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25.03.2020 | original article Open Access

Knock-on effect of periodontitis to the pathogenesis of Alzheimer’s disease?

Wiener klinische Wochenschrift
Friedrich Leblhuber, Julia Huemer, Kostja Steiner, Johanna M. Gostner, Dietmar Fuchs
Wichtige Hinweise
The results of this study have been presented earlier at the 38th International Winter-Workshop Clinical, Chemical and Biochemical Aspects of Pteridines and Related Topics in Innsbruck, February 26th–March 1st, 2019 and were published in abstract form (Pteridines [35]).

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Alzheimer’s disease has chronic inflammatory components, which can be enhanced by systemic immune activation resulting in inflammation or vice versa. There is growing evidence that chronic periodontitis drives systemic inflammation and finally Alzheimer’s disease. Thus, a link might exist between oral pathogens and Alzheimer’s disease. This may be of special significance as there is an age-related incidence of chronic periodontitis.


In this study, 20 consecutive patients with probable Alzheimer’s disease were investigated. Diagnosis was established by cognitive tests, routine laboratory tests and cerebral magnetic resonance tomography. In 35% of these patients with cognitive impairment pathogenic periodontal bacteria were found.


The presence of Porphyromonas gingivalis, the key pathogen and one of the species involved in chronic periodontitis, was found to be associated with lower mini mental state examination scores (p < 0.03) and with a tendency to lower scores in the clock drawing test (p = 0.056). Furthermore, association between lower serum concentrations of the immune biomarker neopterin and the presence of Treponema denticola (p < 0.01) as well as of kynurenine were found in Alzheimer patients positive vs. negative for Tannerella forsytia (p < 0.05).


Data indicate a possible association of specific periodontal pathogens with cognitive impairment, Treponema denticola and Tannerella forsytia may alter the host immune response in Alzheimer’s disease. Albeit still preliminary, findings of the study may point to a possible role of an altered salivary microbiome as a causal link between chronic periodontitis and cognitive impairment in Alzheimer’s disease.

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