What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease? Brutkiewicz 2025

J

Jaybee00

Senior Member (Voting Rights)

Highlights​

The involvement of microbes as etiological agents of chronic diseases is not unprecedented. For example, peptic ulcers, originally thought to result from lifestyle choices, are now known to be caused by Helicobacter pylori.
The potential involvement of various microbes in the etiology of Alzheimer’s disease (AD) has been strengthened by large-scale cohort studies, postmortem analyses of AD brains and evidence of the antimicrobial properties of amyloid peptide and phosphorylated tau.
Regardless of the putative pathogen’s identity, we argue that to establish a causal role of a microbial agent in AD, pathogen infection must reproduce the AD pathology and pathogen eradication should result in the arrest and/or reversal of AD pathology.

Abstract​

Accumulating evidence over several years suggests that microbial infections (e.g., bacteria, viruses, fungi) may play a role in the etiology of Alzheimer’s disease (AD). In this review, we discuss the reported associations between a variety of microbes and the development of AD, as well as potential causal relationships between infections and AD risk. Having evaluated the current state of knowledge, we make specific recommendations for what it would take to present definitive evidence that chronic infections play a causal role in AD pathogenesis.

 
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