedad Española de Periodoncia (SEPA) y Sociedad Española de Neurología (SEN), Madrid, Spain; Servicio de Neurología, Hospital Universitario de La Paz, Universidad Autónoma de Madrid, Madrid, Spain
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Shen H, Jiang Y, Qiu C, Xie X, Zhang H, He Z, Song Z, Zhou W. Abnormal amyloid precursor protein processing in periodontal tissue in a murine model of periodontitis induced by Porphyromonas gingivalis. J Periodontal Res 2024; 59:395-407. [PMID: 38311599 DOI: 10.1111/jre.13224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 11/27/2023] [Accepted: 12/05/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE The study aimed to investigate the change of amyloid precursor protein (APP) processing and amyloid β (Aβ) metabolites in linking periodontitis to Alzheimer's disease (AD). BACKGROUND Aβ is one of the main pathological features of AD, and few studies have discussed changes in its expression in peripheral tissues or analyzed the relationship between the peripheral imbalance of Aβ production and clearance. METHODS A murine model of periodontitis was established by oral infection with Porphyromonas gingivalis (P. gingivalis). Micro-computed tomography (Micro-CT) was used to observe the destruction of the alveolar bone. Nested quantitative polymerase chain reaction (qPCR) was used to measure small quantities of P.gingivalis DNA in different tissues. Behavioral experiments were performed to measure cognitive function in the mice. The mRNA levels of TNF-α, IL-6, IL-8, RANKL, OPG, APP695, APP751, APP770, and BACE1 in the gingival tissues or cortex were detected by RT-PCR. The levels of Aβ1-40 and Aβ1-42 in gingival crevicular fluid (GCF) and plasma were tested by ELISA. RESULTS P. gingivalis oral infection was found to cause alveolar bone resorption and impaired learning and memory. P.gingivalis DNA was detected in the gingiva, blood and cortex of the P.gingivalis group by nested qPCR (p < .05). The mRNA expression of TNF-α, IL-6, IL-8, RANKL/OPG, and BACE1 in the gingival tissue was significantly higher than that in the control group (p < .05). Similarly, upregulated mRNA levels of APP695 and APP770 were observed in the gingival tissuses and cortex of the P. gingivalis group (p < .05). The levels of Aβ1-40 and Aβ1-42 in the GCF and plasma of the P. gingivalis group were significantly higher than those in the control group (p < .05). CONCLUSION P. gingivalis can directly invade the brain via hematogenous infection. The invasion of P. gingivalis could trigger an immune response and lead to an imbalance between Aβ production and clearance in peripheral tissues, which may trigger an abnormal Aβ metabolite in the brain, resulting in the occurrence and development of AD.
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Affiliation(s)
- Hui Shen
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yiting Jiang
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Che Qiu
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xinyi Xie
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Huanyu Zhang
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Zhiyan He
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Zhongchen Song
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wei Zhou
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
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Cho HA, Kim BR, Shin H. Association of periodontal disease treatment with mortality in patients with dementia: a population-based retrospective cohort study (2002-2018). Sci Rep 2024; 14:5243. [PMID: 38438421 PMCID: PMC10912191 DOI: 10.1038/s41598-024-55272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
Dementia is one of the leading causes of death worldwide. In this study, we analyzed the association of periodontal treatment with the risk of death in patients with dementia. The analyzed data were obtained by linking the National Health Insurance Corporation claims data between 2002 and 2018 to the Statistics Korea death registry. In total, 1,131,406 patients with dementia aged ≥ 65 years had undergone dental treatment during the study period. Time-dependent Cox proportional hazards model was performed. The mortality rate was approximately 10% among the patients with dementia. The 17-years cumulative survival rates for patients who received periodontal treatment and their untreated counterparts were 83.5% and 71.5%, respectively. The crude hazard ratio of the periodontal group was approximately twice as high as that of the non-periodontal group (1.99; P < 0.001). Furthermore, in the regression model that was adjusted for socio-demographic variables and systematic chronic diseases, the risk of death in the non-periodontal group was approximately 1.83 times higher than that of the periodontal group (P < 0.00). These findings suggest that preventive periodontal treatment may decrease mortality risk in older people with dementia.
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Affiliation(s)
- Han-A Cho
- Department of Dental Hygiene, Shinhan University, Uijeongbu-si, Gyeonggi-do, 11644, Republic of Korea
| | - Bo-Ra Kim
- Department of Dental Hygiene, Daejeon Health Institute of Technology, Dong-gu, Daejeon Metropolitan City, 34504, Republic of Korea
| | - Hosung Shin
- Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan-daero, Iksan, North Jula, 54538, Republic of Korea.
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Bouziane A, Lattaf S, Abdallaoui Maan L. Effect of Periodontal Disease on Alzheimer's Disease: A Systematic Review. Cureus 2023; 15:e46311. [PMID: 37916259 PMCID: PMC10616904 DOI: 10.7759/cureus.46311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 11/03/2023] Open
Abstract
The aim of this review was to evaluate the relationship between periodontal disease (PD) and the onset and progression of Alzheimer's disease (AD) and to determine whether patients with PD would be at greater risk of developing AD compared to periodontally healthy subjects. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search for cross-sectional, cohort, or case-control studies was conducted on five databases (PubMed, ScienceDirect, EBSCO, Web of Science, and Scopus). No restrictions were applied to the language and year of publication. Exposure was PD, and the outcome of interest was the onset and/or progression of AD. The risk of bias of the included studies was assessed using the Newcastle-Ottawa Scale (NOS) designed for non-randomized studies. Six studies fulfilling the selection criteria were included in this systematic review. Four of the studies were of cohort design and two were of case-control design. All except one showed a significant association between PD and the risk of AD onset and progression. According to the NOS bias risk assessment, three studies were found to be of good quality, and three other cohort studies were of low quality. Data from this systematic review indicate that patients with PD present a significantly higher risk of AD compared to individuals with healthy periodontium. However, results should be interpreted with caution given the methodological limitations found. For future research, powerful and comparable epidemiological studies are needed to evaluate the relationship between PD and AD.
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Affiliation(s)
- Amal Bouziane
- Department of Periodontology, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, MAR
- Laboratory of Biostatistics, Epidemiology, and Clinical Research, Mohammed V University in Rabat, Rabat, MAR
| | - Sara Lattaf
- Department of Periodontology, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, MAR
| | - Lamiaa Abdallaoui Maan
- Department of Periodontology, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, MAR
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Zhao ML, Zhang FJ, Jiang WR, Xia Y, Chen C, Zhang T, Han TL, Yu XY, Mei P, Zhang HM, Jin X, Novakovic B, Leong P, Thompson M, Saffery R, Cannon RD, Zhang H, Ji P. Investigating the impact of oral health on pregnancy and offspring outcomes: protocol for the Lifetime Impact of ORal heAlth (LIORA) cohort study. BMJ Open 2022; 12:e066204. [PMID: 36446451 PMCID: PMC9710366 DOI: 10.1136/bmjopen-2022-066204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Oral health is a fundamental component of well-being, and is closely associated with overall health and quality of life. Oral health may also affect the next generation. The children of mothers with poor oral health are likely to also have poor oral health as they go through life. We aim to investigate associations between maternal oral health and general health, pregnancy outcomes, offspring oral health and offspring general health. METHODS AND ANALYSIS The Lifetime Impact of Oral Health study is a prospective, observational cohort study being done at a single centre in Chongqing, China. A total of 1000 pregnant women will be recruited in their first trimester (11-14 weeks gestation). After obtaining informed consent, general and oral health assessments will be undertaken. Maternal lifestyle, demographic data and biospecimens (blood, hair, urine, nail clippings, saliva, dental plaque, buccal, vaginal and anal swabs) will be collected. Pregnancy outcomes will be recorded at the time of delivery. Cord blood and placenta samples will be collected. The offspring will be followed up for general and oral health examinations, neurodevelopmental assessments and biospecimen (dental plaque, saliva, buccal swabs, exfoliated primary dentition, urine, hair, nail clippings) collection until they are 15 years old. Biological samples will undergo comprehensive metabolomic, microbiome and epigenome analyses. Associations between maternal oral health and general health, pregnancy outcomes, offspring oral health and offspring general health will be investigated and the underlying mechanisms explored. ETHICS AND DISSEMINATION This project has been approved by the Research Ethics Committee of the Affiliated Hospital of Stomatology of Chongqing Medical University (CQHS-REC-2021 LSNo.23). Participants will be required to provide informed consent to participate in the study. Dissemination of findings will take the form of publications in peer-reviewed journals and presentations at national and international conferences. TRIAL REGISTRATION NUMBER ChiCTR2100046898.
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Affiliation(s)
- Mei-Ling Zhao
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Feng-Jing Zhang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Wen-Rong Jiang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Yinyin Xia
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Chang Chen
- Institute of Life Sciences, Chongqing Medical University, Chongqing, China
| | - Ting Zhang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Ting-Li Han
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin-Yang Yu
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peter Mei
- Oral Sciences, University of Otago, Dunedin, New Zealand
| | - Hong-Mei Zhang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Jin
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Boris Novakovic
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Pamela Leong
- Cancer, Disease and Developmental Epigenetics, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Murray Thompson
- Sir John Walsh Research Institute, University of Otago, Dunedin, UK
| | - Richard Saffery
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Cancer and Disease Epigenetics, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | | | - Hua Zhang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
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Schwahn C, Frenzel S, Holtfreter B, Van der Auwera S, Pink C, Bülow R, Friedrich N, Völzke H, Biffar R, Kocher T, Grabe HJ. Effect of periodontal treatment on preclinical Alzheimer's disease-Results of a trial emulation approach. Alzheimers Dement 2021; 18:127-141. [PMID: 34050719 DOI: 10.1002/alz.12378] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION We investigated the relationship between periodontal treatment and pre-clinical Alzheimer's disease (AD). METHODS In this quasi-experimental design, 177 periodontally treated patients from the "Greifswald Approach to Individualized Medicine" cohort, which used the same protocols as the population-based Study of Health in Pomerania TREND (SHIP-TREND), and 409 untreated subjects from SHIP-TREND were analyzed. Subjects were younger than 60 years at the magnetic resonance imaging examination, with a median observation period of 7.3 years. Imaging markers for brain atrophy in late-onset AD and brain aging were used as the outcomes. RESULTS Robust to sensitivity analyses, periodontal treatment had a favorable effect on AD-related brain atrophy (-0.41; 95% confidence interval: -0.70 to -0.12; P = .0051), which corresponds to a shift from the 50th to the 37th percentile of the outcome distribution. For brain aging, the treatment effect was uncertain. CONCLUSION Periodontitis is related to pre-clinical AD in our population.
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Affiliation(s)
- Christian Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Christiane Pink
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Robin Bülow
- Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Center for Cardiovascular Research), Greifswald, Germany
| | - Henry Völzke
- DZHK (German Center for Cardiovascular Research), Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Reiner Biffar
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
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Wadhawan A, Reynolds MA, Makkar H, Scott AJ, Potocki E, Hoisington AJ, Brenner LA, Dagdag A, Lowry CA, Dwivedi Y, Postolache TT. Periodontal Pathogens and Neuropsychiatric Health. Curr Top Med Chem 2021; 20:1353-1397. [PMID: 31924157 DOI: 10.2174/1568026620666200110161105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 02/08/2023]
Abstract
Increasing evidence incriminates low-grade inflammation in cardiovascular, metabolic diseases, and neuropsychiatric clinical conditions, all important causes of morbidity and mortality. One of the upstream and modifiable precipitants and perpetrators of inflammation is chronic periodontitis, a polymicrobial infection with Porphyromonas gingivalis (P. gingivalis) playing a central role in the disease pathogenesis. We review the association between P. gingivalis and cardiovascular, metabolic, and neuropsychiatric illness, and the molecular mechanisms potentially implicated in immune upregulation as well as downregulation induced by the pathogen. In addition to inflammation, translocation of the pathogens to the coronary and peripheral arteries, including brain vasculature, and gut and liver vasculature has important pathophysiological consequences. Distant effects via translocation rely on virulence factors of P. gingivalis such as gingipains, on its synergistic interactions with other pathogens, and on its capability to manipulate the immune system via several mechanisms, including its capacity to induce production of immune-downregulating micro-RNAs. Possible targets for intervention and drug development to manage distal consequences of infection with P. gingivalis are also reviewed.
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Affiliation(s)
- Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Department of Psychiatry, Saint Elizabeths Hospital, Washington, D.C. 20032, United States
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore 21201, United States
| | - Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Alison J Scott
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, United States
| | - Eileen Potocki
- VA Maryland Healthcare System, Baltimore VA Medical Center, Baltimore, United States
| | - Andrew J Hoisington
- Air Force Institute of Technology, Wright-Patterson Air Force Base, United States
| | - Lisa A Brenner
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Christopher A Lowry
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Department of Integrative Physiology, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, United States
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Alabama, United States
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, United States
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Yang CH, Huang PC, Fang CY. Does periodontitis really play a role in dementia? - Novel evidence from molecular insights. J Dent Sci 2020; 16:530-531. [PMID: 33384842 PMCID: PMC7770366 DOI: 10.1016/j.jds.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/11/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Chi-Hsieh Yang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pei-Chi Huang
- Division of Periodontics, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Yuan Fang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Corresponding author. Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan Dist., Taipei City, 116081, Taiwan, ROC.
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Rong X, Xiang L, Li Y, Yang H, Chen W, Li L, Liang D, Zhou X. Chronic Periodontitis and Alzheimer Disease: A Putative Link of Serum Proteins Identification by 2D-DIGE Proteomics. Front Aging Neurosci 2020; 12:248. [PMID: 32973486 PMCID: PMC7472842 DOI: 10.3389/fnagi.2020.00248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/20/2020] [Indexed: 01/16/2023] Open
Abstract
Increasing evidence indicates Chronic Periodontitis (CP) is a comorbidity of Alzheimer’s disease (AD), which is the most common form of age-related dementia, and for the latter, effective diagnostic and treatment strategies are lacking. Although inflammation is present in both diseases, the exact mechanisms and cross-links between CP and AD are poorly understood; and a direct association between the two has not been reported. This study aimed to identify a direct serum proteins link between AD and CP. Two-dimensional differential in-gel electrophoresis was employed to analyze serum samples from 12 CP patients and 12 age-matched controls. Furthermore, to determine the molecular link between CP and AD, neuroblastoma SK-N-SH APPwt cells were treated with 1 μg/ml of lipopolysaccharide from Porphyromonas gingivalis (P.g-LPS). Ten differentially expressed proteins were identified in CP patients. Among them, nine proteins were up-regulated, and one protein was down-regulated. Of the 10 differentially expressed proteins, five proteins were reportedly involved in the pathology of AD: Cofilin-2, Cathepsin B, Clusterin, Triosephosphate isomerase, and inter-alpha-trypsin inhibitor heavy chain H4 (ITI-H4). Western blotting indicated significantly higher expression of Cofilin-2, Cathepsin B, and Clusterin and lower expression of ITI-H4 in the CP group than in the Control group. The serum concentration of Cathepsin B has a good correlation with MMSE scores. Moreover, the protein level of Cathepsin B (but not that of ADAM10 and BACE1) increased significantly along with a prominent increase in Aβ1–40 and Aβ1–42 in the cell lysates of P.g-LPS-treated SK-N-SH APPwt cells. Cathepsin B inhibition resulted in a sharp decrease in Aβ1–40 and Aβ1–42 in the cell lysates. Furthermore, TNF-α was one of the most important inflammatory cytokines for the P.g-LPS-induced Cathepsin B upregulation in SK-N-SH APPwt cells. These results show that CP and AD share an association, while Cathepsin B could be a key link between the two diseases. The discovery of the identical serum proteins provides a potential mechanism underlying the increased risk of AD in CP patients, which could be critical for elucidating the pathophysiology of AD.
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Affiliation(s)
- Xianfang Rong
- Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Liping Xiang
- Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Yanfen Li
- Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Hongfa Yang
- Department of Cardiology, The Second Affiliated Hospital of the University of South China, Hengyang, China
| | - Weijian Chen
- Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Lei Li
- Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Defeng Liang
- Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Xincai Zhou
- Department of Stomatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
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10
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Gao SS, Chu CH, Young FYF. Oral Health and Care for Elderly People with Alzheimer's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165713. [PMID: 32784777 PMCID: PMC7460333 DOI: 10.3390/ijerph17165713] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/29/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023]
Abstract
Dementia is one of the main causes of disability among elderly people. It is a progressive neurodegenerative disease that affects elderly people’s ability to perform daily living activities. Alzheimer’s disease is the main subtype of dementia and causes declining memory, reasoning, and communication skills. They also have behavioural and psychological symptoms, such as depression and aggression. It is essential for them to maintain good oral health, as oral health is an important and integral part of their general health. Neglecting oral health allows dental diseases to develop, and these diseases are difficult and costly to treat. However, dental diseases can be treated with ambulatory care rather than hospitalisation and emergency care. Elderly people should establish daily oral hygiene care routines during the early stages of Alzheimer’s disease. They should have regular dental examinations and early minimal interventions to prevent the need for extensive and complicated procedures. Maintaining oral health becomes challenging, however, when Alzheimer’s disease progresses to the middle and late stages. Because elderly people might forget or lose interest in keeping their teeth healthy, caretakers and community health workers may need to take over this task. Dentists should provide guidance on the maintenance of oral health, as the techniques used to provide this support vary depending on the elderly people concerned. The purpose of this paper is to provide an overview of oral health and the importance of oral care for elderly people with Alzheimer’s disease. The paper also discusses appropriate dental interventions and techniques for maintaining good oral health and helping people with Alzheimer’s to enjoy a satisfactory quality of life.
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Affiliation(s)
- Sherry Shiqian Gao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China;
- Correspondence: ; Tel.: +852-2859-0439
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China;
| | - Fanny Yuk Fun Young
- Department of Business Administration, Hong Kong Shue Yan University, Hong Kong 999077, China;
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11
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Teixeira FB, Saito MT, Matheus FC, Prediger RD, Yamada ES, Maia CSF, Lima RR. Periodontitis and Alzheimer's Disease: A Possible Comorbidity between Oral Chronic Inflammatory Condition and Neuroinflammation. Front Aging Neurosci 2017; 9:327. [PMID: 29085294 PMCID: PMC5649154 DOI: 10.3389/fnagi.2017.00327] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 12/31/2022] Open
Abstract
Periodontitis is an oral chronic infection/inflammatory condition, identified as a source of mediators of inflammation into the blood circulation, which may contribute to exacerbate several diseases. There is increasing evidence that inflammation plays a key role in the pathophysiology of Alzheimer’s disease (AD). Although inflammation is present in both diseases, the exact mechanisms and crosslinks between periodontitis and AD are poorly understood. Therefore, this article aims to review possible comorbidity between periodontitis and AD. Here, the authors discuss the inflammatory aspects of periodontitis, how this oral condition produces a systemic inflammation and, finally, the contribution of this systemic inflammation for worsening neuroinflammation in the progression of AD.
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Affiliation(s)
- Francisco B Teixeira
- Institute of Biological Science, Federal University of Pará, Belém, Brazil.,College of Medicine, Federal University of Pará, Altamira, Brazil
| | - Miki T Saito
- Dental School, Brazil-Amazon Integrated Faculty, Belém, Brazil
| | - Filipe C Matheus
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rui D Prediger
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Elizabeth S Yamada
- Institute of Biological Science, Federal University of Pará, Belém, Brazil
| | | | - Rafael R Lima
- Institute of Biological Science, Federal University of Pará, Belém, Brazil
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