Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
J Neurol. 2018 Jan;265(1):12-23. doi: 10.1007/s00415-017-8639-0. Epub 2017 Oct 10.
Parkinson disease (PD) is a multifactorial disease, where a genetic predisposition combines with putative environmental risk factors. Mounting evidence suggests that the initial PD pathological manifestations may be located in the gut to subsequently affect brain areas. Moreover, several lines of research demonstrated that there are bidirectional connections between the central nervous system and the gut, the "gut-brain axis" that influences both brain and gastrointestinal function. This opens a potential therapeutic window suggesting that specific dietary strategies may interact with the disease process and influence the risk of PD or modify its course. Dietary components can also theoretically modulate the chronic activation of the inflammatory response that is associated with aging, the strongest risk factor for PD, that has been suggested to hasten the underlying neurodegenerative process in PD. Here, we reviewed the evidence supporting an association between certain dietary compound and either the risk or progression of PD and have provided an overview of the possible pathomechanisms linking nutrition and neurodegeneration. The results of our review would not support a clear role for any dietary components in reducing the risk or progression of PD. However, the evidence favouring a connection between gut abnormalities, inflammation, and neurodegeneration in PD have become too compelling to be ignored, so that further research, also in the field of nutritional genomics, is highly warranted.
帕金森病（PD）是一种多因素疾病，遗传易感性与潜在的环境风险因素相结合。越来越多的证据表明，PD 的最初病理表现可能位于肠道，随后会影响大脑区域。此外，有几条研究路线表明，中枢神经系统和肠道之间存在双向联系，即“肠脑轴”，它会影响大脑和胃肠道功能。这为治疗提供了潜在的契机，表明特定的饮食策略可能会与疾病进程相互作用，影响 PD 的发病风险或改变其病程。饮食成分还可以理论上调节与衰老相关的慢性炎症反应的激活，衰老被认为是 PD 的最强风险因素，有研究表明它会加速 PD 潜在的神经退行性过程。在这里，我们回顾了支持某些饮食成分与 PD 的发病风险或进展之间存在关联的证据，并概述了营养与神经退行性变之间可能存在的联系的病理机制。我们的综述结果并不支持任何饮食成分在降低 PD 的发病风险或进展方面有明确作用。然而，越来越多的证据表明，PD 中的肠道异常、炎症和神经退行性变之间存在联系，不容忽视，因此非常有必要开展进一步的研究，包括营养基因组学领域的研究。
