Association Between Oral Bacteria and Alzheimer’s Disease: A Systematic Review and Meta-Analysis

科克伦图书馆 口腔微生物群 荟萃分析 医学 牙龈卟啉单胞菌 细菌 内科学 口腔感染 疾病 微生物群 牙周炎 生物 免疫学 生物信息学 遗传学
作者
Sixin Liu,Stuart G. Dashper,Rui Zhao
出处
期刊:Journal of Alzheimer's Disease [IOS Press]
卷期号:91 (1): 129-150 被引量:14
标识
DOI:10.3233/jad-220627
摘要

Background: Pre-clinical evidence implicates oral bacteria in the pathogenesis of Alzheimer’s disease (AD), while clinical studies show diverse results. Objective: To comprehensively assess the association between oral bacteria and AD with clinical evidence. Methods: Studies investigating the association between oral bacteria and AD were identified through a systematic search of six databases PubMed, Embase, Cochrane Central Library, Scopus, ScienceDirect, and Web of Science. Methodological quality ratings of the included studies were performed. A best evidence synthesis was employed to integrate the results. When applicable, a meta-analysis was conducted using a random-effect model. Results: Of the 16 studies included, ten investigated periodontal pathobionts and six were microbiome-wide association studies. Samples from the brain, serum, and oral cavity were tested. We found over a ten-fold and six-fold increased risk of AD when there were oral bacteria (OR = 10.68 95% CI: 4.48–25.43; p < 0.00001, I2 = 0%) and Porphyromonas gingivalis (OR = 6.84 95% CI: 2.70–17.31; p < 0.0001, I2 = 0%) respectively in the brain. While AD patients exhibited lower alpha diversity of oral microbiota than healthy controls, the findings of bacterial communities were inconsistent among studies. The best evidence synthesis suggested a moderate level of evidence for an overall association between oral bacteria and AD and for oral bacteria being a risk factor for AD. Conclusion: Current evidence moderately supports the association between oral bacteria and AD, while the association was strong when oral bacteria were detectable in the brain. Further evidence is needed to clarify the interrelationship between both individual species and bacterial communities and the development of AD.
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