Title:Periodontal Pathogens and Neuropsychiatric Health
VOLUME: 20 ISSUE: 15
Author(s):Abhishek Wadhawan, Mark A. Reynolds, Hina Makkar, Alison J. Scott, Eileen Potocki, Andrew J. Hoisington, Lisa A. Brenner, Aline Dagdag, Christopher A. Lowry, Yogesh Dwivedi and Teodor T. Postolache*
Affiliation:Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore 21201, Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, VA Maryland Healthcare System, Baltimore VA Medical Center, Baltimore, Air Force Institute of Technology, Wright-Patterson Air Force Base, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Alabama, Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
Keywords:Chronic periodontitis, Porphyromonas gingivalis, Dementia, Cardiovascular disease, Metabolic syndrome, Suicidal
behavior, Mood disorders, micro-RNAs.
Abstract:Increasing evidence incriminates low-grade inflammation in cardiovascular, metabolic diseases,
and neuropsychiatric clinical conditions, all important causes of morbidity and mortality. One of
the upstream and modifiable precipitants and perpetrators of inflammation is chronic periodontitis, a
polymicrobial infection with Porphyromonas gingivalis (P. gingivalis) playing a central role in the disease
pathogenesis. We review the association between P. gingivalis and cardiovascular, metabolic, and
neuropsychiatric illness, and the molecular mechanisms potentially implicated in immune upregulation
as well as downregulation induced by the pathogen. In addition to inflammation, translocation of the
pathogens to the coronary and peripheral arteries, including brain vasculature, and gut and liver vasculature
has important pathophysiological consequences. Distant effects via translocation rely on virulence
factors of P. gingivalis such as gingipains, on its synergistic interactions with other pathogens, and on its
capability to manipulate the immune system via several mechanisms, including its capacity to induce
production of immune-downregulating micro-RNAs. Possible targets for intervention and drug development
to manage distal consequences of infection with P. gingivalis are also reviewed.
