Age and Periodontal Health—Immunological View

Abstract

Purpose of the Review: Aging clearly impacts a wide array of systems, in particular the breadth of the immune system leading to immunosenescence, altered immunoactivation, and coincident inflammaging processes. The net result of these changes leads to increased susceptibility to infections, increased neoplastic occurrences, and elevated frequency of autoimmune diseases with aging. However, as the bacteria in the oral microbiome that contribute to the chronic infection of periodontitis is acquired earlier in life, the characteristics of the innate and adaptive immune systems to regulate these members of the autochthonous microbiota across the lifespan remains ill defined. Recent Findings: Clear data demonstrate that both cells and molecules of the innate and adaptive immune response are adversely impacted by aging, including in the oral cavity, yielding a reasonable tenet that the increased periodontitis noted in aging populations is reflective of the age-associated immune dysregulation. Additionally, this facet of host-microbe interactions and disease needs to accommodate the population variation in disease onset and progression, which may also reflect an accumulation of environmental stressors and/or decreased protective nutrients that could function at the gene level (ie. epigenetic) or translational level for production and secretion of immune system molecules. Summary: Finally, the majority of studies of aging and periodontitis have emphasized the increased prevalence/severity of disease with aging, all based upon chronological age. However, evolving areas of study focusing on “biological aging” to help account for population variation in disease expression, may suggest that chronic periodontitis represents a co-morbidity that contributes to “gerovulnerability” within the population.

Microglial response to experimental periodontitis in a murine model of Alzheimer’s disease

“…This finding suggested that the peak bone resorption as a result of the inflammatory process in the periodontal tissues may have taken place earlier in 5xFAD mice compared to the WT littermates and therefore time-dependent experiments would be needed to further understand the effects of PD. Another explanation of this observation may be a biological mechanism where PD may induce changes in the immune system responses and stimulate immunosenescence 51 – 53 , which could underlie the pathological process in AD. Evaluating the effects of ligature-induced PD in 5xFAD mice at earlier ages or in a slow-progressing AD models (e.g., PSAPP), may demonstrate the role of Aβ pathology in the link between AD and PD.…”

“…The risk of developing PD increases with age; however, PD has a peak rate of occurrence in middle age that may result in priming microglia to a significantly activated state increasing the brain vulnerability to aging and to additional immune challenges or diseases. While microglia in WT mice was impacted by the experimental PD as shown by increased Iba1 expression, the level of inflammatory cytokines was also impacted, suggesting a defective immunological process due to PD 51 – 53 that would lead to a disrupted inflammatory response. As PD can prime macrophages either through microbial factors (e.g., lipopolysaccharide) 54 , 55 or by activation of other immune and non-immune cells 56 , 57 , microglia priming, activation, and polarization due to PD may be plausible 24 .…”

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

“…As humans age, the immune system becomes less efficient and the prevalence of both the inflammation related diseases diabetes and periodontitis increases [109,110].…”

Einschätzung der Mundhygienefähigkeit von pflegebedürftigen Senioren

“…Die Alterung des Immunsystems, die Immunseneszenz, führt zu einer erhöhten Infektanfälligkeit, vermehrten Malignomen und Autoimmunerkrankungen, reduzierter Wirkung von Impfungen, schlechteren Wundheilungs-und Reparaturprozessen [6]. Die Dysregulierung der Immunantwort bedingt eine permanent erhöhte systemische Entzündungsreaktion, die den gesamten Organismus betrifft und als "Gero-Vulnerabilität" betrachtet wird [7]. Vor dem Hintergrund der Multimorbidität von pflegebedürftigen Senioren ist die Prävention von respiratorischen und kardialen Exazerbationen oder Komplikationen gerade auch durch einfache orale Präventionsmaßnahmen wie die tägliche gründliche Mundhygiene von besonderer Bedeutung.…”