Nav: Home

The involvement of the gut in Parkinson's disease: hype or hope?

February 07, 2019

Amsterdam, NL, February 7, 2019 - There is growing evidence that at least in some patients with Parkinson's disease (PD), the disease may begin in the gut. Writing in a special supplement to the Journal of Parkinson's Disease, experts explore the last two decades of research about the gut-brain axis in PD and look ahead at the possible development and impact of these research areas in the next two decades.

PD is a slowly progressive disorder that affects movement, muscle control, and balance. In the last 20 years it has become clear that PD is associated with a number of gastrointestinal symptoms originating from functional and structural changes in the gut and its associated neural structures. Many patients with PD suffer from gut-related symptoms such as constipation, which have an impact on quality of life. Accumulating evidence suggests that in at least a subgroup of patients, these disturbances happen years before the development of motor symptoms and diagnosis of PD and may therefore provide important insights into the origin and development of the disease.

"Better understanding the role of the gut in PD will help us to understand the origin of the disease and to improve treatments," explained Filip Scheperjans, MD, PhD, from the Department of Neurology, Helsinki University Hospital, Helsinki, Finland, and colleagues. "There is accumulating evidence that at least in some PD patients, the origin of the disease may lie in the gut with possible involvement of abnormal protein aggregates, local inflammation, and the gut microbiome. Therefore, further studies into the role of the gut in PD are important and may reveal new possibilities for diagnosis and treatment."

The authors identified four key issues:

  1. Alpha-synuclein deposits are observed in the enteric nervous system (ENS) of PD patients However, it remains to be determined if the alpha-synuclein aggregates in the ENS are biochemically similar to the ones found in the brain as this might be critical in understanding the role of the gut in PD pathogenesis.

  2. Triggering of initial alpha-synuclein aggregation in enteric nerve terminals through extrinsic factors could be facilitated by intestinal hyperpermeability. It remains to be definitely demonstrated that intestinal permeability is increased in PD.

  3. Results of immunohistochemistry-based studies on alpha-synuclein deposits in the ENS of PD patients have provided conflicting results. There is therefore a critical need to develop alternative techniques to detect alpha-synuclein aggregates in the gut.

  4. Alterations of gut microbiota composition in PD have been shown in multiple cross-sectional studies from diverse populations. It will be crucial to determine the mechanisms that connect gut microbiota and PD in large multicenter studies of PD patients before and after diagnosis as well as in animal models employing multiomics approaches.


The authors predict that major advances will be made over the next 20 years in understanding the role of gastrointestinal alpha-synuclein pathology in the etiology of PD and explaining the degree of similarity between pathophysiological processes in PD and those of true prion diseases such as Creutzfeldt-Jakob disease. Accessible and affordable methods such as radio-opaque markers to assess gastrointestinal transit times will find more widespread use in future studies. They believe there is good reason to envision that gut microbiota may have important implications in the future diagnostic and therapeutic landscape of PD and that therapeutic applications based on the gut microbiome are possible through a range of approaches, including dietary interventions, probiotics, prebiotics, and fecal microbiota transplantation. And finally, that a more detailed understanding of microbiome-host-interactions in PD could identify new pathways that could be targeted using more traditional pharmacological approaches.

"Our understanding and appreciation of the importance of the gut-brain connection in PD has grown rapidly in recent years. We are confident that the coming two decades of microbiome-gut-brain-axis research will see an even accelerated development in this area that will reshape our understanding of the pathogenesis of PD," concluded Dr. Scheperjans.

"The gut has emerged as one of the new frontiers in PD research," commented Patrik Brundin, MD, PhD, Van Andel Research Institute, Grand Rapids, MI, USA, and J. William Langston, MD, Stanford Udall Center, Department of Pathology, Stanford University, Palo Alto, CA, USA, Editors-in-Chief of the Journal of Parkinson's Disease. "We predict there will be several advances regarding the gut in the coming 20 years. Changes in the gut might be utilized to diagnose PD earlier; new therapies targeting these changes might slow disease progression, reduce constipation, and improve gut function in patients who have already been diagnosed."
-end-


IOS Press

Related Gut Microbiota Articles:

Gut check: A molecule that balances the immune system in the gut
In the May 19, 2017 issue of Scientific Reports, researchers at the Medical University of South Carolina identified a fundamental way immune cells in the gut learn the difference between good and bad microbes.
The gut microbiota plays a key role in treatment with classic diabetes medication
A clearer picture of how the classic diabetes medication metformin works has emerged.
Fecal microbiota transplant is safe and effective for patients with ulcerative colitis
A single transplant of microbes contained in the stool of a healthy donor is a safe and effective way to increase diversity of good bacteria in the guts of patients with ulcerative colitis, according to new research from Weill Cornell Medicine and NewYork-Presbyterian.
Fecal microbiota transplants improve cognitive impairment caused by severe liver disease
A study presented today found that fecal transplantation of bacteria from one healthy donor into patients that suffer from hepatic encephalopathy, is safe and improves cognitive function compared with standard of care treatment for the condition.
University of Louisville researcher to investigate how gut microbiota protect against malaria
Schmidt intends to pursue further research to determine which microbes are responsible for protecting against malaria illness and to learn more about the mechanism behind that protection
Eating whole grains led to modest improvements in gut microbiota and immune response
In a clinical trial, adults who consumed a diet rich in whole grains rather than refined grains had modest improvements in healthy gut microbiota and certain immune responses.
Your microbiota's previous dining experiences may make new diets less effective
Your microbiota may not be on your side as you try improving your diet this New Year's.
Gut microorganisms affect our physiology
Researchers have found evidence that could shed new light on the complex community of trillions of microorganisms living in all our guts, and how they interact with our bodies.
Study provides clues to improving fecal microbiota transplantation
Results from a placebo-controlled trial provide a strategy for improving fecal microbiota transplantation (FMT) for patients with recurrent Clostridium difficile infection.
Uterine microbiota play a key role in implantation and pregnancy success in in vitro fertilization
Endometrial microbiota (bacteria in the uterine cavity) play an important role in determining whether women are able to get pregnant via in vitro fertilization (IVF), according to a new study published in the American Journal of Obstetrics and Gynecology.

Related Gut Microbiota Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".