Chung Sun Ju, Kim Juyeon, Lee Hyo Jeong, Ryu Ho-Sung, Kim Kiju, Lee Jeong Hoon, Jung Kee Wook, Kim Mi Jung, Kim Mi-Jung, Kim Young Jin, Yun Sung-Cheol, Lee Joo-Yong, Hong Seung-Mo, Myung Seung-Jae
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Neurology, Metro hospital, Anyang, South Korea.
Mov Disord. 2016 Feb;31(2):241-9. doi: 10.1002/mds.26473. Epub 2015 Dec 21.
Gastric and colonic alpha-synuclein immunoreactivity has been reported in patients with Parkinson's disease (PD). However, enteric alpha-synuclein also has been reported in healthy individuals.
We aimed to investigate the utility of alpha-synuclein immunoreactivity from gastric and colonic mucosal tissues obtained by routine endoscopy to detect PD, and to correlate the pathological burden of alpha-synuclein with motor and nonmotor features of PD.
We recruited 104 study subjects, consisting of 38 patients with PD, 13 patients with probable multiple system atrophy (MSA), and 53 healthy controls. Gastric and colonic mucosal tissues obtained by endoscopic gastroduodenoscopy and colonoscopy were assessed using alpha-synuclein immunohistochemistry. Detailed motor and nonmotor features of PD were correlated with enteric alpha-synuclein immunoreactivity.
No difference was seen in the enteric α-SYN immunoreactivity among patients with PD (31.6% for stomach and 10.4% for colon), patients with MSA (40.0% for stomach and 8.0% for colon), and healthy controls (33.3% for stomach and 18.5% for colon). The frequency of positive alpha-synuclein immunoreactivity was higher in gastric biopsy tissues than in colonic biopsy tissues in all of the study groups (P < 0.05). No significant correlation was found between the presence of alpha-synuclein immunoreactivity and the motor and nonmotor features of PD.
The presence of alpha-synuclein immunoreactivity in gastric and colonic mucosa was detected in a similar manner in patients with PD, patients with MSA, and controls, thus suggesting a limited role of enteric mucosal alpha-synuclein as a diagnostic biomarker for PD. Future studies are warranted to detect pathological alpha-synuclein strains.
帕金森病（PD）患者中已报道有胃和结肠α-突触核蛋白免疫反应性。然而，健康个体中也有肠道α-突触核蛋白的报道。
我们旨在研究通过常规内镜检查获得的胃和结肠黏膜组织中α-突触核蛋白免疫反应性在检测PD中的效用，并将α-突触核蛋白的病理负担与PD的运动和非运动特征相关联。
我们招募了104名研究对象，包括38例PD患者、13例可能的多系统萎缩（MSA）患者和53名健康对照。通过内镜下胃十二指肠镜检查和结肠镜检查获得的胃和结肠黏膜组织，采用α-突触核蛋白免疫组织化学进行评估。PD的详细运动和非运动特征与肠道α-突触核蛋白免疫反应性相关联。
PD患者（胃为31.6%，结肠为10.4%）、MSA患者（胃为40.0%，结肠为8.0%）和健康对照（胃为33.3%，结肠为18.5%）的肠道α-SYN免疫反应性未见差异。在所有研究组中，胃活检组织中α-突触核蛋白免疫反应性阳性的频率高于结肠活检组织（P<0.05）。未发现α-突触核蛋白免疫反应性的存在与PD的运动和非运动特征之间存在显著相关性。
PD患者、MSA患者和对照中以相似方式检测到胃和结肠黏膜中存在α-突触核蛋白免疫反应性，因此提示肠道黏膜α-突触核蛋白作为PD诊断生物标志物的作用有限。未来有必要开展研究以检测病理性α-突触核蛋白菌株。
