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Article Details


Periodontal Pathogens and Neuropsychiatric Health

[ Vol. 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*   Pages 1353 - 1397 ( 45 )

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.

Keywords:

Chronic periodontitis, Porphyromonas gingivalis, Dementia, Cardiovascular disease, Metabolic syndrome, Suicidal behavior, Mood disorders, micro-RNAs.

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

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