Scheperjans Filip
aDepartment of Neurology, Helsinki University Hospital bDepartment of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland.
Curr Opin Neurol. 2016 Dec;29(6):773-780. doi: 10.1097/WCO.0000000000000389.
Gastrointestinal dysfunction is highly prevalent in Parkinson's disease and may precede motor symptoms by more than a decade. It has been proposed that the neurodegenerative cascade may actually be initiated in the gut with subsequent spreading to the brain and that gut microbiota could be involved in this process. This review provides a short introduction into the methodology of microbiome-wide association studies and discusses the recently published first comprehensive assessments of gut microbiota in Parkinson's disease.
Three case-control studies have studied gut microbiota composition in Parkinson's disease and all found significant differences between Parkinson's disease patients and controls. However, most of the differentially abundant taxa as well as associations of microbiota with clinical variables differed between studies. This may at least in part be explained by methodological differences between studies in terms of selection of participants, analysis pipelines, statistical analysis, and confounder control.
Current evidence suggests that there are alterations of gut microbiota in Parkinson's disease, but the exact nature of these changes is not established. Future larger studies should assess gut microbiota in Parkinson's disease covering diverse geographical regions, ethnicities, disease stages, and phenotypes using well-defined selection criteria for patients and controls and standardized methodology.
胃肠功能障碍在帕金森病中极为普遍，且可能比运动症状早出现十多年。有人提出，神经退行性级联反应实际上可能始于肠道，随后蔓延至大脑，并且肠道微生物群可能参与了这一过程。本综述简要介绍了全微生物组关联研究的方法，并讨论了最近发表的对帕金森病患者肠道微生物群的首次全面评估。
三项病例对照研究对帕金森病患者的肠道微生物群组成进行了研究，均发现帕金森病患者与对照组之间存在显著差异。然而，不同研究中差异丰富的大多数分类群以及微生物群与临床变量的关联有所不同。这至少部分可以通过研究在参与者选择、分析流程、统计分析和混杂因素控制方面的方法差异来解释。
目前的证据表明帕金森病患者的肠道微生物群存在改变，但这些变化的确切性质尚未明确。未来规模更大的研究应使用针对患者和对照组明确的选择标准以及标准化方法，评估不同地理区域、种族、疾病阶段和表型的帕金森病患者的肠道微生物群。
