Periodontal disease's contribution to Alzheimer's disease progression in Down syndrome

Abstract

Altres ajuts: This study was supported by National institutes of Health (NIH)/National Institute on Aging grants AG035137, AG032554, AG12101, AG022374, and AG13616, NIH DE023139-02, Alzheimer's Association NIRG-12-173937, and NIH/NCATS UL1 TR000038. Conflict of interest: No conflict of interest is reported for A.R.K., M.J., P.C., R.G.C., D.S., K.R.C.A., M.R., A.M., J.O.F., S.V., M.C.-I., and B.B. M.J. de Leon has a patent on an image analysis technology that was licensed to Abiant Imaging, Inc., by NYU, and has a financial interest in this license agreement, and NYU holds stock options on the company. M. de Leon has received compensation for consulting services from Abiant Imaging. Dr L. Glodzic was a principal investigator on an Investigator-Initiated project funded by Forest Laboratories and received an honorarium for serving as a consultant to Roche Pharma. Contributors: A.R.K., M.J.de.L., and J.F. wrote the manuscript. All the other authors reviewed the manuscript and contributed with the scientific literature, concepts, and modeling. All authors reviewed the manuscript for intellectual content and approved the final draft.People with Down syndrome (DS) are at an increased risk for Alzheimer's disease (AD). After 60 years of age, >50% of DS subjects acquire dementia. Nevertheless, the age of onset is highly variable possibly because of both genetic and environmental factors. Genetics cannot be modified, but environmental risk factors present a potentially relevant intervention for DS persons at risk for AD. Among them, inflammation, important in AD of DS type, is potential target. Consistent with this hypothesis, chronic peripheral inflammation and infections may contribute to AD pathogenesis in DS. People with DS have an aggressive form of periodontitis characterized by rapid progression, significant bacterial and inflammatory burden, and an onset as early as 6 years of age. This review offers a hypothetical mechanistic link between periodontitis and AD in the DS population. Because periodontitis is a treatable condition, it may be a readily modifiable risk factor for AD