Neurological Surgery 脳神経外科52巻6号

2024年11月発行

特集 脳神経外科医が知っておくべき生活習慣病の最新治療

Ⅲ その他の生活習慣病と周辺疾患の基礎知識

歯科疾患（齲蝕・歯周病）と生活習慣病，脳血管障害への影響

著者： 殿村修一¹ 猪原匡史¹

所属機関： ¹国立循環器病研究センター脳神経内科

ページ範囲：P.1234 - P.1241

文献概要

Point
・齲蝕・歯周病は，細菌感染症としてだけではなく，生活習慣病としての側面を有する．
・歯科疾患（齲蝕・歯周病）と生活習慣病との間で「負のサイクル」が形成される．
・齲蝕・歯周病は，それぞれ特異的に脳血管障害と関連する．
・歯科疾患による脳血管障害齲蝕原性菌・歯周病菌を含む口内細菌フローラに着目し概説する．

参考文献

1）Botelho J, et al：An umbrella review of the evidence linking oral health and systemic noncommunicable diseases. Nat Commun 13：7614, 2022　doi:10.1038/s41467-022-35337-8

2）Demmer RT, et al：The influence of anti-infective periodontal treatment on C-reactive protein：a systematic review and meta-analysis of randomized controlled trials. PLoS One 8：e77441, 2013　doi:10.1371/journal.pone.0077441

3）Ye Z, et al：Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis. Cochrane Database Syst Rev 10：CD009197, 2022　doi:10.1002/14651858.CD009197.pub5

4）中谷　敏；合同研究班：感染性心内膜炎の予防と治療に関するガイドライン（2017年改訂版）．日本循環器学会，2018

5）Scannapieco FA, et al：Associations between periodontal disease and risk for atherosclerosis, cardiovascular disease, and stroke. A systematic review. Ann Periodontol 8：38-53, 2003

6）Desvarieux M, et al：Relationship between periodontal disease, tooth loss, and carotid artery plaque：the Oral Infections and Vascular Disease Epidemiology Study（INVEST）. Stroke 34：2120-2125, 2003

7）Wu T, et al：Periodontal disease and risk of cerebrovascular disease：the first national health and nutrition examination survey and its follow-up study. Arch Intern Med 160：2749-2755, 2000

8）Sen S, et al：Periodontal disease, regular dental care use, and incident ischemic stroke. Stroke 49：355-362, 2018

9）Sen S, et al：Dental caries, race and incident ischemic stroke, coronary heart disease, and death. Stroke 55：40-49, 2024

10）LaValley EA, et al：Dental caries a risk factor for intracerebral hemorrhage. Cerebrovasc Dis 53：98-104, 2024

11）Patrakka O, et al：Oral bacterial signatures in cerebral thrombi of patients with acute ischemic stroke treated with thrombectomy. J Am Heart Assoc 8：e012330, 2019　doi:10.1161/JAHA.119.012330

12）Patrakka O, et al：Thrombus aspirates from patients with acute ischemic stroke are infiltrated by viridans streptococci. J Am Heart Assoc 12：e030639, 2023　doi:10.1161/JAHA.123.030639

13）Walker M, et al：Thrombus-associated microbiota in acute ischemic stroke patients. Surg Neurol Int 13：247, 2022　doi:10.25259/SNI_104_2022

14）Moutsopoulos NM, et al：Tissue-specific immunity at the oral mucosal barrier. Trends Immunol 39：276-287, 2018

15）Tonomura S, et al：Intracerebral hemorrhage and deep microbleeds associated with cnm-positive Streptococcus mutans；a hospital cohort study. Sci Rep 6：20074, 2016　doi:10.1038/srep20074

16）Watanabe I, et al：Oral cnm-positive streptococcus mutans expressing collagen binding activity is a risk factor for cerebral microbleeds and cognitive impairment. Sci Rep 6：38561, 2016　doi:10.1038/srep38561

gene relates to an increased incidence of cerebral microbleeds. Stroke 51：3632-3639, 2020

18）Ikeda S, et al：Harboring Cnm-expressing Streptococcus mutans in the oral cavity relates to both deep and lobar cerebral microbleeds. Eur J Neurol 30：3487-3496, 2023

19）Nakano K, et al：The collagen-binding protein of Streptococcus mutans is involved in haemorrhagic stroke. Nat Commun 2：485, 2011　doi:10.1038/ncomms1491

20）Nomura R, et al：Potential involvement of Streptococcus mutans possessing collagen binding protein Cnm in infective endocarditis. Sci Rep 10：19118, 2020　doi:10.1038/s41598-020-75933-6

21）Atarashi K, et al：Ectopic colonization of oral bacteria in the intestine drives T1 cell induction and inflammation. Science 358：359-365, 2017

22）Kitamoto S, et al：The intermucosal connection between the mouth and gut in commensal pathobiont-driven colitis. Cell 182：447-462.e14, 2020　doi:10.1016/j.cell.2020.05.048

23）Fu K, et al：Streptococcus anginosus promotes gastric inflammation, atrophy, and tumorigenesis in mice. Cell 187：882-896.e17, 2024　doi:10.1016/j.cell.2024.01.004