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Li F, Ma C, Lei S, Pan Y, Lin L, Pan C, Li Q, Geng F, Min D, Tang X. Gingipains may be one of the key virulence factors of Porphyromonas gingivalis to impair cognition and enhance blood-brain barrier permeability: An animal study. J Clin Periodontol 2024; 51:818-839. [PMID: 38414291 DOI: 10.1111/jcpe.13966] [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: 02/09/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
AIM Blood-brain barrier (BBB) disorder is one of the early findings in cognitive impairments. We have recently found that Porphyromonas gingivalis bacteraemia can cause cognitive impairment and increased BBB permeability. This study aimed to find out the possible key virulence factors of P. gingivalis contributing to the pathological process. MATERIALS AND METHODS C57/BL6 mice were infected with P. gingivalis or gingipains or P. gingivalis lipopolysaccharide (P. gingivalis LPS group) by tail vein injection for 8 weeks. The cognitive behaviour changes in mice, the histopathological changes in the hippocampus and cerebral cortex, the alternations of BBB permeability, and the changes in Mfsd2a and Cav-1 levels were measured. The mechanisms of Ddx3x-induced regulation on Mfsd2a by arginine-specific gingipain A (RgpA) in BMECs were explored. RESULTS P. gingivalis and gingipains significantly promoted mice cognitive impairment, pathological changes in the hippocampus and cerebral cortex, increased BBB permeability, inhibited Mfsd2a expression and up-regulated Cav-1 expression. After RgpA stimulation, the permeability of the BBB model in vitro increased, and the Ddx3x/Mfsd2a/Cav-1 regulatory axis was activated. CONCLUSIONS Gingipains may be one of the key virulence factors of P. gingivalis to impair cognition and enhance BBB permeability by the Ddx3x/Mfsd2a/Cav-1 axis.
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Affiliation(s)
- Fulong Li
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
- Center of Implantology, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Chunliang Ma
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Shuang Lei
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Yaping Pan
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Li Lin
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Chunling Pan
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Qian Li
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Fengxue Geng
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
| | - Dongyu Min
- Traditional Chinese Medicine Experimental Center, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
- Key Laboratory of Ministry of Education for TCM Viscera State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Xiaolin Tang
- Department of Periodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, China
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Yang J, Zhi W, Wang L. Role of Tau Protein in Neurodegenerative Diseases and Development of Its Targeted Drugs: A Literature Review. Molecules 2024; 29:2812. [PMID: 38930877 PMCID: PMC11206543 DOI: 10.3390/molecules29122812] [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: 04/26/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
Tau protein is a microtubule-associated protein that is widely distributed in the central nervous system and maintains and regulates neuronal morphology and function. Tau protein aggregates abnormally and forms neurofibrillary tangles in neurodegenerative diseases, disrupting the structure and function of neurons and leading to neuronal death, which triggers the initiation and progression of neurological disorders. The aggregation of tau protein in neurodegenerative diseases is associated with post-translational modifications, which may affect the hydrophilicity, spatial conformation, and stability of tau protein, promoting tau protein aggregation and the formation of neurofibrillary tangles. Therefore, studying the role of tau protein in neurodegenerative diseases and the mechanism of aberrant aggregation is important for understanding the mechanism of neurodegenerative diseases and finding therapeutic approaches. This review describes the possible mechanisms by which tau protein promotes neurodegenerative diseases, the post-translational modifications of tau protein and associated influencing factors, and the current status of drug discovery and development related to tau protein, which may contribute to the development of new therapeutic approaches to alleviate or treat neurodegenerative diseases.
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Affiliation(s)
- Jiakai Yang
- Graduate Collaborative Training Base of Academy of Military Medical Sciences, Hengyang Medical School, University of South China, Hengyang 421001, China;
- Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, China
| | - Weijia Zhi
- Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, China
| | - Lifeng Wang
- Graduate Collaborative Training Base of Academy of Military Medical Sciences, Hengyang Medical School, University of South China, Hengyang 421001, China;
- Beijing Institute of Radiation Medicine, 27 Taiping Road, Beijing 100850, China
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3
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Dai X, Liang R, Dai M, Li X, Zhao W. Smoking Impacts Alzheimer's Disease Progression Through Oral Microbiota Modulation. Mol Neurobiol 2024:10.1007/s12035-024-04241-1. [PMID: 38795302 DOI: 10.1007/s12035-024-04241-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/13/2024] [Indexed: 05/27/2024]
Abstract
Alzheimer's disease (AD) is an important public health challenge with a limited understanding of its pathogenesis. Smoking is a significant modifiable risk factor for AD progression, and its specific mechanism is often interpreted from a toxicological perspective. However, microbial infections also contribute to AD, with oral microbiota playing a crucial role in its progression. Notably, smoking alters the ecological structure and pathogenicity of the oral microbiota. Currently, there is no systematic review or summary of the relationship between these three factors; thus, understanding this association can help in the development of new treatments. This review summarizes the connections between smoking, AD, and oral microbiota from existing research. It also explores how smoking affects the occurrence and development of AD through oral microbiota, and examines treatments for oral microbiota that delay the progression of AD. Furthermore, this review emphasizes the potential of the oral microbiota to act as a biomarker for AD. Finally, it considers the feasibility of probiotics and oral antibacterial therapy to expand treatment methods for AD.
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Affiliation(s)
- Xingzhu Dai
- Department of Stomatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Rui Liang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Manqiong Dai
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoyu Li
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wanghong Zhao
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Xie C, Zhang Q, Ye X, Wu W, Cheng X, Ye X, Ruan J, Pan X. Periodontitis-induced neuroinflammation impacts dendritic spine immaturity and cognitive impairment. Oral Dis 2024; 30:2558-2569. [PMID: 37455416 DOI: 10.1111/odi.14674] [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: 11/12/2022] [Revised: 06/03/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE This study investigated the spinal changes in ligature-induced periodontitis and the role of periodontitis in cognitive impairment. METHODS Twenty mice were randomized into the control and chronic periodontitis (CP) groups, with the latter receiving ligature-induced periodontitis. Cognitive performance was assessed by fear conditioning test. Periodontal inflammation and alveolar bone resorption were evaluated by micro-computed tomography and histopathology. The hippocampal microglial activation was evaluated by immunohistochemistry (IHC). The expressions of hippocampal cytokines (TNF-α, iNOS, IL-1β, IL-4, IL-10, and TREM2) were measured by reverse transcription-polymerase chain reaction. The morphology and density of the dendritic spines were determined by Golgi-Cox staining. RESULTS The CP mice reported significant inflammatory cell infiltration and alveolar bone resorption, with marked increases in cytokine levels (TNF-α, iNOS, IL-1β, and TREM2) in the brain. Moreover, the CP mice showed significantly reduced freezing to the conditioned stimulus in the cued and contextual tests, indicating impaired memory. Further analyses revealed, in the hippocampus of the CP mice, enhanced microglial activation, decreased dendritic spine density, and increased proportion of thin dendritic spines. CONCLUSIONS Periodontitis-induced neuroinflammation may impair the cognitive function by activating hippocampal microglia and inducing dendritic spine immaturity.
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Affiliation(s)
- Changfu Xie
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Qiuyang Zhang
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Fuzhou Second Hospital, Fuzhou, China
| | - Xinyi Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Weiliang Wu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Xiaojuan Cheng
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Clinical Neurology, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaoan Ye
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Jianyong Ruan
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Xiaodong Pan
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Clinical Neurology, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
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Plachokova AS, Gjaltema J, Hagens ERC, Hashemi Z, Knüppe TBA, Kootstra TJM, Visser A, Bloem BR. Periodontitis: A Plausible Modifiable Risk Factor for Neurodegenerative Diseases? A Comprehensive Review. Int J Mol Sci 2024; 25:4504. [PMID: 38674088 PMCID: PMC11050498 DOI: 10.3390/ijms25084504] [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: 02/27/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
The aim of this comprehensive review is to summarize recent literature on associations between periodontitis and neurodegenerative diseases, explore the bidirectionality and provide insights into the plausible pathogenesis. For this purpose, systematic reviews and meta-analyses from PubMed, Medline and EMBASE were considered. Out of 33 retrieved papers, 6 articles complying with the inclusion criteria were selected and discussed. Additional relevant papers for bidirectionality and pathogenesis were included. Results show an association between periodontitis and Alzheimer's disease, with odds ratios of 3 to 5. A bidirectional relationship is suspected. For Parkinson's disease (PD), current evidence for an association appears to be weak, although poor oral health and PD seem to be correlated. A huge knowledge gap was identified. The plausible mechanistic link for the association between periodontitis and neurodegenerative diseases is the interplay between periodontal inflammation and neuroinflammation. Three pathways are hypothesized in the literature, i.e., humoral, neuronal and cellular, with a clear role of periodontal pathogens, such as Porphyromonas gingivalis. Age, gender, race, smoking, alcohol intake, nutrition, physical activity, socioeconomic status, stress, medical comorbidities and genetics were identified as common risk factors for periodontitis and neurodegenerative diseases. Future research with main emphasis on the collaboration between neurologists and dentists is encouraged.
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Affiliation(s)
- Adelina S. Plachokova
- Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (J.G.); (E.R.C.H.); (Z.H.); (T.B.A.K.); (T.J.M.K.)
| | - Jolijn Gjaltema
- Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (J.G.); (E.R.C.H.); (Z.H.); (T.B.A.K.); (T.J.M.K.)
| | - Eliza R. C. Hagens
- Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (J.G.); (E.R.C.H.); (Z.H.); (T.B.A.K.); (T.J.M.K.)
| | - Zahra Hashemi
- Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (J.G.); (E.R.C.H.); (Z.H.); (T.B.A.K.); (T.J.M.K.)
| | - Tim B. A. Knüppe
- Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (J.G.); (E.R.C.H.); (Z.H.); (T.B.A.K.); (T.J.M.K.)
| | - Thomas J. M. Kootstra
- Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (J.G.); (E.R.C.H.); (Z.H.); (T.B.A.K.); (T.J.M.K.)
| | - Anita Visser
- Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands; (J.G.); (E.R.C.H.); (Z.H.); (T.B.A.K.); (T.J.M.K.)
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Bastiaan R. Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, 6525 GA Nijmegen, The Netherlands;
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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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Brown GC, Heneka MT. The endotoxin hypothesis of Alzheimer's disease. Mol Neurodegener 2024; 19:30. [PMID: 38561809 PMCID: PMC10983749 DOI: 10.1186/s13024-024-00722-y] [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: 11/17/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Lipopolysaccharide (LPS) constitutes much of the surface of Gram-negative bacteria, and if LPS enters the human body or brain can induce inflammation and act as an endotoxin. We outline the hypothesis here that LPS may contribute to the pathophysiology of Alzheimer's disease (AD) via peripheral infections or gut dysfunction elevating LPS levels in blood and brain, which promotes: amyloid pathology, tau pathology and microglial activation, contributing to the neurodegeneration of AD. The evidence supporting this hypothesis includes: i) blood and brain levels of LPS are elevated in AD patients, ii) AD risk factors increase LPS levels or response, iii) LPS induces Aβ expression, aggregation, inflammation and neurotoxicity, iv) LPS induces TAU phosphorylation, aggregation and spreading, v) LPS induces microglial priming, activation and neurotoxicity, and vi) blood LPS induces loss of synapses, neurons and memory in AD mouse models, and cognitive dysfunction in humans. However, to test the hypothesis, it is necessary to test whether reducing blood LPS reduces AD risk or progression. If the LPS endotoxin hypothesis is correct, then treatments might include: reducing infections, changing gut microbiome, reducing leaky gut, decreasing blood LPS, or blocking LPS response.
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Affiliation(s)
- Guy C Brown
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom.
| | - Michael T Heneka
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
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Binda S, Tremblay A, Iqbal UH, Kassem O, Le Barz M, Thomas V, Bronner S, Perrot T, Ismail N, Parker J. Psychobiotics and the Microbiota-Gut-Brain Axis: Where Do We Go from Here? Microorganisms 2024; 12:634. [PMID: 38674579 PMCID: PMC11052108 DOI: 10.3390/microorganisms12040634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
The bidirectional relationship between the gut microbiota and the nervous system is known as the microbiota-gut-brain axis (MGBA). The MGBA controls the complex interactions between the brain, the enteric nervous system, the gut-associated immune system, and the enteric neuroendocrine systems, regulating key physiological functions such as the immune response, sleep, emotions and mood, food intake, and intestinal functions. Psychobiotics are considered tools with the potential to modulate the MGBA through preventive, adjunctive, or curative approaches, but their specific mechanisms of action on many aspects of health are yet to be characterized. This narrative review and perspectives article highlights the key paradigms needing attention as the scope of potential probiotics applications in human health increases, with a growing body of evidence supporting their systemic beneficial effects. However, there are many limitations to overcome before establishing the extent to which we can incorporate probiotics in the management of neuropsychiatric disorders. Although this article uses the term probiotics in a general manner, it remains important to study probiotics at the strain level in most cases.
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Affiliation(s)
- Sylvie Binda
- Lallemand Health Solutions, 19 Rue des Briquetiers, BP 59, 31702 Blagnac, France; (M.L.B.); (V.T.)
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions, 6100 Royalmount Avenue, Montreal, QC H4P 2R2, Canada; (A.T.); (U.H.I.); (O.K.); (S.B.)
| | - Annie Tremblay
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions, 6100 Royalmount Avenue, Montreal, QC H4P 2R2, Canada; (A.T.); (U.H.I.); (O.K.); (S.B.)
| | - Umar Haris Iqbal
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions, 6100 Royalmount Avenue, Montreal, QC H4P 2R2, Canada; (A.T.); (U.H.I.); (O.K.); (S.B.)
| | - Ola Kassem
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions, 6100 Royalmount Avenue, Montreal, QC H4P 2R2, Canada; (A.T.); (U.H.I.); (O.K.); (S.B.)
| | - Mélanie Le Barz
- Lallemand Health Solutions, 19 Rue des Briquetiers, BP 59, 31702 Blagnac, France; (M.L.B.); (V.T.)
| | - Vincent Thomas
- Lallemand Health Solutions, 19 Rue des Briquetiers, BP 59, 31702 Blagnac, France; (M.L.B.); (V.T.)
| | - Stéphane Bronner
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions, 6100 Royalmount Avenue, Montreal, QC H4P 2R2, Canada; (A.T.); (U.H.I.); (O.K.); (S.B.)
| | - Tara Perrot
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Nafissa Ismail
- Department of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - J.Alex Parker
- Département de Neurosciences, Université de Montréal, Montreal, QC H3T 1J4, Canada;
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Verma A, Azhar G, Patyal P, Zhang W, Zhang X, Wei JY. Proteomic analysis of P. gingivalis-Lipopolysaccharide induced neuroinflammation in SH-SY5Y and HMC3 cells. GeroScience 2024:10.1007/s11357-024-01117-z. [PMID: 38507186 DOI: 10.1007/s11357-024-01117-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/26/2024] [Indexed: 03/22/2024] Open
Abstract
Chronic periodontitis and its keystone pathogen, Porphyromonas gingivalis, have increasingly been linked with Alzheimer's disease (AD). However, P.gingivalis-lipopolysaccharide (LPS) mediated release of neuroinflammatory proteins contributes to AD remains underexplored. In this study, we utilized data-independent acquisition mass spectrometry to characterize P.gingivalis-LPS induced profile of differentially expressed proteins associated with the neuroinflammatory response in human neuroblastoma (SH-SY5Y) and human microglial (HMC3) cells. We reported a set of 124 proteins in SH-SY5Y cells and 96 proteins in HMC3 cells whose levels were significantly upregulated or downregulated by exposure to P. gingivalis-LPS. Our findings demonstrate that P. gingivalis-LPS contributed to the elevated expressions of dementia biomarkers and pro-inflammatory cytokines that include APP, Aβ1-42, Aβ1-40, T-Tau, p-Tau, VEGF, TGF-β, IL-1β, IL-6 and TNF-α through 2 distinct pathways of extracellular sensing by cell surface receptors and intracellular cytosolic receptors. Interestingly, intracellular signaling proteins activated with P. gingivalis-LPS transfection using Lipofectamine™ 2000 had significantly higher fold change protein expression compared to the extracellular signaling with P. gingivalis-LPS treatment. Additionally, we also explored P. gingivalis-LPS mediated activation of caspase-4 dependent non canonical inflammasome pathway in both SH-SY5Y and HMC3 cells. In summary, P. gingivalis-LPS induced neuroinflammatory protein expression in SH-SY5Y and HMC3 cells, provided insights into the specific inflammatory pathways underlying the potential link between P. gingivalis-LPS infection and the pathogenesis of Alzheimer's disease and related dementias.
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Affiliation(s)
- Ambika Verma
- Department of Geriatrics, Donald W. Reynolds Institute On Aging, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Gohar Azhar
- Department of Geriatrics, Donald W. Reynolds Institute On Aging, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Pankaj Patyal
- Department of Geriatrics, Donald W. Reynolds Institute On Aging, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Wei Zhang
- Department of Mathematics and Statistics, University of Arkansas at Little Rock, Little Rock, AR, USA
| | - Xiaomin Zhang
- Department of Geriatrics, Donald W. Reynolds Institute On Aging, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Jeanne Y Wei
- Department of Geriatrics, Donald W. Reynolds Institute On Aging, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA.
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Rubinstein T, Brickman AM, Cheng B, Burkett S, Park H, Annavajhala MK, Uhlemann A, Andrews H, Gutierrez J, Paster BJ, Noble JM, Papapanou PN. Periodontitis and brain magnetic resonance imaging markers of Alzheimer's disease and cognitive aging. Alzheimers Dement 2024; 20:2191-2208. [PMID: 38278517 PMCID: PMC10984451 DOI: 10.1002/alz.13683] [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: 10/13/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/28/2024]
Abstract
INTRODUCTION We examined the association of clinical, microbiological, and host response features of periodontitis with MRI markers of atrophy/cerebrovascular disease in the Washington Heights Inwood Columbia Aging Project (WHICAP) Ancillary Study of Oral Health. METHODS We analyzed 468 participants with clinical periodontal data, microbial plaque and serum samples, and brain MRIs. We tested the association of periodontitis features with MRI features, after adjusting for multiple risk factors for Alzheimer's disease/Alzheimer's disease-related dementia (AD/ADRD). RESULTS In fully adjusted models, having more teeth was associated with lower odds for infarcts, lower white matter hyperintensity (WMH) volume, higher entorhinal cortex volume, and higher cortical thickness. Higher extent of periodontitis was associated with lower entorhinal cortex volume and lower cortical thickness. Differential associations emerged between colonization by specific bacteria/serum antibacterial IgG responses and MRI outcomes. DISCUSSION In an elderly cohort, clinical, microbiological, and serological features of periodontitis were associated with MRI findings related to ADRD risk. Further investigation of causal associations is warranted.
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Affiliation(s)
- Tom Rubinstein
- Division of PeriodonticsSection of OralDiagnostic and Rehabilitation SciencesCollege of Dental MedicineNew YorkNew YorkUSA
| | - Adam M. Brickman
- Department of NeurologyVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterNew YorkNew YorkUSA
| | - Bin Cheng
- Department of BiostatisticsMailman School of Public HealthNew YorkNew YorkUSA
| | - Sandra Burkett
- Division of PeriodonticsSection of OralDiagnostic and Rehabilitation SciencesCollege of Dental MedicineNew YorkNew YorkUSA
| | - Heekuk Park
- Division of Infectious DiseasesDepartment of MedicineVagelos College of Physicians and, Surgeons, Irving Medical CenterColumbia UniversityNew YorkNew YorkUSA
| | - Medini K. Annavajhala
- Division of Infectious DiseasesDepartment of MedicineVagelos College of Physicians and, Surgeons, Irving Medical CenterColumbia UniversityNew YorkNew YorkUSA
| | - Anne‐Catrin Uhlemann
- Division of Infectious DiseasesDepartment of MedicineVagelos College of Physicians and, Surgeons, Irving Medical CenterColumbia UniversityNew YorkNew YorkUSA
| | - Howard Andrews
- Department of BiostatisticsMailman School of Public HealthNew YorkNew YorkUSA
| | - Jose Gutierrez
- Department of NeurologyVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Bruce J. Paster
- The Forsyth InstituteCambridgeMassachusettsUSA
- Department of Oral Medicine, Infection and ImmunityHarvard School of Dental MedicineBostonMassachusettsUSA
| | - James M. Noble
- Department of NeurologyVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterNew YorkNew YorkUSA
| | - Panos N. Papapanou
- Division of PeriodonticsSection of OralDiagnostic and Rehabilitation SciencesCollege of Dental MedicineNew YorkNew YorkUSA
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11
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Whitson HE, Banks WA, Diaz MM, Frost B, Kellis M, Lathe R, Schmader KE, Spudich SS, Tanzi R, Garden G. New approaches for understanding the potential role of microbes in Alzheimer's disease. Brain Behav Immun Health 2024; 36:100743. [PMID: 38435720 PMCID: PMC10906156 DOI: 10.1016/j.bbih.2024.100743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Alzheimer's disease (AD) involves a complex pathological process that evolves over years, and its etiology is understood as a classic example of gene-environment interaction. The notion that exposure to microbial organisms may play some role in AD pathology has been proposed and debated for decades. New evidence from model organisms and -omic studies, as well as epidemiological data from the recent COVID-19 pandemic and widespread use of vaccines, offers new insights into the "germ hypothesis" of AD. To review new evidence and identify key research questions, the Duke/University of North Carolina (Duke/UNC) Alzheimer's Disease Research Center hosted a virtual symposium and workshop: "New Approaches for Understanding the Potential Role of Microbes in Alzheimer's disease." Discussion centered around the antimicrobial protection hypothesis of amyloid accumulation, and other mechanisms by which microbes could influence AD pathology including immune cell activation, changes in blood-brain barrier, or direct neurotoxicity. This summary of proceedings reviews the content presented in the symposium and provides a summary of major topics and key questions discussed in the workshop.
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Affiliation(s)
- Heather E. Whitson
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Busse Bldg Rm 3502, Durham, NC, 27710, USA
- Durham VA Medical Center, Geriatric Research Education and Clinical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - William A. Banks
- Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, 170 Manning Dr, CB 7025, Chapel Hill, NC, 27599, USA
| | - Bess Frost
- Barshop Institute for Longevity & Aging Studies, 4939 Charles Katz Rm 1041, University of Texas Health San Antonio, San Antonio, TX, 78229, USA
| | - Manolis Kellis
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, 32 Vassar St., Cambridge, MA, 02139, USA
| | - Richard Lathe
- Division of Infection Medicine, University of Edinburgh Medical School, Edinburgh BioQuarter, Little France, Edinburgh, EH16 4SB, UK
| | - Kenneth E. Schmader
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Busse Bldg Rm 3502, Durham, NC, 27710, USA
- Durham VA Medical Center, Geriatric Research Education and Clinical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - Serena S. Spudich
- Department of Neurology, Yale University School of Medicine, 300 George Street, Room 8300, New Haven, CT, 06510, USA
| | - Rudolph Tanzi
- Genetics and Aging Research Unit, Massachusetts General Hospital, 114 16th Street, Charlestown, MA, 02129, USA
| | - Gwenn Garden
- University of North Carolina - Dept of Neurology, 170 Manning Drive, Campus Box 7025, Chapel Hill, NC, 27599-7025, USA
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12
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Liu S, Butler CA, Ayton S, Reynolds EC, Dashper SG. Porphyromonas gingivalis and the pathogenesis of Alzheimer's disease. Crit Rev Microbiol 2024; 50:127-137. [PMID: 36597758 DOI: 10.1080/1040841x.2022.2163613] [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: 08/17/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023]
Abstract
The cause of Alzheimer's disease (AD), and the pathophysiological mechanisms involved, remain major unanswered questions in medical science. Oral bacteria, especially those species associated with chronic periodontitis and particularly Porphyromonas gingivalis, are being linked causally to AD pathophysiology in a subpopulation of susceptible individuals. P. gingivalis produces large amounts of proteolytic enzymes, haem and iron capture proteins, adhesins and internalins that are secreted and attached to the cell surface and concentrated onto outer membrane vesicles (OMVs). These enzymes and adhesive proteins have been shown to cause host tissue damage and stimulate inflammatory responses. The ecological and pathophysiological roles of P. gingivalis OMVs, their ability to disperse widely throughout the host and deliver functional proteins lead to the proposal that they may be the link between a P. gingivalis focal infection in the subgingivae during periodontitis and neurodegeneration in AD. P. gingivalis OMVs can cross the blood brain barrier and may accelerate AD-specific neuropathology by increasing neuroinflammation, plaque/tangle formation and dysregulation of iron homeostasis, thereby inducing ferroptosis leading to neuronal death and neurodegeneration.
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Affiliation(s)
- Sixin Liu
- School of Dentistry, University of Michigan, Ann Arbor, United States of America
| | - Catherine A Butler
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Parkville, Australia
| | - Scott Ayton
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - Eric C Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Parkville, Australia
| | - Stuart G Dashper
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Parkville, Australia
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13
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Cichońska D, Mazuś M, Kusiak A. Recent Aspects of Periodontitis and Alzheimer's Disease-A Narrative Review. Int J Mol Sci 2024; 25:2612. [PMID: 38473858 DOI: 10.3390/ijms25052612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Periodontitis is an inflammatory condition affecting the supporting structures of the teeth. Periodontal conditions may increase the susceptibility of individuals to various systemic illnesses, including Alzheimer's disease. Alzheimer's disease is a neurodegenerative condition characterized by a gradual onset and progressive deterioration, making it the primary cause of dementia, although the exact cause of the disease remains elusive. Both Alzheimer's disease and periodontitis share risk factors and clinical studies comparing the associations and occurrence of periodontitis among individuals with Alzheimer's disease have suggested a potential correlation between these conditions. Brains of individuals with Alzheimer's disease have substantiated the existence of microorganisms related to periodontitis, especially Porphyromonas gingivalis, which produces neurotoxic gingipains and may present the capability to breach the blood-brain barrier. Treponema denticola may induce tau hyperphosphorylation and lead to neuronal apoptosis. Lipopolysaccharides-components of bacterial cell membranes and mediators of inflammation-also have an impact on brain function. Further research could unveil therapeutic approaches targeting periodontal pathogens to potentially alleviate AD progression.
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Affiliation(s)
- Dominika Cichońska
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
| | - Magda Mazuś
- Student Research Group of the Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
| | - Aida Kusiak
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
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14
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Li R, Wang J, Xiong W, Luo Y, Feng H, Zhou H, Peng Y, He Y, Ye Q. The oral-brain axis: can periodontal pathogens trigger the onset and progression of Alzheimer's disease? Front Microbiol 2024; 15:1358179. [PMID: 38362505 PMCID: PMC10868393 DOI: 10.3389/fmicb.2024.1358179] [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] [Received: 12/19/2023] [Accepted: 01/18/2024] [Indexed: 02/17/2024] Open
Abstract
Alzheimer's disease (AD) is the most prevalent form of dementia, characterized by a progressive cognitive decline. Sporadic AD, accounting for more than 95% of cases, may arise due to the influence of environmental factors. It was reported that periodontitis, a common oral ailment, shares several risk factors with AD, including advanced age, smoking, diabetes, and hypertension, among others. Periodontitis is an inflammatory disease triggered by dysbiosis of oral microorganisms, whereas Alzheimer's disease is characterized by neuroinflammation. Many studies have indicated that chronic inflammation can instigate brain AD-related pathologies, including amyloid-β plaques, Tau protein hyperphosphorylation, neuroinflammation, and neurodegeneration. The potential involvement of periodontal pathogens and/or their virulence factors in the onset and progression of AD by the oral-brain axis has garnered significant attention among researchers with ongoing investigations. This review has updated the periodontal pathogens potentially associated with AD, elucidating their impact on the central nervous system, immune response, and related pathological processes in the brain to provide valuable insights for future research on the oral-brain axis.
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Affiliation(s)
- Ruohan Li
- Center of Regenerative Medicine, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Junnan Wang
- Center of Regenerative Medicine, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Wei Xiong
- Center of Regenerative Medicine, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yu Luo
- Center of Regenerative Medicine, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
- Department of Stomatology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Huixian Feng
- Department of Stomatology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Heng Zhou
- Center of Regenerative Medicine, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Youjian Peng
- Department of Stomatology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yan He
- Institute of Regenerative and Translational Medicine, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Qingsong Ye
- Center of Regenerative Medicine, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
- Department of Stomatology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
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15
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Matsuo T, Nakao K, Hara K. Inhibitory Effects of the Heat-Killed Lactic Acid Bacterium Enterococcus faecalis on the Growth of Porphyromonas gingivalis. CURRENT THERAPEUTIC RESEARCH 2024; 100:100731. [PMID: 38380421 PMCID: PMC10877105 DOI: 10.1016/j.curtheres.2024.100731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Background Porphyromonas gingivalis, a gram-negative obligate anaerobic bacterium, is a major pathogen involved in the onset and progression of periodontal disease, a chronic inflammatory disorder observed in approximately two-thirds of the Japanese population older than age 30 years. P gingivalis cells produce and secrete gingipain, a powerful proteolytic enzyme, on their surfaces and in external environments. Objectives The effects of heat-killed Enterococcus faecalis (HkEf), a lactic acid bacterium, on the growth of P gingivalis were evaluated in vitro by measuring the viable cell count of P gingivalis and gingipain activity. Methods HkEf solution (1.63 or 163 mg/mL) was added to 1 mL P gingivalis culture to generate a final HkEf concentration of 0.64 or 64 mg/mL. The cultures were incubated anaerobically. The number of viable P gingivalis cells and gingipain activity were measured after incubation for 0, 12, 24, 48, and 72 hours. The number of viable P gingivalis cells was calculated by counting the number of colonies after culture. Gingipain activity was quantified by adding a chromogenic substrate to P gingivalis culture medium and measuring the absorbance of the reaction solution with a plate reader. Mean (SE) was calculated for viable cell counts and gingipain activity, and Wilcoxon rank-sum test was used to test for significant differences. Results The counts of viable P gingivalis cells in the control group increased as incubation time progressed for 12, 24, 48, and 72 hours; similar results were observed in the low-concentration HkEf group. In the high-concentration HkEf group, the increase in the viable cell count was significantly inhibited compared with that of the control group. Furthermore, gingipain activity in the low- and high-concentration HkEf groups was significantly inhibited over time compared with that of the control group. Although the pH of the culture solution tended to decrease in the high-concentration HkEf group, it was not considered to have affected the growth of P gingivalis. Conclusions HkEf exhibits inhibitory effects on the growth of P gingivalis and gingipain activity.
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Affiliation(s)
| | - Koji Nakao
- Academic Division, NUTRI Co Ltd, Tokyo, Japan
| | - Kosuke Hara
- Academic Division, NUTRI Co Ltd, Tokyo, Japan
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16
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Panwar A, Rentsendorj A, Jhun M, Cohen RM, Cordner R, Gull N, Pechnick RN, Duvall G, Mardiros A, Golchian D, Schubloom H, Jin LW, Van Dam D, Vermeiren Y, De Reu H, De Deyn PP, Raskatov JA, Black KL, Irvin DK, Williams BA, Wheeler CJ. Antigen-specific age-related memory CD8 T cells induce and track Alzheimer's-like neurodegeneration. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.22.576704. [PMID: 38328072 PMCID: PMC10849535 DOI: 10.1101/2024.01.22.576704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Cerebral (Aβ) plaque and (pTau) tangle deposition are hallmarks of Alzheimer's disease (AD), yet are insufficient to confer complete AD-like neurodegeneration experimentally. Factors acting upstream of Aβ/pTau in AD remain unknown, but their identification could enable earlier diagnosis and more effective treatments. T cell abnormalities are emerging AD hallmarks, and CD8 T cells were recently found to mediate neurodegeneration downstream of tangle deposition in hereditary neurodegeneration models. The precise impact of T cells downstream of Aβ/fibrillar pTau, however, appears to vary depending on the animal model used. Our prior work suggested that antigen-specific memory CD8 T (" hi T") cells act upstream of Aβ/pTau after brain injury. Here we examine whether hi T cells influence sporadic AD-like pathophysiology upstream of Aβ/pTau. Examining neuropathology, gene expression, and behavior in our hi T mouse model we show that CD8 T cells induce plaque and tangle-like deposition, modulate AD-related genes, and ultimately result in progressive neurodegeneration with both gross and fine features of sporadic human AD. T cells required Perforin to initiate this pathophysiology, and IFNγ for most gene expression changes and progression to more widespread neurodegenerative disease. Analogous antigen-specific memory CD8 T cells were significantly elevated in the brains of human AD patients, and their loss from blood corresponded to sporadic AD and related cognitive decline better than plasma pTau-217, a promising AD biomarker candidate. Our work is the first to identify an age-related factor acting upstream of Aβ/pTau to initiate AD-like pathophysiology, the mechanisms promoting its pathogenicity, and its relevance to human sporadic AD. Significance Statement This study changes our view of Alzheimer's Disease (AD) initiation and progression. Mutations promoting cerebral beta-amyloid (Aβ) deposition guarantee rare genetic forms of AD. Thus, the prevailing hypothesis has been that Aβ is central to initiation and progression of all AD, despite contrary animal and patient evidence. We show that age-related T cells generate neurodegeneration with compelling features of AD in mice, with distinct T cell functions required for pathological initiation and neurodegenerative progression. Knowledge from these mice was applied to successfully predict previously unknown features of human AD and generate novel tools for its clinical management.
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17
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Kang HS, Kim JH, Kim JH, Bang WJ, Choi HG, Kim NY, Park HY, Kwon MJ. Unlocking the Protective Potential of Upper Respiratory Infection Treatment Histories against Alzheimer's Disease: A Korean Adult Population Study. J Clin Med 2024; 13:260. [PMID: 38202267 PMCID: PMC10780066 DOI: 10.3390/jcm13010260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
With increasing interest in the inflammation-pathogen infection hypothesis and its potential links to Alzheimer's disease (AD) development, there is growing consideration of using upper respiratory infection (URI) treatments as interventions for AD. This nested case-control study explored the potential association between prior URI histories and AD development in a Korean adult population using the national health screening cohort data (2002-2019). The study included 26,920 AD patients and 107,680 matched control individuals, focusing on those seeking respiratory treatment. Logistic regression analyses assessed the impact of URI histories and treatment on AD risk while adjusting for covariates. Our results revealed that over a 1-year period, individuals with URI histories (≥1, ≥2, or ≥3 instances) exhibited decreasing probabilities of developing AD, with risk reductions of 19%, 15%, and 12%, respectively. Expanding our investigation to a 2-year period consistently showed a 17% reduction in AD risk. This effect remained robust across diverse demographic groups and after adjusting for covariates, encompassing comorbidities, hypertension, hyperlipidemia, blood glucose levels, and lifestyle factors. Subgroup analyses further substantiated this association. In conclusion, our findings cautiously suggest a potential protective role of prior URI treatment histories in mitigating the risk of AD development.
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Affiliation(s)
- Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Woo Jin Bang
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Hyo Geun Choi
- Suseo Seoul E.N.T. Clinic and MD Analytics, 10, Bamgogae-ro 1-gil, Gangnam-gu, Seoul 06349, Republic of Korea;
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang 14068, Republic of Korea;
| | - Ha Young Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea;
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
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Cruciani F, Aparo A, Brusini L, Combi C, Storti SF, Giugno R, Menegaz G, Boscolo Galazzo I. Identifying the joint signature of brain atrophy and gene variant scores in Alzheimer's Disease. J Biomed Inform 2024; 149:104569. [PMID: 38104851 DOI: 10.1016/j.jbi.2023.104569] [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: 02/22/2023] [Revised: 11/20/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
The joint modeling of genetic data and brain imaging information allows for determining the pathophysiological pathways of neurodegenerative diseases such as Alzheimer's disease (AD). This task has typically been approached using mass-univariate methods that rely on a complete set of Single Nucleotide Polymorphisms (SNPs) to assess their association with selected image-derived phenotypes (IDPs). However, such methods are prone to multiple comparisons bias and, most importantly, fail to account for potential cross-feature interactions, resulting in insufficient detection of significant associations. Ways to overcome these limitations while reducing the number of traits aim at conveying genetic information at the gene level and capturing the integrated genetic effects of a set of genetic variants, rather than looking at each SNP individually. Their associations with brain IDPs are still largely unexplored in the current literature, though they can uncover new potential genetic determinants for brain modulations in the AD continuum. In this work, we explored an explainable multivariate model to analyze the genetic basis of the grey matter modulations, relying on the AD Neuroimaging Initiative (ADNI) phase 3 dataset. Cortical thicknesses and subcortical volumes derived from T1-weighted Magnetic Resonance were considered to describe the imaging phenotypes. At the same time the genetic counterpart was represented by gene variant scores extracted by the Sequence Kernel Association Test (SKAT) filtering model. Moreover, transcriptomic analysis was carried on to assess the expression of the resulting genes in the main brain structures as a form of validation. Results highlighted meaningful genotype-phenotype interactionsas defined by three latent components showing a significant difference in the projection scores between patients and controls. Among the significant associations, the model highlighted EPHX1 and BCAS1 gene variant scores involved in neurodegenerative and myelination processes, hence relevant for AD. In particular, the first was associated with decreased subcortical volumes and the second with decreasedtemporal lobe thickness. Noteworthy, BCAS1 is particularly expressed in the dentate gyrus. Overall, the proposed approach allowed capturing genotype-phenotype interactions in a restricted study cohort that was confirmed by transcriptomic analysis, offering insights into the underlying mechanisms of neurodegeneration in AD in line with previous findings and suggesting new potential disease biomarkers.
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Affiliation(s)
- Federica Cruciani
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy.
| | - Antonino Aparo
- Department of Computer Science, University of Verona, Verona, Italy
| | - Lorenza Brusini
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Carlo Combi
- Department of Computer Science, University of Verona, Verona, Italy
| | - Silvia F Storti
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Rosalba Giugno
- Department of Computer Science, University of Verona, Verona, Italy
| | - Gloria Menegaz
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
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Zhao J, Li T, Wang J. Association between psoriasis and dementia: A systematic review. Neurologia 2024; 39:55-62. [PMID: 38161072 DOI: 10.1016/j.nrleng.2023.12.005] [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: 09/30/2020] [Accepted: 12/14/2020] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Risk factors for dementia include genetic factors, aging, environmental factors, certain diseases, and unhealthy lifestyle; most types of dementia share a common chronic systemic inflammatory phenotype. Psoriasis is also considered to be a chronic systemic inflammatory disease. It has been suggested that psoriasis may also contribute to the risk of dementia. The aim of this study was to systematically review the literature on the association between psoriasis and dementia. DEVELOPMENT Articles were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Web of Science databases to identify articles published in peer-reviewed journals and studying the association between psoriasis and dementia. Studies meeting the inclusion criteria were reviewed. We used the Newcastle-Ottawa Scale to assess the quality of each study. After applying the inclusion and exclusion criteria, we included 8 studies for review, 3 of which were found to present a higher risk of bias. Six of the 8 studies supported the hypothesis that prior diagnosis of psoriasis increases the risk of dementia; one study including only a few cases reported that psoriasis decreased the risk of dementia, and one study including relatively young patients found no significant association between psoriasis and the risk of dementia. CONCLUSION Most studies included in this review supported the hypothesis that psoriasis constitutes a risk factor for dementia. However, well-designed stratified cohort studies assessing both psoriasis severity and treatment status are still required to determine the real effect of psoriasis on the risk of dementia and its subtypes.
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Affiliation(s)
- J Zhao
- Academy of Life Sciences, School of Medicine, Xi'an International University, Xi'an, China.
| | - T Li
- Disease Prevention and Control Section, Shangcai People's Hospital, Shangcai, China
| | - J Wang
- Academy of Life Sciences, School of Medicine, Xi'an International University, Xi'an, China
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20
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Cabanillas J, Risco R, Munive-Degregori A, Guerrero ME, Mauricio F, Mayta-Tovalino F. Periodontitis and Neuropathic Diseases: A Literature Review. J Int Soc Prev Community Dent 2024; 14:10-15. [PMID: 38559636 PMCID: PMC10980301 DOI: 10.4103/jispcd.jispcd_68_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/20/2022] [Accepted: 05/27/2022] [Indexed: 04/04/2024] Open
Abstract
Aim This narrative review aimed at identifying the existing scientific literature investigating periodontitis and neuropathic diseases. Materials and Methods A search of the literature published between 2000 and 2022 was carried out in the electronic databases of Scopus and PubMed. Studies in which the eligible articles were mainly published in English were included. Descriptive correlational studies, case-control studies, comparative studies, and cohort studies were also included. The following main keywords were used: "Neuropathic diseases," "Periodontitis," "Alzheimer's disease," and "Porphyromonas gingivalis." Results This narrative review found that cognitively impaired persons with severe periodontitis had a higher prevalence and incidence of periodontal diseases than the rest of the population. A significant positive correlation of salivary interleukin (IL)-1beta and immediate recall scores involved in cognition was also evident. It indicates that the most investigated parameter was whether there is any common link between periodontal disease and neurodegeneration. No randomized controlled clinical studies were found in the current literature review. Conclusions Based on the literature reviewed, there is currently no strong scientific evidence to support or discourage the cause-effect relationship of periodontal diseases and neurodegenerative diseases.
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Affiliation(s)
- Jesus Cabanillas
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Ruth Risco
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Arnaldo Munive-Degregori
- Academic Department of Rehabilitative Stomatology, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Maria Eugenia Guerrero
- Academic Department of Medical and Surgical Stomatology, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Franco Mauricio
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Frank Mayta-Tovalino
- CHANGE Research Working Group, Faculty of Health Sciences, Universidad Cientifica del Sur, Lima, Peru
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21
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Moghadam MT, Mojtahedi A, Bakhshayesh B, Babakhani S, Ajorloo P, Shariati A, Mirzaei M, Heidarzadeh S, Jazi FM. The Effect of Bacterial Composition Shifts in the Oral Microbiota on Alzheimer's Disease. Curr Mol Med 2024; 24:167-181. [PMID: 35986539 DOI: 10.2174/1566524023666220819140748] [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: 03/21/2022] [Revised: 05/16/2022] [Accepted: 05/30/2022] [Indexed: 11/22/2022]
Abstract
Alzheimer's disease (AD), a neurological disorder, despite significant advances in medical science, has not yet been definitively cured, and the exact causes of the disease remain unclear. Due to the importance of AD in the clinic, large expenses are spent annually to deal with this neurological disorder, and neurologists warn of an increase in this disease in elderly in the near future. It has been believed that microbiota dysbiosis leads to Alzheimer's as a multi-step disease. In this regard, the presence of footprints of perturbations in the oral microbiome and the predominance of pathogenic bacteria and their effect on the nervous system, especially AD, is a very interesting topic that has been considered by researchers in the last decade. Some studies have looked at the mechanisms by which oral microbiota cause AD. However, many aspects of this interaction are still unclear as to how oral microbiota composition can contribute to this disease. Understanding this interaction requires extensive collaboration by interdisciplinary researchers to explore all aspects of the issue. In order to reveal the link between the composition of the oral microbiota and this disease, researchers from various domains have sought to explain the mechanisms of shift in oral microbiota in AD in this review.
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Affiliation(s)
- Majid Taati Moghadam
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mojtahedi
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Babak Bakhshayesh
- Department of Neurology, Neuroscience Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Sajad Babakhani
- Department of Microbiology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Ajorloo
- Department of Biology, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
| | - Aref Shariati
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Mehrnaz Mirzaei
- Department of Microbiology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Siamak Heidarzadeh
- Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Faramarz Masjedian Jazi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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22
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Zhang M, Mi N, Ying Z, Lin X, Jin Y. Advances in the prevention and treatment of Alzheimer's disease based on oral bacteria. Front Psychiatry 2023; 14:1291455. [PMID: 38156323 PMCID: PMC10754487 DOI: 10.3389/fpsyt.2023.1291455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023] Open
Abstract
With the global population undergoing demographic shift towards aging, the prevalence of Alzheimer's disease (AD), a prominent neurodegenerative disorder that primarily afflicts individuals aged 65 and above, has increased across various geographical regions. This phenomenon is accompanied by a concomitant decline in immune functionality and oral hygiene capacity among the elderly, precipitating compromised oral functionality and an augmented burden of dental plaque. Accordingly, oral afflictions, including dental caries and periodontal disease, manifest with frequency among the geriatric population worldwide. Recent scientific investigations have unveiled the potential role of oral bacteria in instigating both local and systemic chronic inflammation, thereby delineating a putative nexus between oral health and the genesis and progression of AD. They further proposed the oral microbiome as a potentially modifiable risk factor in AD development, although the precise pathological mechanisms and degree of association have yet to be fully elucidated. This review summarizes current research on the relationship between oral bacteria and AD, describing the epidemiological and pathological mechanisms that may potentially link them. The purpose is to enrich early diagnostic approaches by incorporating emerging biomarkers, offering novel insights for clinicians in the early detection of AD. Additionally, it explores the potential of vaccination strategies and guidance for clinical pharmacotherapy. It proposes the development of maintenance measures specifically targeting oral health in older adults and advocates for guiding elderly patients in adopting healthy lifestyle habits, ultimately aiming to indirectly mitigate the progression of AD while promoting oral health in the elderly.
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Affiliation(s)
| | | | | | | | - Ying Jin
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang, China
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23
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Qian J, Lu J, Cheng S, Zou X, Tao Q, Wang M, Wang N, Zheng L, Liao W, Li Y, Yan F. Periodontitis salivary microbiota exacerbates colitis-induced anxiety-like behavior via gut microbiota. NPJ Biofilms Microbiomes 2023; 9:93. [PMID: 38062089 PMCID: PMC10703887 DOI: 10.1038/s41522-023-00462-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
The gut-brain axis is a bidirectional communication system between the gut and central nervous system. Many host-related factors can affect gut microbiota, including oral bacteria, making the brain a vulnerable target via the gut-brain axis. Saliva contains a large number of oral bacteria, and periodontitis, a common oral disease, can change the composition of salivary microbiota. However, the role and mechanism of periodontitis salivary microbiota (PSM) on the gut-brain axis remain unclear. Herein, we investigated the nature and mechanisms of this relationship using the mice with dextran sulfate sodium salt (DSS)-induced anxiety-like behavior. Compared with healthy salivary microbiota, PSM worsened anxiety-like behavior; it significantly reduced the number of normal neurons and activated microglia in DSS mice. Antibiotic treatment eliminated the effect of PSM on anxiety-like behavior, and transplantation of fecal microbiota from PSM-gavaged mice exacerbated anxiety-like behavior. These observations indicated that the anxiety-exacerbating effect of PSM was dependent on the gut microbiota. Moreover, the PSM effect on anxiety-like behavior was not present in non-DSS mice, indicating that DSS treatment was a prerequisite for PSM to exacerbate anxiety. Mechanistically, PSM altered the histidine metabolism in both gut and brain metabolomics. Supplementation of histidine-related metabolites had a similar anxiety-exacerbating effect as that of PSM, suggesting that histidine metabolism may be a critical pathway in this process. Our results demonstrate that PSM can exacerbate colitis-induced anxiety-like behavior by directly affecting the host gut microbiota, emphasizing the importance of oral diseases in the gut-brain axis.
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Affiliation(s)
- Jun Qian
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jiangyue Lu
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shuyu Cheng
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xihong Zou
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Qing Tao
- Center for Translational Medicine and Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Min Wang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Nannan Wang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Lichun Zheng
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Wenzheng Liao
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yanfen Li
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
| | - Fuhua Yan
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
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24
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Zürcher C, Humpel C. Saliva: a challenging human fluid to diagnose brain disorders with a focus on Alzheimer's disease. Neural Regen Res 2023; 18:2606-2610. [PMID: 37449596 DOI: 10.4103/1673-5374.373675] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Biomarkers are molecules of biological processes that help in both the diagnosis of human diseases and in follow-up assessments of therapeutic responses. Biomarkers can be measured in many human fluids, such as blood, cerebrospinal fluid, urine, and saliva. The -omics methods (genomics, RNomics, proteomics, and metabolomics) are useful at measuring thousands of markers in a small volume. Saliva is a human fluid that is easily accessible, without any ethical concerns. Yet, saliva remains unexplored in regard to many human disease biomarkers. In this review, we will give an overview on saliva and how it can be influenced by exogenous factors. As we focus on the potential use of saliva as a diagnostic tool in brain disorders (especially Alzheimer's disease), we will cover how saliva is linked to the brain. We will discuss that saliva is a heterogeneous human fluid, yet useful for the discovery of biomarkers in human disorders. However, a procedure and consensus that is controlled, validated, and standardized for the collection and processing of saliva is required, followed by a highly sensitive diagnostic approach.
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Affiliation(s)
- Christine Zürcher
- University Hospital for Restorative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Humpel
- Laboratory of Psychiatry & Experimental Alzheimer's Research, Department of Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
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25
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Phuna ZX, Madhavan P. A reappraisal on amyloid cascade hypothesis: the role of chronic infection in Alzheimer's disease. Int J Neurosci 2023; 133:1071-1089. [PMID: 35282779 DOI: 10.1080/00207454.2022.2045290] [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: 09/01/2020] [Accepted: 02/09/2022] [Indexed: 10/18/2022]
Abstract
Alzheimer disease (AD) is a progressive neurological disorder that accounted for the most common cause of dementia in the elderly population. Lately, 'infection hypothesis' has been proposed where the infection of microbes can lead to the pathogenesis of AD. Among different types of microbes, human immunodeficiency virus-1 (HIV-1), herpes simplex virus-1 (HSV-1), Chlamydia pneumonia, Spirochetes and Candida albicans are frequently detected in the brain of AD patients. Amyloid-beta protein has demonstrated to exhibit antimicrobial properties upon encountering these pathogens. It can bind to microglial cells and astrocytes to activate immune response and neuroinflammation. Nevertheless, HIV-1 and HSV-1 can develop into latency whereas Chlamydia pneumonia, Spirochetes and Candida albicans can cause chronic infections. At this stage, the DNA of microbes remains undetectable yet active. This can act as the prolonged pathogenic stimulus that over-triggers the expression of Aβ-related genes, which subsequently lead to overproduction and deposition of Aβ plaque. This review will highlight the pathogenesis of each of the stated microbial infection, their association in AD pathogenesis as well as the effect of chronic infection in AD progression. Potential therapies for AD by modulating the microbiome have also been suggested. This review will aid in understanding the infectious manifestations of AD.
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Affiliation(s)
- Zhi Xin Phuna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
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26
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Yoo JE, Huh Y, Park SH, Han K, Park HS, Cho KH, Ahn JS, Jun SH, Nam GE. Association between Dental Diseases and Oral Hygiene Care and the Risk of Dementia: A Retrospective Cohort Study. J Am Med Dir Assoc 2023; 24:1924-1930.e3. [PMID: 37709259 DOI: 10.1016/j.jamda.2023.08.011] [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: 05/23/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES To investigate the associations of dental diseases and oral hygiene care with the risk of dementia. DESIGN Retrospective longitudinal cohort study. SETTING AND PARTICIPANTS We conducted a population-based study of individuals in the Korean National Health Insurance System. A total of 2,555,618 participants who underwent cardiovascular and dental screenings in 2008 were included. METHODS Dental diseases including periodontal diseases, dental caries, and tooth loss were assessed by dentists. Information on oral hygiene care, including professional dental cleaning and the frequency of tooth brushing, was collected using a self-administered questionnaire. Study outcomes were all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). RESULTS Periodontal diseases [adjusted hazard ratio (aHR) 1.07, 95% CI 1.04-1.09], dental caries (aHR 1.03, 95% CI 1.00-1.05), and 8-14 missing teeth (aHR 1.07, 95% CI 1.02-1.12) were associated with an increased risk of all-cause dementia. In contrast, either professional dental cleaning or frequent tooth brushing were associated with decreased risks of all-cause dementia (aHR 0.91, 95% CI 0.89-0.93 each; aHR 0.83, 95% CI 0.80-0.86 for both). The increased risks by dental diseases were reduced by oral hygiene care: periodontal diseases with professional dental cleaning (aHR 0.94, 95% CI 0.91-0.98) or tooth brushing ≥2 times/day (aHR 0.97, 95% CI 0.94-1.00) and 1 to 7 missing teeth with professional dental cleaning (aHR 0.94, 95% CI 0.89-0.98) or tooth brushing ≥2 times/day (aHR 0.92, 95% CI 0.89-0.95). Consistent results were noted for AD and VaD and in various subgroup analyses. CONCLUSION AND IMPLICATIONS Periodontal disease, dental caries, and a high number of missing teeth were independently associated with a higher risk of dementia. Conversely, improved oral hygiene care, such as professional dental cleaning and frequent tooth brushing, may modify the risk of dementia associated with dental diseases.
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Affiliation(s)
- Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center Seoul National University Hospital, Seoul, Republic of Korea; Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youn Huh
- Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University, Gyeonggi-do, Republic of Korea
| | - Sang-Hyun Park
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Hye Soon Park
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyung Hwan Cho
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin-Soo Ahn
- Department of Dental Biomaterials Science and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Sang Ho Jun
- Department of Oral & Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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27
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Bai XB, Xu S, Zhou LJ, Meng XQ, Li YL, Chen YL, Jiang YH, Lin WZ, Chen BY, Du LJ, Tian GC, Liu Y, Duan SZ, Zhu YQ. Oral pathogens exacerbate Parkinson's disease by promoting Th1 cell infiltration in mice. MICROBIOME 2023; 11:254. [PMID: 37978405 PMCID: PMC10655362 DOI: 10.1186/s40168-023-01685-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/29/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is a common chronic neurological disorder with a high risk of disability and no cure. Periodontitis is an infectious bacterial disease occurring in periodontal supporting tissues. Studies have shown that periodontitis is closely related to PD. However, direct evidence of the effect of periodontitis on PD is lacking. Here, we demonstrated that ligature-induced periodontitis with application of subgingival plaque (LIP-SP) exacerbated motor dysfunction, microglial activation, and dopaminergic neuron loss in 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD mice. RESULTS The 16S rRNA gene sequencing revealed that LIP-SP induced oral and gut dysbiosis. Particularly, Veillonella parvula (V. parvula) and Streptococcus mutans (S. mutans) from oral ligatures were increased in the fecal samples of MPTP + LIP-SP treated mice. We further demonstrated that V. parvula and S. mutans played crucial roles in LIP-SP mediated exacerbation of motor dysfunction and neurodegeneration in PD mice. V. parvula and S. mutans caused microglial activation in the brain, as well as T helper 1 (Th1) cells infiltration in the brain, cervical lymph nodes, ileum and colon in PD mice. Moreover, we observed a protective effect of IFNγ neutralization on dopaminergic neurons in V. parvula- and S. mutans-treated PD mice. CONCLUSIONS Our study demonstrates that oral pathogens V. parvula and S. mutans necessitate the existence of periodontitis to exacerbate motor dysfunction and neurodegeneration in MPTP-induced PD mice. The underlying mechanisms include alterations of oral and gut microbiota, along with immune activation in both brain and peripheral regions. Video Abstract.
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Affiliation(s)
- Xue-Bing Bai
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Shuo Xu
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Lu-Jun Zhou
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xiao-Qian Meng
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yu-Lin Li
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yan-Lin Chen
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yi-Han Jiang
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Wen-Zhen Lin
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Bo-Yan Chen
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Lin-Juan Du
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Guo-Cai Tian
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yan Liu
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Sheng-Zhong Duan
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China.
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China.
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Ya-Qin Zhu
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
- College of Stomatology, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai, 200011, China.
- National Center for Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
- National Clinical Research Center for Oral Diseases, 639 Zhizaoju Road, Shanghai, 200011, China.
- Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
- Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China.
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28
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Bello-Corral L, Alves-Gomes L, Fernández-Fernández JA, Fernández-García D, Casado-Verdejo I, Sánchez-Valdeón L. Implications of gut and oral microbiota in neuroinflammatory responses in Alzheimer's disease. Life Sci 2023; 333:122132. [PMID: 37793482 DOI: 10.1016/j.lfs.2023.122132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
A diverse and stable microbiota promotes a healthy state, nevertheless, an imbalance in gut or oral bacterial composition, called dysbiosis, can cause gastrointestinal disorders, systemic inflammatory states and oxidative stress, among others. Recently, gut and oral dysbiosis has been linked to Alzheimer's disease (AD), which is considered the most common form of dementia and a public health priority due to its high prevalence and incidence. The aim of this review is to highlight the implications of gut and oral microbiota in the neuroinflammation characteristic of AD pathology and the subsequent cognitive impairment. It is a systematic review of the current literature obtained by searching the PubMed, Web of Science and Scopus databases. The characteristic intestinal dysbiosis in AD patients leads to increased permeability of the intestinal barrier and activates immune cells in the central nervous system due to translocation of microbiota-derived metabolites and/or bacteria into the circulation leading to increased neuroinflammation and neuronal loss, thus generating the cognitive impairment characteristic of AD. The presence in the central nervous system of Porphyromonas gingivalis can cause an increased neuroinflammation and beta-amyloid peptide accumulation.
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Affiliation(s)
- Laura Bello-Corral
- Health Research Nursing Group (GREIS), University of Leon, 24071, Leon, Spain; Department of Nursing and Physiotherapy, University of Leon, 24071, Leon, Spain
| | | | - Jesús Antonio Fernández-Fernández
- Health Research Nursing Group (GREIS), University of Leon, 24071, Leon, Spain; Department of Nursing and Physiotherapy, University of Leon, 24071, Leon, Spain
| | - Daniel Fernández-García
- Health Research Nursing Group (GREIS), University of Leon, 24071, Leon, Spain; Department of Nursing and Physiotherapy, University of Leon, 24071, Leon, Spain
| | - Inés Casado-Verdejo
- Health Research Nursing Group (GREIS), University of Leon, 24071, Leon, Spain; Department of Nursing and Physiotherapy, University of Leon, 24401, Ponferrada, Spain
| | - Leticia Sánchez-Valdeón
- Health Research Nursing Group (GREIS), University of Leon, 24071, Leon, Spain; Department of Nursing and Physiotherapy, University of Leon, 24071, Leon, Spain.
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Tang D, Sun C, Yang J, Fan L, Wang Y. Advances in the Study of the Pathology and Treatment of Alzheimer's Disease and Its Association with Periodontitis. Life (Basel) 2023; 13:2203. [PMID: 38004343 PMCID: PMC10672606 DOI: 10.3390/life13112203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Alzheimer's disease (AD) has become one of the leading causes of health problems in the elderly, and studying its causes and treatments remains a serious challenge for researchers worldwide. The two main pathological features of Alzheimer's disease are the extracellular deposition of β-amyloid (Aβ) to form senile plaques and the intracellular aggregation of hyperphosphorylated Tau protein to form neurofibrillary tangles (NFTs). Researchers have proposed several hypotheses to elucidate the pathogenesis of AD, but due to the complexity of the pathophysiologic factors involved in the development of AD, no effective drugs have been found to stop the progression of the disease. Currently, the mainstay drugs used to treat AD can only alleviate the patient's symptoms and do not have a therapeutic effect. As researchers explore interactions among diseases, much evidence suggests that there is a close link between periodontitis and AD, and that periodontal pathogenic bacteria can exacerbate Aβ deposition and Tau protein hyperphosphorylation through neuroinflammatory mechanisms, thereby advancing the pathogenesis of AD. This article reviews recent advances in the pathogenesis of AD, available therapeutic agents, the relevance of periodontitis to AD, and mechanisms of action.
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Affiliation(s)
- Dan Tang
- School of Life Science and Engineering, Lanzhou University of Technology, Lanzhou 730050, China; (C.S.); (L.F.)
| | - Chang Sun
- School of Life Science and Engineering, Lanzhou University of Technology, Lanzhou 730050, China; (C.S.); (L.F.)
| | - Jumei Yang
- Lanzhou University Second Hospital, Lanzhou 730000, China;
| | - Lili Fan
- School of Life Science and Engineering, Lanzhou University of Technology, Lanzhou 730050, China; (C.S.); (L.F.)
| | - Yonggang Wang
- School of Life Science and Engineering, Lanzhou University of Technology, Lanzhou 730050, China; (C.S.); (L.F.)
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30
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Weintraub J, Kaeberlein M, Perissinotto C, Atchison K, Chen X, D’Souza R, Feine J, Ghezzi E, Kirkwood K, Ryder M, Slashcheva L, Touger-Decker R, Wu B, Kapila Y. Geroscience: Aging and Oral Health Research. Adv Dent Res 2023; 31:2-15. [PMID: 37933846 PMCID: PMC10767691 DOI: 10.1177/08959374231200840] [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] [Indexed: 11/08/2023]
Abstract
Research in aging has significantly advanced; scientists are now able to identify interventions that slow the biologic aging processes (i.e., the "hallmarks of aging"), thus delaying the onset and progression of multiple diseases, including oral conditions. Presentations given during the 3-part session "Geroscience: Aging and Oral Health Research," held during the 2023 American Association for Dental, Oral, and Craniofacial Research meeting, are summarized in this publication. Speakers' topics spanned the translational research spectrum. Session 1 provided an overview of the geroscience and health span (disease-free and functional health throughout life) concepts. The common molecular mechanisms between oral cancer and aging were discussed, and research was presented that showed periodontal microflora as a potential factor in Alzheimer's disease progression. Session 2 focused on behavioral and social science aspects of aging and their oral health significance. The keynote provided evidence that loneliness and isolation can have major health effects. These social conditions, along with poor oral health, tooth loss, and cognitive decline, could potentially affect healthy eating ability and systemic health in older adults. Research could help elucidate the directions and pathways connecting these seemingly disparate conditions. Session 3 focused on the delivery of oral care in different settings and the many barriers to access care faced by older adults. Research is needed to identify and implement effective technology and strategies to improve access to dental care, including new delivery and financing mechanisms, workforce models, interprofessional provider education and practice, and use of big data from medical-dental integration of electronic health records. Research to improve the "oral health span," reduce oral health disparities, and increase health equity must be tackled at all levels from biologic pathways to social determinants of health and health policies.
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Affiliation(s)
- J.A. Weintraub
- Department of Pediatric and Public Health, Adams School of Dentistry University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M. Kaeberlein
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - C. Perissinotto
- Division of Geriatrics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - K.A. Atchison
- Section of Public and Population Health, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
| | - X. Chen
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University College of Dentistry, Columbus, OH, USA
| | | | - J.S. Feine
- Population Health, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Quebec, Canada
| | - E.M. Ghezzi
- Department of Cariology, Restorative Sciences & Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - K.L. Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
- Department of Head & Neck/Plastic & Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - M. Ryder
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - L.D. Slashcheva
- Apple Tree Dental, Research Director, Innovations Team, Corporate Office, Fergus Falls, MN, USA
| | - R. Touger-Decker
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, School of Health Professions, Rutgers State University of New Jersey, Newark, NJ, USA
| | - B. Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Y. Kapila
- Biosystems and Function and Periodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
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Carballo Á, López-Dequidt I, Custodia A, Botelho J, Aramburu-Núñez M, Machado V, Pías-Peleteiro JM, Ouro A, Romaus-Sanjurjo D, Vázquez-Vázquez L, Jiménez-Martín I, Aguiar P, Rodríguez-Yáñez M, Aldrey JM, Blanco J, Castillo J, Sobrino T, Leira Y. Association of periodontitis with cognitive decline and its progression: Contribution of blood-based biomarkers of Alzheimer's disease to this relationship. J Clin Periodontol 2023; 50:1444-1454. [PMID: 37584311 DOI: 10.1111/jcpe.13861] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 08/17/2023]
Abstract
AIM To assess whether periodontitis is associated with cognitive decline and its progression as well as with certain blood-based markers of Alzheimer's disease. MATERIALS AND METHODS Data from a 2-year follow-up prospective cohort study (n = 101) was analysed. Participants with a previous history of hypertension and aged ≥60 years were included in the analysis. All of them received a full-mouth periodontal examination and cognitive function assessments (Addenbrooke's Cognitive Examination (ACE) and Mini-Mental State Examination [MMSE]). Plasma levels of amyloid beta (Aβ)1-40 , Aβ1-42 , phosphorylated and total Tau (p-Tau and t-Tau) were determined at baseline, 12 and 24 months. RESULTS Periodontitis was associated with poor cognitive performance (MMSE: β = -1.5 [0.6]) and progression of cognitive impairment (hazard ratio [HR] = 1.8; 95% confidence interval: 1.0-3.1). Subjects with periodontitis showed greater baseline levels of p-Tau (1.6 [0.7] vs. 1.2 [0.2] pg/mL, p < .001) and Aβ1-40 (242.1 [77.3] vs. 208.2 [73.8] pg/mL, p = .036) compared with those without periodontitis. Concentrations of the latter protein also increased over time only in the periodontitis group (p = .005). CONCLUSIONS Periodontitis is associated with cognitive decline and its progression in elderly patients with a previous history of hypertension. Overexpression of p-Tau and Aβ1-40 may play a role in this association.
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Affiliation(s)
- Álvaro Carballo
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Iria López-Dequidt
- Stroke Unit, Neurology Department, University Clinical Hospital, Santiago de Compostela, Spain
| | - Antía Custodia
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - João Botelho
- Periodontology Department and Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - Marta Aramburu-Núñez
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - Vanessa Machado
- Periodontology Department and Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - Juan Manuel Pías-Peleteiro
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
- Dementia Unit, Neurology Department, University Clinical Hospital, Santiago de Compostela, Spain
| | - Alberto Ouro
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - Daniel Romaus-Sanjurjo
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - Laura Vázquez-Vázquez
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - Isabel Jiménez-Martín
- Dementia Unit, Neurology Department, University Clinical Hospital, Santiago de Compostela, Spain
| | - Pablo Aguiar
- Molecular Imaging Group, Department of Radiology, Faculty of Medicine and Center for Research In Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital, Santiago de Compostela, Spain
| | - Manuel Rodríguez-Yáñez
- Stroke Unit, Neurology Department, University Clinical Hospital, Santiago de Compostela, Spain
| | - José Manuel Aldrey
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
- Dementia Unit, Neurology Department, University Clinical Hospital, Santiago de Compostela, Spain
| | - Juan Blanco
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Castillo
- Neuroimaging and Biotechnology Laboratory (NOBEL) Group, Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Tomás Sobrino
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - Yago Leira
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratories (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, Madrid, Spain
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Zhao C, Kuraji R, Ye C, Gao L, Radaic A, Kamarajan P, Taketani Y, Kapila YL. Nisin a probiotic bacteriocin mitigates brain microbiome dysbiosis and Alzheimer's disease-like neuroinflammation triggered by periodontal disease. J Neuroinflammation 2023; 20:228. [PMID: 37803465 PMCID: PMC10557354 DOI: 10.1186/s12974-023-02915-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023] Open
Abstract
INTRODUCTION Periodontitis-related oral microbial dysbiosis is thought to contribute to Alzheimer's disease (AD) neuroinflammation and brain amyloid production. Since probiotics can modulate periodontitis/oral dysbiosis, this study examined the effects of a probiotic/lantibiotic, nisin, in modulating brain pathology triggered by periodontitis. METHODS A polymicrobial mouse model of periodontal disease was used to evaluate the effects of this disease on brain microbiome dysbiosis, neuroinflammation, Alzheimer's-related changes, and nisin's therapeutic potential in this context. RESULTS 16S sequencing and real-time PCR data revealed that Nisin treatment mitigated the changes in the brain microbiome composition, diversity, and community structure, and reduced the levels of periodontal pathogen DNA in the brain induced by periodontal disease. Nisin treatment significantly decreased the mRNA expression of pro-inflammatory cytokines (Interleukin-1β/IL-1 β, Interleukin 6/IL-6, and Tumor Necrosis Factor α/TNF-α) in the brain that were elevated by periodontal infection. In addition, the concentrations of amyloid-β 42 (Aβ42), total Tau, and Tau (pS199) (445.69 ± 120.03, 1420.85 ± 331.40, 137.20 ± 36.01) were significantly higher in the infection group compared to the control group (193.01 ± 31.82, 384.27 ± 363.93, 6.09 ± 10.85), respectively. Nisin treatment markedly reduced the Aβ42 (261.80 ± 52.50), total Tau (865.37 ± 304.93), and phosphorylated Tau (82.53 ± 15.77) deposition in the brain of the infection group. DISCUSSION Nisin abrogation of brain microbiome dysbiosis induces beneficial effects on AD-like pathogenic changes and neuroinflammation, and thereby may serve as a potential therapeutic for periodontal-dysbiosis-related AD.
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Affiliation(s)
- Chuanjiang Zhao
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, 94143, USA
- Department of Periodontology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510050, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510050, China
| | - Ryutaro Kuraji
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, 94143, USA
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, 102-8159, Japan
| | - Changchang Ye
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, 94143, USA
- Department of Periodontology, West China School of Stomatology, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610093, China
| | - Li Gao
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, 94143, USA
- Department of Periodontology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510050, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510050, China
| | - Allan Radaic
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, 94143, USA
- Department of Biosystems and Function and Periodontics, School of Dentistry, University of California Los Angeles, Los Angeles, CA, 90024, USA
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, 94143, USA
- Department of Biosystems and Function and Periodontics, School of Dentistry, University of California Los Angeles, Los Angeles, CA, 90024, USA
| | - Yoshimasa Taketani
- Department of Biosystems and Function and Periodontics, School of Dentistry, University of California Los Angeles, Los Angeles, CA, 90024, USA
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, Sakado, 350-0283, Japan
| | - Yvonne L Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, 94143, USA.
- Department of Biosystems and Function and Periodontics, School of Dentistry, University of California Los Angeles, Los Angeles, CA, 90024, USA.
- Section of Biosystems and Function, Section of Periodontology, UCLA School of Dentistry, 10833 Le Conte Ave, Box 951668, Los Angeles, CA, 90095-1668, USA.
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Eslami S, Hosseinzadeh Shakib N, Fooladfar Z, Nasrollahian S, Baghaei S, Mosaddad SA, Motamedifar M. The role of periodontitis-associated bacteria in Alzheimer's disease: A narrative review. J Basic Microbiol 2023; 63:1059-1072. [PMID: 37311215 DOI: 10.1002/jobm.202300250] [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: 05/02/2023] [Revised: 06/01/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023]
Abstract
Alzheimer's disease causes memory loss and dementia in older adults through a neurodegenerative mechanism. Despite the pathophysiological clarification of this cognitive disorder, novel molecular and cellular pathways should be identified to determine its exact mechanism. Alzheimer's disease (AD) is pathologically characterized by senile plaques comprising beta-amyloid and neurofibrillary tangles (NFTs) formed by hyperphosphorylated tau as a microtubule-associated protein with a key role in the pathogenesis of AD. Periodontitis through inflammatory pathways is a risk factor for deteriorating cognitive impairment in AD patients. Poor oral hygiene coupled with immunocompromised status in older adults causes periodontal diseases and chronic inflammations through an oral bacterial imbalance. Toxic bacterial products, including bacteria themselves, can reach the central nervous system through the bloodstream and evoke inflammatory responses. The present review was conducted to investigate relationships between AD and periodontitis-involved bacteria as a risk factor.
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Affiliation(s)
- Saba Eslami
- Research Central Laboratory, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zahra Fooladfar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Nasrollahian
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saman Baghaei
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Motamedifar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Yamaguchi S, Murakami T, Satoh M, Komiyama T, Ohi T, Miyoshi Y, Endo K, Hiratsuka T, Hara A, Tatsumi Y, Totsune T, Asayama K, Kikuya M, Nomura K, Hozawa A, Metoki H, Imai Y, Watanabe M, Ohkubo T, Hattori Y. Associations of Dental Health With the Progression of Hippocampal Atrophy in Community-Dwelling Individuals: The Ohasama Study. Neurology 2023; 101:e1056-e1068. [PMID: 37407259 PMCID: PMC10491442 DOI: 10.1212/wnl.0000000000207579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/10/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although tooth loss and periodontitis have been considered risk factors of Alzheimer disease, recent longitudinal researches have not found a significant association with hippocampal atrophy. Therefore, this study aimed to clarify a longitudinal association between the number of teeth present (NTP) and hippocampal atrophy dependent on the severity of periodontitis in a late middle-aged and older adult population. METHODS This study included community-dwelling individuals aged 55 years or older who had no cognitive decline and had undergone brain MRI and oral and systemic data collection twice at 4-year intervals. Hippocampal volumes were obtained from MRIs by automated region-of-interest analysis. The mean periodontal probing depth (PD) was used as a measure of periodontitis. Multiple regression analysis was performed with the annual symmetric percentage change (SPC) of the hippocampal volume as the dependent variable and including an interaction term between NTP and mean PD as the independent variable. The interaction details were examined using the Johnson-Neyman technique and simple slope analysis. The 3-way interaction of NTP, mean PD, and time on hippocampal volume was analyzed using a linear mixed-effects model, and the interaction of NTP and time was examined in subgroups divided by the median mean PD. In all models, dropout bias was adjusted by inverse probability weighting. RESULTS Data of 172 participants were analyzed. The qualitative interaction between NTP and the mean PD was significant for the annual SPC in the left hippocampus. The regression coefficient of the NTP on the annual SPC in the left hippocampus was positive (B = 0.038, p = 0.026) at the low-level mean PD (mean -1 SD) and negative (B = -0.054, p = 0.001) at the high-level mean PD (mean +1 SD). Similar results were obtained in the linear mixed-effects model; the interaction of NTP and time was significant in the higher mean PD group. DISCUSSION In a late middle-aged and older cohort, fewer teeth were associated with a faster rate of left hippocampal atrophy in patients with mild periodontitis, whereas having more teeth was associated with a faster rate of atrophy in those with severe periodontitis. The importance of keeping teeth healthy is suggested.
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Affiliation(s)
- Satoshi Yamaguchi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan.
| | - Takahisa Murakami
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Michihiro Satoh
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takamasa Komiyama
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takashi Ohi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yoshitada Miyoshi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Kosei Endo
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takako Hiratsuka
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Azusa Hara
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yukako Tatsumi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Tomoko Totsune
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Kei Asayama
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Masahiro Kikuya
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Kyoko Nomura
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Atsushi Hozawa
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Hirohito Metoki
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yutaka Imai
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Makoto Watanabe
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takayoshi Ohkubo
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yoshinori Hattori
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
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Skallevold HE, Rokaya N, Wongsirichat N, Rokaya D. Importance of oral health in mental health disorders: An updated review. J Oral Biol Craniofac Res 2023; 13:544-552. [PMID: 37396968 PMCID: PMC10314291 DOI: 10.1016/j.jobcr.2023.06.003] [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] [Received: 12/30/2022] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
Background Mental disorders are indeed an expanding threat, which requires raised awareness, education, prevention, and treatment initiatives nationally and globally. This review presents an updated review on the relationships between oral health and mental health disorders and the importance of oral health in mental health disorders. Method A literature search was done regarding mental disorders and oral health approaches in Google Scholar and PubMed from the year 1995 until 2023. All the English-language papers were evaluated based on the inclusion criteria. Publications included original research papers, review articles and book chapters. Results Common mental disorders include depression, anxiety, bipolar disorder, Schizophrenia, dementia, and alcohol and drug use disorders. The interplay of oral health and mental disorders involves dysregulated microbiome, translocated bacteria, and systemic inflammation, among others. Conclusion There is a complex relationship between mental disorders and oral diseases. Various oral health problems are associated with mental health problems. The interplay of oral health and mental disorders involves dysregulated microbiome, translocated bacteria, and systemic inflammation, among others. Mental health nurses including physicians and dental professionals should be involved in the oral health care of mental health disorder patients. Therefore, multidisciplinary should be involved in the care of mental health disorders, and they should consider oral health care as an essential part of their care for patients with mental health disorders. Future investigations should strive to elucidate the exact biological relationships, to develop new directions for treatment.
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Affiliation(s)
- Hans Erling Skallevold
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Natthamet Wongsirichat
- Faculty of Dentistry, Bangkok Thonburi University, 16/10 Taweewatana, Bangkok, 10170, Thailand
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Bangkok, 10400, Thailand
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Ishida E, Furusho H, Renn TY, Shiba F, Chang HM, Oue H, Terayama R, Ago Y, Tsuga K, Miyauchi M. Mouse maternal odontogenic infection with Porphyromonas gingivalis induces cognitive decline in offspring. Front Pediatr 2023; 11:1203894. [PMID: 37635786 PMCID: PMC10450928 DOI: 10.3389/fped.2023.1203894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Porphyromonas gingivalis (P. gingivalis), a major periodontal pathogen, causes intrauterine infection/inflammation. Offspring exposed to intrauterine infection/inflammation have an increased risk of neurological disorders, regardless of gestational age. However, the relationship between maternal periodontitis and offspring functional/histological changes in the brain has not yet been elucidated. Methods In this study, we used a gestational mouse model to investigate the effects of maternal odontogenic infection of P. gingivalis on offspring behavior and brain tissue. Results The step-through passive avoidance test showed that the latency of the acquisition trial was significantly shorter in the P. gingivalis group (p < 0.05), but no difference in spontaneous motor/exploratory parameters by open-field test. P. gingivalis was diffusely distributed throughout the brain, especially in the hippocampus. In the hippocampus and amygdala, the numbers of neuron cells and cyclic adenosine monophosphate response element binding protein-positive cells were significantly reduced (p < 0.05), whereas the number of ionized calcium binding adapter protein 1-positive microglia was significantly increased (p < 0.05). In the hippocampus, the number of glial fibrillary acidic protein-positive astrocytes was also significantly increased (p < 0.05). Discussion The offspring of P. gingivalis-infected mothers have reduced cognitive function. Neurodegeneration/neuroinflammation in the hippocampus and amygdala may be caused by P. gingivalis infection, which is maternally transmitted. The importance of eliminating maternal P. gingivalis-odontogenic infection before or during gestation in maintenance healthy brain function in offspring should be addressed in near future.
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Affiliation(s)
- Eri Ishida
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hisako Furusho
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ting-Yi Renn
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fumie Shiba
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hung-Ming Chang
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hiroshi Oue
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryuji Terayama
- Department of Maxillofacial Anatomy and Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Ago
- Department of Cellular and Molecular Pharmacology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mutsumi Miyauchi
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Catumbela CSG, Giridharan VV, Barichello T, Morales R. Clinical evidence of human pathogens implicated in Alzheimer's disease pathology and the therapeutic efficacy of antimicrobials: an overview. Transl Neurodegener 2023; 12:37. [PMID: 37496074 PMCID: PMC10369764 DOI: 10.1186/s40035-023-00369-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/05/2023] [Indexed: 07/28/2023] Open
Abstract
A wealth of pre-clinical reports and data derived from human subjects and brain autopsies suggest that microbial infections are relevant to Alzheimer's disease (AD). This has inspired the hypothesis that microbial infections increase the risk or even trigger the onset of AD. Multiple models have been developed to explain the increase in pathogenic microbes in AD patients. Although this hypothesis is well accepted in the field, it is not yet clear whether microbial neuroinvasion is a cause of AD or a consequence of the pathological changes experienced by the demented brain. Along the same line, the gut microbiome has also been proposed as a modulator of AD. In this review, we focus on human-based evidence demonstrating the elevated abundance of microbes and microbe-derived molecules in AD hosts as well as their interactions with AD hallmarks. Further, the direct-purpose and potential off-target effects underpinning the efficacy of anti-microbial treatments in AD are also addressed.
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Affiliation(s)
- Celso S G Catumbela
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Vijayasree V Giridharan
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77054, USA
| | - Tatiana Barichello
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77054, USA
- Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Rodrigo Morales
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA.
- Centro Integrativo de Biologia y Quimica Aplicada (CIBQA), Universidad Bernardo O'Higgins, 8370993, Santiago, Chile.
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Visentin D, Gobin I, Maglica Ž. Periodontal Pathogens and Their Links to Neuroinflammation and Neurodegeneration. Microorganisms 2023; 11:1832. [PMID: 37513004 PMCID: PMC10385044 DOI: 10.3390/microorganisms11071832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/05/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Pathogens that play a role in the development and progression of periodontitis have gained significant attention due to their implications in the onset of various systemic diseases. Periodontitis is characterized as an inflammatory disease of the gingival tissue that is mainly caused by bacterial pathogens. Among them, Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia are regarded as the main periodontal pathogens. These pathogens elicit the release of cytokines, which in combination with their virulence factors induce chronic systemic inflammation and subsequently impact neural function while also altering the permeability of the blood-brain barrier. The primary objective of this review is to summarize the existing information regarding periodontal pathogens, their virulence factors, and their potential association with neuroinflammation and neurodegenerative diseases. We systematically reviewed longitudinal studies that investigated the association between periodontal disease and the onset of neurodegenerative disorders. Out of the 24 studies examined, 20 showed some degree of positive correlation between periodontal disease and neurodegenerative disorders, with studies focusing on cognitive function demonstrating the most robust effects. Therefore, periodontal pathogens might represent an exciting new approach to develop novel preventive treatments for neurodegenerative diseases.
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Affiliation(s)
- David Visentin
- Department of Biotechnology, University of Rijeka, 51000 Rijeka, Croatia
| | - Ivana Gobin
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Željka Maglica
- Department of Biotechnology, University of Rijeka, 51000 Rijeka, Croatia
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Wereszczyński M, Śmigiel A, Tomaszewska I, Niedźwieńska A. Investigating the relationship between periodontitis and specific memory processes in the search for cognitive markers of Alzheimer's disease risk. Sci Rep 2023; 13:11555. [PMID: 37464028 DOI: 10.1038/s41598-023-38674-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/12/2023] [Indexed: 07/20/2023] Open
Abstract
The spontaneous retrieval deficit (SRD) hypothesis argues that individuals in the preclinical stages of Alzheimer's disease (AD) are particularly impaired in spontaneous retrieval, which manifests in reduced mind-wandering. Our main purpose was to provide novel evidence to support the SRD hypothesis by investigating, for the first time, the relationship between mind-wandering and periodontitis, the latter being the risk factor for AD. The second objective was to address the lack of deeper understanding of the relationship between oral health and specific cognitive abilities by investigating whether periodontitis would be primarily associated with memory. Sixty community-dwelling dementia-free older adults completed neuropsychological tests that focused on various cognitive abilities and a computerised task, during which mind-wandering was evaluated. Periodontal health was assessed subjectively, and through an oral examination by a qualified dentist that focused on visible periodontitis-related changes in gingival tissues and the number of periodontitis bacteria. In line with our predictions, objective and subjective symptoms of poorer periodontal health were associated with less mind-wandering, providing further support for the SRD hypothesis. Again in line with predictions, poorer periodontal health was associated with worse episodic memory, with no relationship between periodontitis and the measure targeting various cognitive abilities, from which memory was excluded.
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Affiliation(s)
- Michał Wereszczyński
- Department of Psychology, Jagiellonian University, Kraków, Poland.
- Doctoral School in the Social Sciences - Jagiellonian University, Kraków, Poland.
| | | | - Iwona Tomaszewska
- Centre of Innovative Medical Education, Collegium Medicum, Jagiellonian University, Kraków, Poland
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Jia S, Li X, Du Q. Host insulin resistance caused by Porphyromonas gingivalis-review of recent progresses. Front Cell Infect Microbiol 2023; 13:1209381. [PMID: 37520442 PMCID: PMC10373507 DOI: 10.3389/fcimb.2023.1209381] [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] [Received: 04/20/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Porphyromonas gingivalis (P. gingivalis) is a Gram-negative oral anaerobic bacterium that plays a key role in the pathogenesis of periodontitis. P. gingivalis expresses a variety of virulence factors that disrupt innate and adaptive immunity, allowing P. gingivalis to survive and multiply in the host and destroy periodontal tissue. In addition to periodontal disease, P.gingivalis is also associated with systemic diseases, of which insulin resistance is an important pathological basis. P. gingivalis causes a systemic inflammatory response, disrupts insulin signaling pathways, induces pancreatic β-cell hypofunction and reduced numbers, and causes decreased insulin sensitivity leading to insulin resistance (IR). In this paper, we systematically review the studies on the mechanism of insulin resistance induced by P. gingivalis, discuss the association between P. gingivalis and systemic diseases based on insulin resistance, and finally propose relevant therapeutic approaches. Overall, through a systematic review of the mechanisms related to systemic diseases caused by P. gingivalis through insulin resistance, we hope to provide new insights for future basic research and clinical interventions for related systemic diseases.
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Affiliation(s)
- Shuxian Jia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiaobing Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qin Du
- Department of Stomatology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Olivera E, Sáez A, Carniglia L, Caruso C, Lasaga M, Durand D. Alzheimer's disease risk after COVID-19: a view from the perspective of the infectious hypothesis of neurodegeneration. Neural Regen Res 2023; 18:1404-1410. [PMID: 36571334 PMCID: PMC10075115 DOI: 10.4103/1673-5374.360273] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In light of the rising evidence of the association between viral and bacterial infections and neurodegeneration, we aimed at revisiting the infectious hypothesis of Alzheimer's disease and analyzing the possible implications of COVID-19 neurological sequelae in long-term neurodegeneration. We wondered how SARS-CoV-2 could be related to the amyloid-β cascade and how it could lead to the pathological hallmarks of the disease. We also predict a paradigm change in clinical medicine, which now has a great opportunity to conduct prospective surveillance of cognitive sequelae and progression to dementia in people who suffered severe infections together with other risk factors for Alzheimer's disease.
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Affiliation(s)
- Eugenia Olivera
- Instituto de Investigaciones Biomédicas INBIOMED UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Albany Sáez
- Instituto de Investigaciones Biomédicas INBIOMED UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Lila Carniglia
- Instituto de Investigaciones Biomédicas INBIOMED UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Carla Caruso
- Instituto de Investigaciones Biomédicas INBIOMED UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Mercedes Lasaga
- Instituto de Investigaciones Biomédicas INBIOMED UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Daniela Durand
- Instituto de Investigaciones Biomédicas INBIOMED UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Argentina
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López-Villodres JA, Escamilla A, Mercado-Sáenz S, Alba-Tercedor C, Rodriguez-Perez LM, Arranz-Salas I, Sanchez-Varo R, Bermúdez D. Microbiome Alterations and Alzheimer's Disease: Modeling Strategies with Transgenic Mice. Biomedicines 2023; 11:1846. [PMID: 37509487 PMCID: PMC10377071 DOI: 10.3390/biomedicines11071846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
In the last decade, the role of the microbiota-gut-brain axis has been gaining momentum in the context of many neurodegenerative and metabolic disorders, including Alzheimer's disease (AD) and diabetes, respectively. Notably, a balanced gut microbiota contributes to the epithelial intestinal barrier maintenance, modulates the host immune system, and releases neurotransmitters and/or neuroprotective short-chain fatty acids. However, dysbiosis may provoke immune dysregulation, impacting neuroinflammation through peripheral-central immune communication. Moreover, lipopolysaccharide or detrimental microbial end-products can cross the blood-brain barrier and induce or at least potentiate the neuropathological progression of AD. Thus, after repeated failure to find a cure for this dementia, a necessary paradigmatic shift towards considering AD as a systemic disorder has occurred. Here, we present an overview of the use of germ-free and/or transgenic animal models as valid tools to unravel the connection between dysbiosis, metabolic diseases, and AD, and to investigate novel therapeutical targets. Given the high impact of dietary habits, not only on the microbiota but also on other well-established AD risk factors such as diabetes or obesity, consistent changes of lifestyle along with microbiome-based therapies should be considered as complementary approaches.
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Affiliation(s)
- Juan Antonio López-Villodres
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
| | - Alejandro Escamilla
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
- Instituto de Investigacion Biomedica de Malaga-IBIMA-Plataforma Bionand, 29071 Malaga, Spain
| | - Silvia Mercado-Sáenz
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
| | - Carmen Alba-Tercedor
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
| | - Luis Manuel Rodriguez-Perez
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
- Instituto de Investigacion Biomedica de Malaga-IBIMA-Plataforma Bionand, 29071 Malaga, Spain
| | - Isabel Arranz-Salas
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
- Instituto de Investigacion Biomedica de Malaga-IBIMA-Plataforma Bionand, 29071 Malaga, Spain
- Unidad de Anatomia Patologica, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Raquel Sanchez-Varo
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
- Instituto de Investigacion Biomedica de Malaga-IBIMA-Plataforma Bionand, 29071 Malaga, Spain
- Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain
| | - Diego Bermúdez
- Departamento Fisiologia Humana, Histologia Humana, Anatomia Patologica y Educacion Fisica y Deportiva, Facultad de Medicina, Universidad de Malaga, 29071 Malaga, Spain
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Almarhoumi R, Alvarez C, Harris T, Tognoni CM, Paster BJ, Carreras I, Dedeoglu A, Kantarci A. Microglial cell response to experimental periodontal disease. J Neuroinflammation 2023; 20:142. [PMID: 37316834 PMCID: PMC10265806 DOI: 10.1186/s12974-023-02821-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/29/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES Microglial activation is critical for modulating the neuroinflammatory process and the pathological progression of neurodegenerative diseases, such as Alzheimer's disease (AD). Microglia are involved in forming barriers around extracellular neuritic plaques and the phagocytosis of β-amyloid peptide (Aβ). In this study, we tested the hypothesis that periodontal disease (PD) as a source of infection alters inflammatory activation and Aβ phagocytosis by the microglial cells. METHODS Experimental PD was induced using ligatures in C57BL/6 mice for 1, 10, 20, and 30 days to assess the progression of PD. Animals without ligatures were used as controls. Maxillary bone loss and local periodontal tissue inflammation associated with the development of PD were confirmed by morphometric bone analysis and cytokine expression, respectively. The frequency and the total number of activated microglia (CD45+ CD11b+ MHCII+) in the brain were analyzed by flow cytometry. Mouse microglial cells (1 × 105) were incubated with heat-inactivated bacterial biofilm isolated from the ligatures retrieved from the teeth or with Klebsiella variicola, a relevant PD-associated bacteria in mice. Expression of pro-inflammatory cytokines, toll-like receptors (TLR), and receptors for phagocytosis was measured by quantitative PCR. The phagocytic capacity of microglia to uptake β-amyloid was analyzed by flow cytometry. RESULTS Ligature placement caused progressive periodontal disease and bone resorption that was already significant on day 1 post-ligation (p < 0.05) and continued to increase until day 30 (p < 0.0001). The severity of periodontal disease increased the frequency of activated microglia in the brains on day 30 by 36%. In parallel, heat-inactivated PD-associated total bacteria and Klebsiella variicola increased the expression of TNFα, IL-1β, IL-6, TLR2, and TLR9 in microglial cells (1.6-, 83-, 3.2-, 1.5-, 1.5-fold, respectively p < 0.01). Incubation of microglia with Klebsiella variicola increased the Aβ-phagocytosis by 394% and the expression of the phagocytic receptor MSR1 by 33-fold compared to the non-activated cells (p < 0.0001). CONCLUSIONS We showed that inducing PD in mice results in microglia activation in vivo and that PD-associated bacteria directly promote a pro-inflammatory and phagocytic phenotype in microglia. These results support a direct role of PD-associated pathogens in neuroinflammation.
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Affiliation(s)
- Rawan Almarhoumi
- Forsyth Institute, 245 First Street, Cambridge, MA 02142 USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115 USA
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Carla Alvarez
- Forsyth Institute, 245 First Street, Cambridge, MA 02142 USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115 USA
| | - Theodore Harris
- Forsyth Institute, 245 First Street, Cambridge, MA 02142 USA
| | - Christina M. Tognoni
- Department of Veterans Affairs, VA Boston Healthcare System, Research and Development Service, Building 1A-(151), 150 S. Huntington Avenue, Boston, MA 02130 USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118 USA
| | - Bruce J. Paster
- Forsyth Institute, 245 First Street, Cambridge, MA 02142 USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115 USA
| | - Isabel Carreras
- Department of Veterans Affairs, VA Boston Healthcare System, Research and Development Service, Building 1A-(151), 150 S. Huntington Avenue, Boston, MA 02130 USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118 USA
- Department of Biochemistry, Boston University School of Medicine, Boston, MA 02118 USA
| | - Alpaslan Dedeoglu
- Department of Veterans Affairs, VA Boston Healthcare System, Research and Development Service, Building 1A-(151), 150 S. Huntington Avenue, Boston, MA 02130 USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118 USA
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114 USA
| | - Alpdogan Kantarci
- Forsyth Institute, 245 First Street, Cambridge, MA 02142 USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115 USA
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Weber C, Dilthey A, Finzer P. The role of microbiome-host interactions in the development of Alzheimer´s disease. Front Cell Infect Microbiol 2023; 13:1151021. [PMID: 37333848 PMCID: PMC10272569 DOI: 10.3389/fcimb.2023.1151021] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Alzheimer`s disease (AD) is the most prevalent cause of dementia. It is often assumed that AD is caused by an aggregation of extracellular beta-amyloid and intracellular tau-protein, supported by a recent study showing reduced brain amyloid levels and reduced cognitive decline under treatment with a beta-amyloid-binding antibody. Confirmation of the importance of amyloid as a therapeutic target notwithstanding, the underlying causes of beta-amyloid aggregation in the human brain, however, remain to be elucidated. Multiple lines of evidence point towards an important role of infectious agents and/or inflammatory conditions in the etiology of AD. Various microorganisms have been detected in the cerebrospinal fluid and brains of AD-patients and have thus been hypothesized to be linked to the development of AD, including Porphyromonas gingivalis (PG) and Spirochaetes. Intriguingly, these microorganisms are also found in the oral cavity under normal physiological conditions, which is often affected by multiple pathologies like caries or tooth loss in AD patients. Oral cavity pathologies are mostly accompanied by a compositional shift in the community of oral microbiota, mainly affecting commensal microorganisms and referred to as 'dysbiosis'. Oral dysbiosis seems to be at least partly mediated by key pathogens such as PG, and it is associated with a pro-inflammatory state that promotes the destruction of connective tissue in the mouth, possibly enabling the translocation of pathogenic microbiota from the oral cavity to the nervous system. It has therefore been hypothesized that dysbiosis of the oral microbiome may contribute to the development of AD. In this review, we discuss the infectious hypothesis of AD in the light of the oral microbiome and microbiome-host interactions, which may contribute to or even cause the development of AD. We discuss technical challenges relating to the detection of microorganisms in relevant body fluids and approaches for avoiding false-positives, and introduce the antibacterial protein lactoferrin as a potential link between the dysbiotic microbiome and the host inflammatory reaction.
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Isola G, Santonocito S, Lupi SM, Polizzi A, Sclafani R, Patini R, Marchetti E. Periodontal Health and Disease in the Context of Systemic Diseases. Mediators Inflamm 2023; 2023:9720947. [PMID: 37214190 PMCID: PMC10199803 DOI: 10.1155/2023/9720947] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 09/04/2022] [Accepted: 04/07/2023] [Indexed: 05/24/2023] Open
Abstract
During recent years, considerable progress has been made in understanding the etiopathogenesis of periodontitis in its various forms and their interactions with the host. Furthermore, a number of reports have highlighted the importance of oral health and disease in systemic conditions, especially cardiovascular diseases and diabetes. In this regard, research has attempted to explain the role of periodontitis in promoting alteration in distant sites and organs. Recently, DNA sequencing studies have revealed how oral infections can occur in distant sites such as the colon, reproductive tissues, metabolic diseases, and atheromas. The objective of this review is to describe and update the emerging evidence and knowledge regarding the association between periodontitis and systemic disease and to analyse the evidence that has reported periodontitis as a risk factor for the development of various forms of systemic diseases in order to provide a better understanding of the possible shared etiopathogenetic pathways between periodontitis and the different forms of systemic diseases.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Saturnino Marco Lupi
- Department of Clinical Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Rossana Sclafani
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Romeo Patini
- Institute of Dentistry and Maxillofacial Surgery, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Enrico Marchetti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Cheataini F, Ballout N, Al Sagheer T. The effect of neuroinflammation on the cerebral metabolism at baseline and after neural stimulation in neurodegenerative diseases. J Neurosci Res 2023. [PMID: 37186320 DOI: 10.1002/jnr.25198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 05/17/2023]
Abstract
Neuroinflammation is a reaction of nervous tissue to an attack caused by an infection, a toxin, or a neurodegenerative disease. It involves brain metabolism adaptation in order to meet the increased energy needs of glial cell activation, but the nature of these adaptations is still unknown. Increasing interest concerning neuroinflammation leads to the identification of its role in neurodegenerative diseases. Few reports studied the effect of metabolic alteration on neuroinflammation. Metabolic damage initiates a pro-inflammatory response by microglial activation. Moreover, the exact neuroinflammation effect on cerebral cell metabolism remains unknown. In this study, we reviewed systematically the neuroinflammation effect in animal models' brains. All articles showing the relationship of neuroinflammation with brain metabolism, or with neuronal stimulation in neurodegenerative diseases were considered. Moreover, this review examines also the mitochondrial damage effect in neurodegeneration diseases. Then, different biosensors are classified regarding their importance in the determination of metabolite change. Finally, some therapeutic drugs inhibiting neuroinflammation are cited. Neuroinflammation increases lymphocyte infiltration and cytokines' overproduction, altering cellular energy homeostasis. This review demonstrates the importance of neuroinflammation as a mediator of disease progression. Further, the spread of depolarization effects pro-inflammatory genes expression and microglial activation, which contribute to the degeneration of neurons, paving the road to better management and treatment of neurodegenerative diseases.
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Affiliation(s)
- Fatima Cheataini
- Neuroscience Research Center (NRC), Faculty of Medical Science, Lebanese University, Hadath, Beirut, Lebanon
| | - Nissrine Ballout
- Neuroscience Research Center (NRC), Faculty of Medical Science, Lebanese University, Hadath, Beirut, Lebanon
| | - Tareq Al Sagheer
- Neuroscience Research Center (NRC), Faculty of Medical Science, Lebanese University, Hadath, Beirut, Lebanon
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Guo H, Li B, Yao H, Liu D, Chen R, Zhou S, Ji Y, Zeng L, Du M. Profiling the oral microbiomes in patients with Alzheimer's disease. Oral Dis 2023; 29:1341-1355. [PMID: 34931394 DOI: 10.1111/odi.14110] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To analyse the characteristics of the oral microbiomes and expected to find biomarkers about Alzheimer's disease (AD). SUBJECTS AND METHODS AD patients (n = 26) and cognitive intact people (n = 26) were examined for cognition, depression, oral health and collected saliva and gingival crevicular fluid (GCF) in the morning. Full-length 16S rRNA gene was amplified and sequencing was performed using the PacBio platform. RESULTS The predominant bacterium of salivary microbiome and periodontal microbiome from AD patients was Streptococcus oralis and Porphyromonas gingivalis, respectively. With respect to β diversity analysis, there was a significance difference in periodontal microbiome between AD patients and cognitively intact subjects. The relative abundance of Veillonella parvula significantly increased in oral microbiomes from AD patients. Interestingly, the dominant species were different between early-onset AD and late-onset AD patients. Moreover, the predominant species were changed as the clinical severity of AD. Furthermore, the correlation analysis revealed that V. parvula was associated with AD in both saliva and GCF and that P. gingivalis was associated with AD only in GCF. CONCLUSIONS In this study, the microbiome community of oral microbes was altered in AD patients and periodontal microbiome was sensitive to cognition changes. Moreover, V. parvula and P. gingivalis were associated with AD.
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Affiliation(s)
- Haiying Guo
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Biao Li
- Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Hantao Yao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Danfeng Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Rourong Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Shuhui Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Yaoting Ji
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Lin Zeng
- Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Minquan Du
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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Jin R, Ning X, Liu X, Zhao Y, Ye G. Porphyromonas gingivalis-induced periodontitis could contribute to cognitive impairment in Sprague–Dawley rats via the P38 MAPK signaling pathway. Front Cell Neurosci 2023; 17:1141339. [PMID: 37056710 PMCID: PMC10086325 DOI: 10.3389/fncel.2023.1141339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundPeriodontitis is one of the most common oral diseases and has been shown to be a risk factor for systemic diseases. Our aim was to investigate the relationship between periodontitis and cognitive impairment and to explore the role of the P38 MAPK signaling pathway in this process.MethodsWe established a periodontitis model by ligating the first molars of SD rats with silk thread and injecting Porphyromonas gingivalis (P. gingivalis) or P. gingivalis plus the P38 MAPK inhibitor SB203580 at the same time for ten weeks. We assessed alveolar bone resorption and spatial learning and memory using microcomputed tomography and the Morris water maze test, respectively. We used transcriptome sequencing to explore the genetic differences between the groups. The gingival tissue, peripheral blood and hippocampal tissue were assessed for the cytokines TNF-α, IL-1β, IL-6, IL-8 and C reactive protein (CRP) with enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT–PCR). We observed the presence of P. gingivalis in the hippocampus of rats by paraffin-fluorescence in situ hybridization (FISH). We determined the activation of microglia by immunofluorescence. Finally, Western blot analysis was employed to determine the expression of amyloid precursor protein (APP), β-site APP-cleaving enzyme 1 (BACE1) and P38MAPK pathway activation.ResultsWe demonstrated that silk ligature-induced periodontitis plus injection of P. gingivalis into subgingival tissue could lead to memory and cognitive impairment. Transcriptome sequencing results suggested that there were neurodegenerative diseases in the P. gingivalis group, and the MWM test showed that periodontitis reduced the spatial learning and memory ability of mild cognitive impairment (MCI) model rats. We found high levels of inflammatory factors (TNF-α, IL-1β, IL-6, and IL-8) and CRP in the gingiva, peripheral blood and hippocampus, and the expression of APP and BACE1 was upregulated, as was the P38 MAPK pathway activation. Activated microglia and the presence of P. gingivalis were also found in the hippocampus. P38 MAPK inhibitors mitigated all of these changes.ConclusionOur findings strongly suggest that topical application of P. gingivalis increases the inflammatory burden in the peripheral and central nervous systems (CNS) and that neuroinflammation induced by activation of P38 MAPK leads to impaired learning and memory in SD rats. It can also modulate APP processing. Therefore, P38 MAPK may serve as a linking pathway between periodontitis and cognitive impairment.
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Affiliation(s)
- Ru Jin
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences and Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital, Chongqing Medical University, Chongqing, China
| | - Xiaoqiao Ning
- The First People’s Hospital of Wanzhou, Chongqing, China
| | - Xiang Liu
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences and Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital, Chongqing Medical University, Chongqing, China
| | - Yueyang Zhao
- Department of Anatomy, Chongqing Medical University, Chongqing, China
| | - Guo Ye
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences and Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital, Chongqing Medical University, Chongqing, China
- *Correspondence: Guo Ye,
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Zmysłowska-Polakowska E, Płoszaj T, Skoczylas S, Mojsak P, Ciborowski M, Kretowski A, Lukomska-Szymanska M, Szadkowska A, Mlynarski W, Zmysłowska A. Evaluation of the Oral Bacterial Genome and Metabolites in Patients with Wolfram Syndrome. Int J Mol Sci 2023; 24:ijms24065596. [PMID: 36982670 PMCID: PMC10053501 DOI: 10.3390/ijms24065596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/11/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
In Wolfram syndrome (WFS), due to the loss of wolframin function, there is increased ER stress and, as a result, progressive neurodegenerative disorders, accompanied by insulin-dependent diabetes. The aim of the study was to evaluate the oral microbiome and metabolome in WFS patients compared with patients with type 1 diabetes mellitus (T1DM) and controls. The buccal and gingival samples were collected from 12 WFS patients, 29 HbA1c-matched T1DM patients (p = 0.23), and 17 healthy individuals matched by age (p = 0.09) and gender (p = 0.91). The abundance of oral microbiota components was obtained by Illumina sequencing the 16S rRNA gene, and metabolite levels were measured by gas chromatography–mass spectrometry. Streptococcus (22.2%), Veillonella (12.1%), and Haemophilus (10.8%) were the most common bacteria in the WFS patients, while comparisons between groups showed significantly higher abundance of Olsenella, Dialister, Staphylococcus, Campylobacter, and Actinomyces in the WFS group (p < 0.001). An ROC curve (AUC = 0.861) was constructed for the three metabolites that best discriminated WFS from T1DM and controls (acetic acid, benzoic acid, and lactic acid). Selected oral microorganisms and metabolites that distinguish WFS patients from T1DM patients and healthy individuals may suggest their possible role in modulating neurodegeneration and serve as potential biomarkers and indicators of future therapeutic strategies.
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Affiliation(s)
| | - T. Płoszaj
- Department of Clinical Genetics, Medical University of Lodz, 92-213 Lodz, Poland
| | - S. Skoczylas
- Department of Clinical Genetics, Medical University of Lodz, 92-213 Lodz, Poland
| | - P. Mojsak
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - M. Ciborowski
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - A. Kretowski
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
| | | | - A. Szadkowska
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, 92-213 Lodz, Poland
| | - W. Mlynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, 92-213 Lodz, Poland
| | - A. Zmysłowska
- Department of Clinical Genetics, Medical University of Lodz, 92-213 Lodz, Poland
- Correspondence: ; Tel./Fax: +48-42-272-57-67
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Prajjwal P, Asharaf S, Makhanasa D, Yamparala A, Tariq H, Aleti S, Gadam S, Vora N. Association of Alzheimer's dementia with oral bacteria, vitamin B12, folate, homocysteine levels, and insulin resistance along with its pathophysiology, genetics, imaging, and biomarkers. Dis Mon 2023; 69:101546. [PMID: 36931946 DOI: 10.1016/j.disamonth.2023.101546] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Alzheimer's disease is a prevalent form of dementia, particularly among the elderly population. It is characterized by progressive cognitive decline and neurodegeneration. Despite numerous studies, the exact cause of Alzheimer's disease remains uncertain, and various theories have been proposed, including Aβ amyloid deposition in the brain and tau protein hyper-phosphorylation. This review article explores the potential pathogenesis of Alzheimer's disease, focusing on the effects of derangements in the levels of vitamin B12, folate, and homocysteine, as well as the impact of oral bacteria causing periodontitis and insulin resistance, and their relationship to Alzheimer's. Studies have shown that high levels of homocysteine and low levels of vitamin B12 and folate, are associated with an increased risk of developing Alzheimer's disease. The article also explores the link between Alzheimer's disease and oral bacteria, specifically dental infections and periodontitis, which contribute to the inflammatory processes in the nervous system of Alzheimer's patients. There could be derangement in the insulin signaling further causing disruption in glucose metabolism within the brain, suggesting that Alzheimer's disease may represent a form of type 2 diabetes mellitus associated with the brain, commonly known as type 3 diabetes. Neuroimaging techniques, including MRI, PET, and tau PET, can identify the predictive characteristics of Alzheimer's disease, with amyloid PET being the most useful in ruling out the disease. The article concludes by stressing the importance of understanding genetic and neuroimaging factors in the diagnosing and treating Alzheimer's disease.
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Affiliation(s)
| | - Shahnaz Asharaf
- Internal Medicine, Travancore Medical College, Kollam, Kerala, India
| | | | | | - Halla Tariq
- Internal Medicine, Multan Medical and Dental College, Multan, Pakistan
| | - Soumya Aleti
- Internal Medicine, Berkshire Medical Center, Pittsfield, MA, USA
| | - Srikanth Gadam
- Internal Medicine, Postdoctoral Research Fellow, Mayo Clinic, USA
| | - Neel Vora
- Internal Medicine, B. J. Medical College, Ahmedabad, India
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