aLaboratory of Neuroimaging and Alzheimer's Epidemiology bLaboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy cStress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK dMemory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland.
Curr Opin Neurol. 2017 Dec;30(6):630-638. doi: 10.1097/WCO.0000000000000496.
Despite the extensive research carried out in the past decades, the current pathophysiological notions of neurodegenerative disease as well as effective treatments to reduce their progression are largely unknown. Alterations of the human microbiota, the plethora of different microscopic organisms that our body hosts, have been linked to neurodegenerative disease risk, onset and progression. This review summarizes the current knowledge on the possible role of microbiota in neurodegenerative disorders and briefly discusses strategies to restore microbiota homeostasis.
Preclinical evidences and human cross-sectional studies posit the gut microbiota as a key actor in the Parkinson's disease onset and progression, reporting the presence of a specific gut microbiota profile in association with the modulation of disease and symptoms. Gut microbiota alterations have been correlated with brain disease and peripheral inflammation also in Alzheimer's patients.
The interaction between the microbiota and the host is promising to answer clinical questions that have so far escaped clarification with the current pathophysiological notions of health and disease. However, human longitudinal studies starting in the earlier disease phases are needed to understand the causative relation between microbiota and the hallmarks of these neurodegenerative disorders and to develop innovative treatments aimed at preventing or slowing brain damages.
目的综述：尽管过去几十年进行了广泛的研究，但神经退行性疾病的当前病理生理概念以及减少其进展的有效治疗方法在很大程度上仍是未知的。人类微生物组（我们体内存在的大量不同微观生物体）的改变与神经退行性疾病的风险、发病和进展有关。这篇综述总结了微生物组在神经退行性疾病中的可能作用的最新知识，并简要讨论了恢复微生物组平衡的策略。
最新发现：临床前证据和人类横断面研究将肠道微生物组作为帕金森病发病和进展的关键因素，报告了与疾病和症状调节相关的特定肠道微生物组特征的存在。在阿尔茨海默病患者中，肠道微生物组的改变也与大脑疾病和外周炎症有关。
总结：微生物组与宿主之间的相互作用有望回答目前健康和疾病的病理生理概念尚未阐明的临床问题。然而，需要在疾病早期阶段开始的人类纵向研究来了解微生物组与这些神经退行性疾病特征之间的因果关系，并开发旨在预防或减缓脑损伤的创新治疗方法。
