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Inflammation as a potential mediator for the association between periodontal disease and Alzheimer’s disease

Authors Amber Watts, Eileen M Crimmins, Margaret Gatz

Published 10 October 2008 Volume 2008:4(5) Pages 865—876

DOI http://dx.doi.org/10.2147/NDT.S3610

Review by Single-blind

Peer reviewer comments 2

Amber Watts1, Eileen M Crimmins1, Margaret Gatz2

1Davis School of Gerontology; 2Department of Psychology, University of Southern California, Los Angeles, CA, USA

Abstract: Periodontal disease (PDD) is associated with increased risk of cardiovascular disease, cerebrovascular disease, and mortality in many studies, while other studies have begun to suggest an association of PDD with Alzheimer’s disease (AD). This paper discusses how infectious pathogens and systemic infection may play a role in AD. The roles of infection and inflammation are addressed specifically with regard to known AD pathologic lesions including senile plaques, neuron death, neurofibrillary tangles, and cerebrovascular changes. A testable model of proposed pathways between periodontal infection and AD is presented including three possible mechanisms: a) direct effects of infectious pathogens, b) inflammatory response to pathogens, and c) the effects on vascular integrity. The role of gene polymorphisms is discussed, including apolipoprotein (APOE) ε4 as a pro-inflammatory and pro-infection genotype.

Keywords: periodontal disease, infection, inflammation, Alzheimer’s disease

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