背景:牙周炎对全身性疾病的负面影响,包括糖尿病,心血管疾病,和阿尔茨海默病(AD),已被广泛描述。
目的:本系统综述旨在收集目前对牙周炎与AD相关的病理生理机制的认识。
方法:对PubMed/MEDLINE进行电子系统搜索,Scopus,使用以下PECO问题进行Embase数据库:牙周炎或牙周细菌如何影响阿尔茨海默病的特征?”仅包括探索牙周炎与AD病理之间生物学联系的临床前研究。本研究已在国际前瞻性系统审查注册中心(PROSPERO)注册。使用Syrcle和Camarades方案评估偏倚风险.
结果:经过对标题和摘要的系统筛选(n=3,307),选择了36个标题进行摘要阅读,其中13个被排除在外(k=1),纳入了23条。口服或全身暴露于牙周病原体或其副产物是原位脑表现和全身效应的原因。在血清和大脑中均发现细胞因子和淀粉样肽(Aβ)及其衍生物的比率显着升高。此外,在受感染的动物中,tau蛋白的过度磷酸化,海马小胶质细胞增生,观察到神经元死亡。暴露于牙周感染会对认知行为产生负面影响,导致记忆力下降。
结论:由牙周病原体引起的全身炎症和脑转移感染有助于神经炎症,淀粉样变性,和tau磷酸化,导致脑损伤和随后的认知障碍。
The negative effects of periodontitis on systemic diseases, including diabetes, cardiovascular diseases, and Alzheimer\'s disease (AD), have been widely described.
This systematic review aimed to gather the current understanding of the pathophysiological mechanisms linking periodontitis to AD.
An electronic systematic search of the PubMed/MEDLINE, Scopus, and Embase databases was performed using the following PECO question: How can periodontitis or periodontal bacteria influence Alzheimer\'s disease features?\". Only preclinical studies exploring the biological links between periodontitis and AD pathology were included. This study was registered at the International Prospective Register of Systematic Reviews (PROSPERO), and the Syrcle and Camarades protocols were used to assess the risk of bias.
After a systematic screening of titles and abstracts (n = 3,307), thirty-six titles were selected for abstract reading, of which 13 were excluded (k = 1), resulting in the inclusion of 23 articles. Oral or systemic exposure to periodontopathogens or their byproducts is responsible for both in situ brain manifestations and systemic effects. Significant elevated rates of cytokines and amyloid peptides (Aβ) and derivate products were found in both serum and brain. Additionally, in infected animals, hyperphosphorylation of tau protein, hippocampal microgliosis, and neuronal death were observed. Exposure to periodontal infection negatively impairs cognitive behavior, leading to memory decline.
Systemic inflammation and brain metastatic infections induced by periodontal pathogens contribute to neuroinflammation, amyloidosis, and tau phosphorylation, leading to brain damage and subsequent cognitive impairment.