慢性牙周炎与神经系统退行性疾病相关性的研究进展

Research progress on the correlation between chronic periodontitis and neurodegenerative diseases

阿尔茨海默症、帕金森症、多发性硬化症是当前临床上较为常见的神经系统退行性疾病,多发于老年人,临床主要表现为痴呆、认知或感觉功能障碍,发病机制较为复杂。迄今,对于此类疾病仍无有效的治愈措施。现有研究表明,外周循环的炎性反应能够影响中枢神经系统,进而引起神经炎症。慢性牙周炎作为一种较为常见的口腔局部炎症,能够通过引发外周炎症而对神经系统造成影响。牙周微环境稳态的失调使得牙周致病菌及其代谢产物引发宿主免疫反应,进而释放大量炎性因子。牙周致病菌及其细胞因子可能通过血液循环途径、神经旁路途径、软脑膜细胞介导途径、NLRP3炎症小体途径以及微生物-肠-脑轴途径影响中枢神经系统并造成神经损伤,在神经系统退行性疾病的发生发展中发挥重要的作用。目前临床上对于牙周炎已有有效的预防及治疗措施,慢性牙周炎与神经系统退行性疾病之间的相关性可能为防治神经系统退行性疾病提供新思路。本文就慢性牙周炎与常见神经系统退行性疾病之间的相关性及其影响神经系统的可能方式作一综述。

Alzheimer’s disease,Parkinson’s disease and multiple sclerosis are the most common neurodegenerative diseases occuring in the elderly,whichmainifest as dementiacognitive or sensory dysfunction,and the pathogenesis is relatively complex.So far,there is no effective cure for such diseases.Existing studies suggest that inflammatory response of periphera circulation can affect the central nervous system,and then cause neuroinflammation.As a more common oral local inflammatory disease,chronic periodontitis may affect the nervous system bytriggering an inflammatory response.Due to the Imbalance of periodontal microenvironment homeostasis,periodontal pathogens and their metabolites trigger host immune response and release a large number of inflammatory factors.Periodontal pathogens and their cytokines may affect the central nervous system and cause nerve injury through the blood circulation pathway,nerve bypass pathway,leptomeninges cell-mediated pathway,NLRP3 inflammasome pathway and microbiota-brain-gut axis pathway,which play an important role in the occurrence and development of neurodegenerative diseases.At present,there are effective prevention and treatment measures for periodontitis in clinic.The correlation between chronic periodontitis and neurodegenerative diseases may provide new ideas for the prevention and treatment of neurodegenerative diseases.In this article,the correlation between chronic periodontitis and common neurodegenerative diseases and the ways of chronic periodontitis affecting the nervous system were reviewed.