ARTYKUŁ PRZEGLĄDOWY
Zapalenie przyzębia a choroba Alzheimera – dwukierunkowy związek

Periodontitis and Alzheimer’s disease – a bidirectional relationship

Katarzyna Dębska, Kamila Szymacha, Natalia Lewkowicz

Streszczenie
Zapalenie przyzębia (periodontitis) i choroba Alzheimera (Alzheimer’s disease – AD) to schorzenia o złożonej etiologii, które w ostatnim czasie są ze sobą coraz częściej zestawiane, nie tylko ze względu na wspólne czynniki ryzyka. Badacze udowadniają dwukierunkowy związek obu chorób, podkreślając zarówno wpływ zapalenia przyzębia na chorobę Alzheimera, jak i skutki choroby Alzheimera na przyzębie. Oddziaływanie bakterii charakterystycznych dla periodontitis, ich produktów, a nawet sam proces zapalenia są wymieniane jako możliwe mechanizmy wpływu zapalenia przyzębia na etiopatogenezę AD. Wpływ choroby Alzheimera na stan jamy ustnej przejawia się natomiast skłonnością pacjentów z AD na zapadanie na przewlekłe choroby jamy ustnej, w tym zapalenie przyzębia, co wynika z pogorszenia higieny jamy ustnej z powodu upośledzenia zdolności kognitywnych.

Abstract
Periodontitis and Alzheimer’s disease are illnesses with complicated etiology. The association between these disorders has recently become more apparent (not solely due to common risk factors). Researchers established a bidirectional relationship between periodontitis and AD by examining these diseases’ impact on one another. Periodontal bacteria, their metabolites as well as inflammation can significantly influence the progression of Alzheimer’s disease. In turn, AD’s effect on oral health manifests itself in patients’ susceptibility to chronic oral health conditions, like periodontitis, attributed to the deteriorating state of their oral hygiene as cognitive abilities decline.

Hasła indeksowe: zapalenie przyzębia, choroba Alzheimera

Key words: periodontitis, Alzheimer’s disease

Piśmiennictwo:

1. 2022 Alzheimer’s disease facts and figures. Alzheimers Dement. 2022; 18(4): 700-789.
2. Liccardo D, Marzano F, Carraturo F i wsp. Potential Bidirectional Relationship Between Periodontitis and Alzheimer’s Disease. Front Physiol. 2020; 11: 683.
3. Chen CK, Wu YT, Chang YC. Association between chronic periodontitis and the risk of Alzheimer’s disease: A retrospective, population-based, matched-cohort study. Alzheimers Res Ther. 2017; 9(1): 56.
4. de Oliveira Araújo R, Villoria GEM, Luiz RR i wsp. Association between periodontitis and Alzheimer’s disease and its impact on the self-perceived oral health status: a case-control study. Clin Oral Investig. 2021; 25(2): 555-562.
5. Tatulian SA. Challenges and hopes for Alzheimer’s disease. Drug Discov Today. 2022; 27(4): 1027-1043.
6. Koedam ELGE, Lauffer V, van der Vlies AE i wsp. Early-versus late-onset Alzheimer’s disease: more than age alone. J Alzheimers Dis. 2010; 19(4): 1401-1408.
7. Abeysinghe AADT, Deshapriya RDUS, Udawatte C. Alzheimer’s disease; a review of the pathophysiological basis and therapeutic interventions. Life Sci. 2020; 256: 117996.
8. Mustapic M, Eitan E, Werner Jr JK i wsp. Plasma extracellular vesicles enriched for neuronal origin: A potential window into brain pathologic processes. Front Neurosci. 2017; 11: 278.
9. Pulliam L, Sun B, Mustapic M i wsp. Plasma neuronal exosomes serve as biomarkers of cognitive impairment in HIV infection and Alzheimer’s disease. J Neurovirol. 2019; 25(5): 702-709.
10. Kwon TH, Lamster IB, Levin L. Current Concepts in the Management of Periodontitis. Int Dent J. 2021; 71(6): 462-476.
11. Mehrotra N, Singh S. Periodontitis. Treasure Island: StatPearls Publishing; 2022.
12. Choi S, Kim K, Chang J i wsp. Association of Chronic Periodontitis on Alzheimer’s Disease or Vascular Dementia. J Am Geriatr Soc. 2019; 67(6): 1234-1239.
13. Dominy SS, Lynch C, Ermini F i wsp. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019; 5(1): eaau3333.
14. Dioguardi M, Crincoli V, Laino L i wsp. The role of periodontitis and periodontal bacteria in the onset and progression of Alzheimer’s disease: A systematic review. J Clin Med. 2020; 9(2): 495.
15. Wu DT, Cho YW, Spalti MD i wsp. The link between periodontitis and Alzheimer’s disease – emerging clinical evidence. Dent Rev. 2023; 3(1): 100062.
16. Kisby B, Jarrell JT, Agar ME i wsp. Alzheimer’s Disease and Its Potential Alternative Therapeutics. J Alzheimers Dis Parkinsonism. 2019; 9(5): 477.
17. Moussa N, Dayoub N. Exploring the role of COX-2 in Alzheimer’s disease: Potential therapeutic implications of COX-2 inhibitors. Saudi Pharm J. 2023; 31(9): 101729.
18. Chuhuaicura P, Dias FJ, Arias A i wsp. Mastication as a protective factor of the cognitive decline in adults: A qualitative systematic review. Int Dent J. 2019; 69(5): 334-340.
19. Dioguardi M, Di Gioia G, Caloro GA i wsp. The association between tooth loss and Alzheimer’s disease: A systematic review with meta-analysis of case control studies. Dent J (Basel). 2019; 7(2): 49.
20. Graves AR, Moore SJ, Bloss EB i wsp. Hippocampal Pyramidal Neurons Comprise Two Distinct Cell Types That Are Countermodulated By Metabotropic Receptors. Neuron. 2012; 76(4): 776-789.
21. Ming Y, Hsu SW, Yen YY i wsp. Association of oral health-related quality of life and Alzheimer disease: A systematic review. J Prosthet Dent. 2020; 124(2): 168-175.
22. Zuluaga DJM, Montoya JAG, Contreras CI i wsp. Association between oral health, cognitive impairment and oral health-related quality of life. Gerodontology. 2012; 29(2): e667-673.
23. Ribeiro GR, Costa JLR, Bovi Ambrosano GM i wsp. Oral health of the elderly with Alzheimer’s disease. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114(3): 338-343.
24. Ma KS, Hasturk H, Carreras I i wsp. Dementia and the Risk of Periodontitis: A Population-Based Cohort Study. J Dent Res. 2022; 101(3): 270-277.
25. Aragón F, Zea-Sevilla MA, Montero J i wsp. Oral health in Alzheimer’s disease: a multicenter case-control study. Clin Oral Investig. 2018; 22(9): 3061-3070.
26. Marchini L, Ettinger R, Caprio T i wsp. Oral health care for patients with Alzheimer’s disease: An update. Spec Care Dentist. 2019; 39(3): 262-273.
27. Gao SS, Chu CH, Young FYF. Oral health and care for elderly people with Alzheimer’s disease. Int J Environ Res Public Health. 2020; 17(16): 5713.
28. Zhang J, Wang Z, Li Y i wsp. Effects of a Caregiver Training Program on Oral Hygiene of Alzheimer’s Patients in Institutional Care. J Am Med Dir Assoc. 2021; 22(7): 1429-1434.e1.