Billions of nerve cells make up the human brain. They are all connected, however in Alzheimer’s disease (AD) these connections are broken. The result is death of nerve cells and tissue damage which can result in a range of symptoms such as confusion, memory loss and difficulty competing daily tasks. There is currently no cure for AD. Gum disease, also known as periodontitis is the inflammation of the gums and destruction of the alveolar bone possibly leading to tooth loss (How, Song, Chan, 2016). The bacteria associated with gum disease has multiple effects on the brain, such as inflammation, therefore has been considered to increase the likelihood of AD.
According to Abbayya et al (2015), bacteria such as Porphyromonas gingivalis (P. Gingivalis), a common gram negative bacteria that is associated with the development of gum disease can inhabit the brain. The blood stream is a possible route for the bacteria to travel through the body. When the bacteria enters the bloodstream, the body’s immune system is stimulated. Subsequently, inflammatory molecules called cytokines are released in response to these foreign bacteria. AD is commonly diagnosed in the presence of β-amyloid peptides. These are peptides present within the brain that are stimulated after a cascade of inflammatory mediators, such as cytokines stimulated from P. Gingivalis (Akiyama et al, 2014). Hence relating AD to the inflammatory response to microbes in the oral cavity.
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If bacteria have inhabited the brain, the presence of gingipains would be an indication. P. Gingivalis secretes a protease called gingipain. This is an enzyme that breaks down cytokines, hence gingipains could indicate bacterial presence. A study conducted on mice investigated whether gingipains can travel from the mouth to the brain. Gingipains were present in the hippocampus of the mice that had P. Gingivalis inserted into their oral cavity. Therefore, suggesting bacteria can inhabit the brain. These mice displayed signs of collapsing neurons, as displayed in patients with AD (IIievski et al, 2018).
Periodontitis can also be caused by other bacteria including F. nucleatum and P. intermedia. In response to the presence of foreign bodies such as these, the body will produce igG and igA antibodies. The presence of antibodies in the bloodstream can indicate if the bacteria is able to travel in the blood. A study conducted by Stein et al (2012), suggests there is an association between the presence of antibodies and AD. Participants who suffered with AD had raised levels of these specific antibodies in their blood compared to healthy individuals who did not have AD. Thus suggesting there is a link to AD and could potentially link to inflammatory responses as described by Abbayya et al (2015).
To conclude, The most obvious finding from Abbayya et al (2015) is that inflammatory responses related to AD might be caused by bacteria entering the blood stream and inhabiting the brain. Links have been found to antibodies present within the brain and AD, perhaps supporting the proposal that bacteria travel within the blood to reach the brain. Thus linking to the investigation results from IIievski et al (2018) showing gingipains were found in the hippocampus of mice brains. These findings suggest a strong relationship, however does not confirm bacteria is the cause. To conclude, there should be further research such as using drugs that target the bacteria. This should be carried out on humans and could lead to production of a new treatment.
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