Oral microbiome
In the complex, multifactorial pathophysiology of glaucoma, as in most neurodegenerative diseases, inflammatory changes play a role. There is, of course, a particular form of glaucoma, uveitic glaucoma, but the pathophysiology is different.
Studies suggest that overt peripheral inflammation can exacerbate neurodegeneration in Alzheimer’s and Parkinson’s disease, but patients with glaucoma do not seem to have overt inflammation in other parts of their body. Some years ago, we started asking the question: What is it that creates inflammation in a tissue that is supposed to be protected? Based on clinical experience of patients who were progressing despite having well-controlled intraocular pressures, we hypothesized that chronic subclinical infection in other parts of the body may contribute to neurodegeneration and progression of the disease. We started exploring the oral microbiome, and we detected differences in the oral microbiome of patients with and without glaucoma. We then tested this hypothesis in animal models of the disease, exposing them to bacterial products to determine whether neurodegeneration will be exacerbated and identify possible mechanisms leading to this effect. We showed that we could specifically upregulate the number of activated microglia in the optic nerve head in animals by exposing them to bacterial lipopolysaccharide (LPS) not in the eye itself but somewhere in the periphery.
Source: Healio