Visanji Naomi P, Marras Connie, Hazrati Lili-Naz, Liu Louis W C, Lang Anthony E
Morton and Gloria Shulman Movement Disorders Centre and the Edmund J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada.
Mov Disord. 2014 Apr;29(4):444-50. doi: 10.1002/mds.25789. Epub 2013 Dec 26.
An accurate early diagnostic test for Parkinson's disease (PD) is a critical unmet need. Recently, independent groups using different histological techniques have reported that the presence of alpha-synuclein (α-syn) in colonic biopsy tissue is able to distinguish living patients with PD from those without the disease. In addition, a further study has suggested that the presence of α-syn in colonic biopsy tissue may be evident in early or even prodromal PD. However, several questions remain regarding the translation of these findings into using the assessment of α-syn deposition in the enteric nervous system as a diagnostic biomarker for prodromal PD. Here we address critical issues related to the location and quantification of enteric α-syn, detection of α-syn with currently available histological techniques, timing of detection of α-syn deposition, and, most crucially, whether enteric α-syn can distinguish those with PD from both healthy individuals and individuals with other related diseases. We conclude that, although enteric α-syn is a very exciting prospect, further studies will be vital to determine whether enteric α-syn deposition has the potential to be the biomarker for prodromal PD that the field so desperately seeks.
帕金森病（PD）的准确早期诊断测试是一项尚未满足的关键需求。最近，使用不同组织学技术的独立研究小组报告称，结肠活检组织中α-突触核蛋白（α-syn）的存在能够区分患有PD的活体患者和未患该病的患者。此外，进一步的研究表明，结肠活检组织中α-syn的存在在早期甚至前驱期PD中可能很明显。然而，关于将这些发现转化为利用对肠神经系统中α-syn沉积的评估作为前驱期PD的诊断生物标志物，仍存在几个问题。在这里，我们讨论与肠α-syn的定位和定量、用现有组织学技术检测α-syn、检测α-syn沉积的时间，以及最关键的是，肠α-syn能否将PD患者与健康个体及其他相关疾病患者区分开来等相关的关键问题。我们得出结论，尽管肠α-syn是一个非常令人兴奋的前景，但进一步的研究对于确定肠α-syn沉积是否有可能成为该领域迫切寻求的前驱期PD的生物标志物至关重要。
