The relationship between periodontal disease and age-related disease

Takahito Iwashimizu , Hiroki Tabata , Hikaru Otsuka , Huicong Shi , Yoshifumi Tamura
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Abstract

Our objectives of this narrative review is to summarize the scientific perspective on the effect of periodontal disease on age-related diseases, focusing on chronic low-level systemic inflammation, and discuss the goals for future research. In this review, we summarized the findings of articles that showed the mechanisms of periodontal disease and each age-related disease. Periodontal disease is a prevalent infectious disease due to oral anaerobic bacteria that results in dissolution of the gums around the teeth (gingiva) and the bone supporting the teeth, leading to decreased quality of life. The disease is more prevalent with increasing age and associated with age-related diseases, such as diabetes, non-alcoholic fatty liver disease, cardiovascular disease, dementia, and osteoporosis via chronic low-level systemic inflammation, which requires long-term care and increases medical costs. Chronic low-level systemic inflammation due to periodontal disease is a common risk factor for age-related diseases, but the mechanisms of inflammation in each disease vary. Periodontal pathogens mainly cause three patterns of inflammation: cytokine crosstalk that attacks the whole body, changes in the balance of gut microbiota, and production of proteases like gingipains that can subvert immune responses to reach various systemic organs, especially the brain. Several age-related diseases, such as diabetes and dementia, can be improved by treating periodontal disease as inflammatory markers are reduced. In conclusion, it will be necessary to confirm whether the exact mechanism in the human body is the same as that in mice. Improvement in chronic low-level systemic inflammation caused by periodontal disease may be effective in the treatment of age-related diseases.

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牙周病与年龄相关疾病之间的关系
我们撰写这篇叙述性综述的目的是总结牙周病对老年相关疾病影响的科学视角,重点关注慢性低水平系统性炎症,并讨论未来研究的目标。在这篇综述中,我们总结了表明牙周病和各种老年相关疾病机制的文章的研究结果。牙周病是由口腔厌氧菌引起的一种流行性传染病,会导致牙齿周围的牙龈(牙龈)和支撑牙齿的牙槽骨溶解,从而导致生活质量下降。随着年龄的增长,这种疾病的发病率会越来越高,并通过慢性低水平全身性炎症与糖尿病、非酒精性脂肪肝、心血管疾病、痴呆症和骨质疏松症等老年性疾病相关,需要长期护理并增加医疗费用。牙周病导致的慢性低水平全身炎症是老年相关疾病的常见风险因素,但每种疾病的炎症机制各不相同。牙周病原体主要引起三种模式的炎症:攻击全身的细胞因子串联、肠道微生物群平衡的改变,以及产生蛋白酶(如gingipains),这种蛋白酶可以颠覆免疫反应,到达全身各器官,尤其是大脑。通过治疗牙周病,可以减少炎症指标,从而改善糖尿病和痴呆症等几种与年龄有关的疾病。总之,有必要确认人体的确切机制是否与小鼠相同。改善由牙周病引起的慢性低水平全身炎症可能对治疗老年相关疾病有效。
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