Publication: Alzheimer hastalığı ile periodontal hastalıklar arasında bir ilişki olabilir mi
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2020-10-01
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Abstract
Alzheimer hastalığı (AH), antimikrobiyal peptit olarak bilinen βamiloid birikimi ve anormal şekilde fosforile tau proteinlerinden
oluşan nörofibriler yumakların varlığı ile karakterize nöroinflamatuar
ve nörodejeneratif bir hastalık olarak tanımlanır. Periodontal
hastalığın patogenezinde rol oynayan Porphyromonas gingivalis (P.
gingivalis) AH ile ilişkili önemli bakteriyel patojenden biri olarak kabul
edilmiştir. Ağız boşluğunda bulunan bu bakteriye ait metabolik yan
ürünlerinin ağız boşluğunun ötesinde bağışıklık sistemini aktive
edebildiği böylece sistemik koşulların gelişimini teşvik edebildiği
gözlenmiştir. Artan sayıda yapılan çalışmalar P. gingivalis'in beyin
kolonizasyonunun inflamatuar ve dejeneratif durumu birbirine
bağlayabileceğini bildirmiştir. AH'li kişilerin beyinlerinden alınan
otopsi örneklerinde ve beyin omurilik sıvılarında P. gingivalis
infiltrasyonunun varlığı tespit edilmiştir. P. gingivalis tarafından
üretilen proteaz sınıfı olan gingipainlerin AH'li bireylerin
beyinlerinden alınan örneklerde nöronlar, tau yumakları ve β-amiloid
ile ilişkili olduğu bulunmuştur. Yerleşik beyin enfeksiyonları olan
farelere oral yoldan verilen gingipain inhibitörlerinin beyindeki P.
gingivalis DNA bolluğunu ve bakteri enfeksiyonunun nörotoksik
etkilerini azalttığı bildirilmiştir. Dolayısıyla gingipain inhibisyonu hem
periodontitis hem de AH'nın tedavisine potansiyel bir yaklaşım
sağlayabildiği düşünülmüştür. Bu derlemenin amacı, periodontal
hastalık ile Alzheimer hastalığı ve demans arasında nedensel bir ilişki
olasılığını değerlendirmek ve literatürlerdeki daha fazla araştırma
gerektiren temel boşlukları belirlemek olmuştur.
Alzheimer's disease (AD) is a progressive neuroinflammatory and neurodegenerative disease of the brain defined by the accumulation and deposition of amyloid-β, which has been identified as an antimicrobial peptide and the presence of neurofibrillary tangles composed of aggregates of aberrantly phosphorylated tau proteins. Porphyromonas gingivalis (P. gingivalis) is one of the several important bacterial pathogens associated with AD. The presence of periodontal pathogens and their metabolic by products in the mouth may in fact modulate the immune response beyond the oral cavity, therefore promoting the development of systemic conditions. Recent work suggests that brain colonization by the periodontal pathogen P. gingivalis may link these two inflammatory and degenerative conditions. Evidence of P. gingivalis infiltration has been detected in autopsy specimens from the brains of people with AD and in cerebrospinal fluid of individuals diagnosed with AD. Gingipains, a class of P. gingivalis proteases, are found in association with neurons, tau tangles, and amyloid-β in specimens from the brains of individuals with AD. Oral administration of gingipain inhibitors to mice with established brain infections decreases the abundance of P. gingivalis DNA in brain andmitigates the neurotoxic effects of P. gingivalis infection. Therefore, gingipain inhibition could provide a potential approach to the treatment of both periodontitis and AD. The aims of this review are to assess the literature to evaluate the possibility of a causal relationship between periodontal disease and Alzheimer's disease and dementia, and to identify
Alzheimer's disease (AD) is a progressive neuroinflammatory and neurodegenerative disease of the brain defined by the accumulation and deposition of amyloid-β, which has been identified as an antimicrobial peptide and the presence of neurofibrillary tangles composed of aggregates of aberrantly phosphorylated tau proteins. Porphyromonas gingivalis (P. gingivalis) is one of the several important bacterial pathogens associated with AD. The presence of periodontal pathogens and their metabolic by products in the mouth may in fact modulate the immune response beyond the oral cavity, therefore promoting the development of systemic conditions. Recent work suggests that brain colonization by the periodontal pathogen P. gingivalis may link these two inflammatory and degenerative conditions. Evidence of P. gingivalis infiltration has been detected in autopsy specimens from the brains of people with AD and in cerebrospinal fluid of individuals diagnosed with AD. Gingipains, a class of P. gingivalis proteases, are found in association with neurons, tau tangles, and amyloid-β in specimens from the brains of individuals with AD. Oral administration of gingipain inhibitors to mice with established brain infections decreases the abundance of P. gingivalis DNA in brain andmitigates the neurotoxic effects of P. gingivalis infection. Therefore, gingipain inhibition could provide a potential approach to the treatment of both periodontitis and AD. The aims of this review are to assess the literature to evaluate the possibility of a causal relationship between periodontal disease and Alzheimer's disease and dementia, and to identify
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Keywords
DİŞ HEKİMLİĞİ, ORAL CERRAHİ VE TIP, Klinik Tıp, Klinik Tıp (MED), DENTISTRY, ORAL SURGERY & MEDICINE, CLINICAL MEDICINE, Clinical Medicine (MED), Alzheimer disease, COR388, gingipain, neuroinflammation, periodontitis, Porphyromonas gingivalis, PERIODONTAL-DISEASE, TOOTH LOSS, VIRULENCE FACTORS, DEMENTIA, Alzheimer Hastalığı, Porphyromonas gingivalis, Periodontal Hastalıklar, Gingipain, Alzheimer's Disease, Porphyromonas gingivalis, Periodontal Diseases
Citation
OLUKPINAR GENÇ B., KADİR T., "Alzheimer Hastalığı ile Periodontal Hastalıklar Arasında Bir İlişki Olabilir mi?", Selcuk Dental Journal, cilt.91, sa.S1, 2020