Increasing evidence incriminates low-grade inflammation in cardiovascular, metabolic diseases, and neuropsychiatric clinical conditions, all important causes of morbidity and mortality. One of the upstream and modifiable precipitants and perpetrators of inflammation is chronic periodontitis, a polymicrobial infection with Porphyromonas gingivalis (P. gingivalis) playing a central role in the disease pathogenesis. We review the association between P. gingivalis and cardiovascular, metabolic, and neuropsychiatric illness, and the molecular mechanisms potentially implicated in immune upregulation as well as downregulation induced by the pathogen. In addition to inflammation, translocation of the pathogens to the coronary and peripheral arteries, including brain vasculature, and gut and liver vasculature has important pathophysiological consequences. Distant effects via translocation rely on virulence factors of P. gingivalis such as gingipains, on its synergistic interactions with other pathogens, and on its capability to manipulate the immune system via several mechanisms, including its capacity to induce production of immune-downregulating micro-RNAs. Possible targets for intervention and drug development to manage distal consequences of infection with P. gingivalis are also reviewed.

越来越多的证据表明，在心血管疾病，代谢疾病和神经精神病学临床状况中，低度炎症是所有发病率和死亡率的重要原因。慢性牙周炎是炎症的上游且可改变的沉淀物和犯罪者，慢性牙周炎是牙龈卟啉单胞菌（P. gingivalis）的多菌种感染，在疾病发病机理中起着重要作用。我们审查了牙龈卟啉单胞菌与心血管，代谢和神经精神疾病之间的关联，以及由病原体诱导的免疫上调和下调中潜在的分子机制。除炎症外，病原体向冠状动脉和外周动脉（包括脑血管，肠和肝血管）的移位也具有重要的病理生理后果。易位的远距离影响取决于牙龈卟啉单胞菌的毒力因子，例如牙龈蛋白酶，其与其他病原体的协同相互作用以及其通过多种机制操纵免疫系统的能力，包括其诱导产生免疫下调的微RNA的能力。 。还审查了干预和药物开发以控制牙龈卟啉单胞菌感染的远端后果的可能目标。