Herpes Simplex Virus Type 1 and Other Pathogens are Key Causative Factors in Sporadic Alzheimer’s Disease
Open accessAbstract
This review focuses on research in epidemiology, neuropathology, molecular biology, and genetics regarding the hypothesis that pathogens interact with susceptibility genes and are causative in sporadic Alzheimer's disease (AD). Sporadic AD is a complex multifactorial neurodegenerative disease with evidence indicating coexisting multi-pathogen and inflammatory etiologies. There are significant associations between AD and various pathogens, including Herpes simplex virus type 1 (HSV-1), Cytomegalovirus, and other Herpesviridae, Chlamydophila pneumoniae, spirochetes, Helicobacter pylori, and various periodontal pathogens. These pathogens are able to evade destruction by the host immune system, leading to persistent infection. Bacterial and viral DNA and RNA and bacterial ligands increase the expression of pro-inflammatory molecules and activate the innate and adaptive immune systems. Evidence demonstrates that pathogens directly and indirectly induce AD pathology, including amyloid-β (Aβ) accumulation, phosphorylation of tau protein, neuronal injury, and apoptosis. Chronic brain infection with HSV-1, Chlamydophila pneumoniae, and spirochetes results in complex processes that interact to cause a vicious cycle of uncontrolled neuroinflammation and neurodegeneration. Infections such as Cytomegalovirus, Helicobacter pylori, and periodontal pathogens induce production of systemic pro-inflammatory cytokines that may cross the blood-brain barrier to promote neurodegeneration. Pathogen-induced inflammation and central nervous system accumulation of Aβ damages the blood-brain barrier, which contributes to the pathophysiology of AD. Apolipoprotein E4 (ApoE4) enhances brain infiltration by pathogens including HSV-1 and Chlamydophila pneumoniae. ApoE4 is also associated with an increased pro-inflammatory response by the immune system. Potential antimicrobial treatments for AD are discussed, including the rationale for antiviral and antibiotic clinical trials.
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Viruses such as herpes viruses, cytomegalovirus, HIV, VZV, EBV, and Hepatitis C virus have been implicated in Alzheimer's disease pathogenesis.
“Viruses, such as herpes viruses, cytomegalovirus, human immunodeficiency virus (HIV), Varicela zoster virus (VZV), Epstein–Barr virus (EBV), and Hepatitis C virus, have been implicated in Alzheimer’s disease pathogenesis [7, 10].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [7]
Many studies have shown a direct influence of viral infections on cognition, especially in the development of MCI and dementia.
“Many studies have shown a direct influence of viral infections on cognition, especially in the development of MCI and dementia [5–7].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [7]
Viral presence in the CNS may interfere with pathogenic mechanisms related to neurodegenerative diseases, such as Alzheimer's disease.
“Viral presence in the CNS may interfere with pathogenic mechanisms related to neurodegenerative diseases, such as Alzheimer’s disease (AD) [7, 10].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [7]
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- Authors
- Harris, S. A., & Harris, E. A.
- Affiliations
- St Vincent Hospital (US)
- Indiana University School of Medicine (US)
- Corresponding author
- Harris, Steven A.
- Venue
- Journal of Alzheimer's Disease
- Publisher
- SAGE Publications
- Published
- 2015-09-09
- Volume
- 48
- Issue
- 2
- Pages
- 319-353
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- PMC
- PMC4923765
- OpenAlex
- W2213335032
- Cited by
- 279
- References
- 274
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 17 · 2023: 59 · 2022: 23 · 2021: 29 · 2020: 30 · 2019: 26 · 2018: 29 · 2017: 23 · 2016: 16 · 2015: 1 · 2014: 1
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Journal of Alzheimer s Disease (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, cc-by-nc)
- Publisher
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- sporadic Alzheimer's disease, herpes simplex virus type 1
- MeSH terms
- Alzheimer Disease, Animals, Brain, Herpes Simplex, Humans, Herpesvirus 1, Human
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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