From the Parkinson's Disease and Movement Disorders Center (C.H.A., E.D.-D., A.D.), Department of Neurology, Mayo Clinic, Scottsdale; Banner Sun Health Research Institute (B.N.D., J.H., J.H.-W., G.S., L.I.S., H.A.S., D.G.W., T.G.B.), Sun City; the Department of Otolaryngology (M.L.H., D.G.L., T.N.), Mayo Clinic, Phoenix, AZ; and the Tokyo Institute of Psychiatry (H.A.), Tokyo, Japan.
Neurology. 2014 Mar 11;82(10):858-64. doi: 10.1212/WNL.0000000000000204. Epub 2014 Feb 5.
This study investigates salivary gland biopsies in living patients with Parkinson disease (PD).
Patients with PD for ≥5 years underwent outpatient transcutaneous needle core biopsies (18-gauge or 16-gauge) of 1 submandibular gland. Minor salivary glands were removed via a small incision in the lower lip. Tissue was fixed in formalin and serial 6-µm paraffin sections were immunohistochemically stained for phosphorylated α-synuclein and reviewed for evidence of Lewy type α-synucleinopathy (LTS).
Fifteen patients with PD were biopsied: 9 female/6 male, mean age 68.7 years, mean PD duration 11.8 years. Twelve of the needle core biopsies had microscopically evident submandibular gland tissue to assess and 9/12 (75%) had LTS. Only 1/15 (6.7%) minor salivary gland biopsies were positive for LTS. Five patients had an adverse event; all were minor and transient.
This study demonstrates the feasibility of performing needle core biopsies of the submandibular gland in living patients with PD to assess LTS. Although this was a small study, this tissue biopsy method may be important for tissue confirmation of PD in patients being considered for invasive procedures and in research studies of other PD biomarkers.
本研究调查了帕金森病（PD）患者活体唾液腺活检。
PD 患者≥5 年，接受门诊经皮针芯活检（18 号或 16 号），活检 1 个下颌下腺。在下唇小切口处切除小唾液腺。组织用福尔马林固定，用 6μm 厚石蜡切片进行磷酸化α-突触核蛋白免疫组织化学染色，并检查Lewy 型α-突触核蛋白病（LTS）的证据。
对 15 名 PD 患者进行了活检：9 名女性/6 名男性，平均年龄 68.7 岁，平均 PD 病程 11.8 年。12 个针芯活检有明显的下颌下腺组织可供评估，其中 9/12（75%）有 LTS。仅 1/15（6.7%）的小唾液腺活检 LTS 阳性。5 例患者发生不良事件，均为轻微且短暂。
本研究证明了对 PD 患者活体下颌下腺进行针芯活检以评估 LTS 的可行性。尽管这是一项小型研究，但这种组织活检方法可能对考虑进行有创性操作的 PD 患者和其他 PD 生物标志物研究中的组织确认具有重要意义。
