{"id":2376,"date":"2019-11-13T08:45:33","date_gmt":"2019-11-13T07:45:33","guid":{"rendered":"https:\/\/kompetenz-statt-demenz.dsgip.de\/?p=2376"},"modified":"2019-11-13T10:36:30","modified_gmt":"2019-11-13T09:36:30","slug":"gum-disease-and-alzheimers","status":"publish","type":"post","link":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/gum-disease-and-alzheimers\/","title":{"rendered":"Keep your mouth healthy: Gum disease and Alzheimer\u2019s disease"},"content":{"rendered":"

The association between cognitive function and oral health has been well documented <\/span>s<\/b>o far<\/span> by some<\/span> observational studies. On the one hand it has been reported that periodontal disease and tooth loss are associated with increased risk of dementia. On the other hand, improved memory after dental intervention has also\u00a0 been observed.\u00a0<\/span><\/p>\n

Those<\/span> findings started the discussion about what would come first: Does<\/span> initial cognitive decline lead to poor oral hygiene and dental loss, followed by poor nutrition, including decreased intake of vitamins, which would precipitate dementia? Or does<\/span> periodontal disease increase concentrations of circulating inflammatory markers that might be involved in the pathogenesis of dementia?<\/span><\/p>\n

Recently, this relationship has become clearer, with the characterization of Amyloid <\/span>\u03b2 <\/span>(<\/span>A\u03b2) <\/span>as an <\/span>antimicrobial peptide.<\/b> Chronic periodontitis and infection with <\/span>Porphyromonas gingivalis <\/span><\/i>\u2013 a keystone pathogen in the development of chronic periodontitis \u2013 are significant risk factors for developing A<\/span>\u03b2<\/span>-plaques, dementia and AD.\u00a0<\/span><\/p>\n

In a study published in <\/span>Science Advances<\/span><\/i> (1), a multinational team of investigators found that the presence of oral\u00a0<\/span>P gingivalis<\/span><\/i>\u00a0infection in mice resulted in brain infiltration by the bacteria, what was followed by increased production of A\u03b2, the component of amyloid plaques implicated in AD. They also found that AD brains showed a greater immunoreactivity to <\/span>gingipains <\/span><\/i>\u2013 a virulence factor produced by <\/span>P gingivalis\u00a0<\/span><\/i>\u2013 than brains of non-AD control <\/span>groups <\/span>. Moreover, DNA from\u00a0<\/span>P gingivalis\u00a0<\/span><\/i>was found in the cerebral spinal fluid (CSF) of living AD patients and in postmortem studies of AD patients.<\/span><\/p>\n

These findings offer evidence that brain infection with <\/span>P gingivalis<\/span><\/i>\u00a0is not a result of poor dental care following the onset of dementia or a consequence of late-stage disease, but an early event that can explain the pathology found in middle aged individuals before cognitive decline.\u00a0<\/span><\/p>\n

It supports the concept that A<\/b>\u03b2 is an antimicrobial peptide and reinforces the importance of maintaining a healthy microbiome to prevent AD.<\/b><\/p>\n

Once the oral cavity is infected, <\/span>P gingivalis <\/span><\/i>may access the brain via a number of pathways including: 1) infection of monocytes followed by brain recruitment, 2) direct infection and damage to endothelial cells protecting the blood-brain barrier, and\/or 3) infection and spreading through cranial nerves [e.g., olfactory or trigeminal] to the brain.\u00a0<\/span><\/p>\n

After entering the brain, it modulates inflammatory innate and adaptive immune responses and activ<\/span>ates the A<\/span>\u03b2 inflammatory cascade (see section <\/span>causes <\/span><\/i><\/a>for further information) with production of <\/span>A<\/span>\u03b2<\/span>-plaques<\/span>.\u00a0<\/span><\/p>\n

Treating chronic periodontitis and <\/span>P gingivalis<\/span><\/i>\u00a0infection with antibiotics or using a <\/span>gingipain <\/span><\/i>inhibitor could reduce the inflammatory response and brake A<\/span>\u03b2<\/span>-plaques formation. But the whole problem would reappear in case of a new episode of <\/span>P gingivalis<\/span><\/i>\u00a0infection.\u00a0<\/span><\/p>\n

Conclusion:<\/b><\/p>\n

The most important <\/b>factor<\/i><\/b> here is to keep a strong and healthy oral microbi<\/b>ome, which can prevent dysbiosis and assure the balance of oral cavity immune system. Who would have thought that a clean toothbrush and a proper oral hygiene (without too much fluoride) helps to stay mentally fit?<\/b><\/p>\n

References:<\/span><\/p>\n

Dominy SS, Lynch C, Ermini F, et al.\u00a0<\/span>Porphyromonas gingivalis<\/span><\/i>\u00a0in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors.\u00a0<\/span>Sci Adv<\/span><\/i>. 2019;5(1):eaau3333.<\/span> https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30746447<\/span><\/a><\/p>\n

Yamamoto T, Kondo K, Hirai H, et al. Association between self-reported dental health status and onset of dementia: a 4-year prospective cohort study of older Japanese adults from the Aichi Gerontological Evaluation Study (AGES) Project. <\/span>Psychosom Med <\/span><\/i>2012; April 74 (3): 241-8 <\/span>https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22408130<\/span><\/a><\/p>\n

Wu B, Fillenbaum GG, Plassman BL, Guo L. Association Between Oral Health and Cognitive Status: A Systematic Review [published correction appears in J Am Geriatr Soc. 2016 Aug;64(8):1752].\u00a0<\/span>J Am Geriatr Soc<\/span><\/i>. 2016;64(4):739\u2013751. <\/span>https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27037761<\/span><\/a><\/p>\n

Harding A, Robinson S, Crean S, Singhrao SK. Can better management of periodontal disease delay the onset and progression of Alzheimer\u2019s disease? <\/span>J Alzheimers Dis<\/span><\/i>. 2017; 58 (2):337-348 <\/span>https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28453484<\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

The association between cognitive function and oral health has been well documented so far by some observational studies. On the one hand it has been reported that periodontal disease and tooth loss are associated with increased risk of dementia. On the other hand, improved memory after dental intervention has also\u00a0 been observed.<\/p>\n","protected":false},"author":6,"featured_media":2377,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[78,86],"tags":[],"class_list":["post-2376","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-causes","category-periodontosis"],"acf":[],"_links":{"self":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts\/2376","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/comments?post=2376"}],"version-history":[{"count":5,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts\/2376\/revisions"}],"predecessor-version":[{"id":2401,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts\/2376\/revisions\/2401"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/media\/2377"}],"wp:attachment":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/media?parent=2376"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/categories?post=2376"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/tags?post=2376"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}