ALZHEİMER HASTALIĞI İLE PERİODONTAL HASTALIKLAR ARASINDA BİR İLİŞKİ OLABİLİR Mİ?

Year 2022, , 675 - 684, 24.08.2022

Beyza Olukpınar Genç , Tanju Kadir

https://doi.org/10.15311/selcukdentj.972749

Cited By: 1

Abstract

Alzheimer hastalığı (AH), antimikrobiyal peptit olarak bilinen β-amiloid 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.

Keywords

Alzheimer hastalığı, Porphyromonas gingivalis, Periodontal hastalıklar, Gingipain

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