UW School of Medicine and Public Health, Madison, WI, USA.
Lab. for Enteric NeuroScience (LENS), Translational Research of Gastrointestinal Disorder (TARGID), CHROMETA, University of Leuven, Leuven, Belgium.
Cell Tissue Res. 2018 Jul;373(1):313-326. doi: 10.1007/s00441-018-2856-4. Epub 2018 Jun 14.
Apart from the characteristic and progressive motor- and movement-related problems, Parkinson's disease (PD) patients also suffer from several non-motor symptoms, including gastrointestinal dysfunction. The fact that the enteric nervous system (ENS) controls motility and that one of the typical PD hallmarks, α-synuclein-positive deposits, has also been found in the intestinal wall have rendered the ENS and the gut a popular subject of study in the context of PD. The possibility that these deposits could serve as an early biomarker is obviously of tremendous medical benefit but also the idea that the gut may possibly be a gateway via which the disease is initiated and progressively makes its way via the peripheral nerves to the central nervous system has increased the interest in the ENS-PD link. Furthermore, the fact that gastrointestinal symptoms are present in PD suggests that the ENS might be affected as well. However, despite a large body of literature on the topic, the actual role or the magnitude of involvement of the ENS in PD remains elusive. The multitudes of experimental approaches and animal models have complicated the interpretation of results and the outcome of different studies does not necessarily align well. In this review, we chose to highlight some elements of interest and some items of confusion, particularly those where research should be focusing. We also list a number of open questions in the field that could serve as a guideline for future, preferably concerted research.
除了特征性的进行性运动和运动相关问题外，帕金森病（PD）患者还患有多种非运动症状，包括胃肠道功能障碍。肠神经系统（ENS）控制运动，而 PD 的一个典型特征是α-突触核蛋白阳性沉积物也存在于肠壁中，这使得 ENS 和肠道成为 PD 研究的热门课题。这些沉积物可能作为早期生物标志物的可能性显然具有巨大的医学益处，但也有观点认为，肠道可能是疾病通过外周神经向中枢神经系统传播的途径，这增加了人们对 ENS-PD 联系的兴趣。此外，胃肠道症状存在于 PD 中表明 ENS 也可能受到影响。然而，尽管有大量关于该主题的文献，但 ENS 在 PD 中的实际作用或参与程度仍不清楚。大量的实验方法和动物模型使结果的解释变得复杂，不同研究的结果并不一定完全一致。在这篇综述中，我们选择强调一些有趣的元素和一些混淆的地方，特别是那些应该是研究重点的地方。我们还列出了该领域的一些悬而未决的问题，这些问题可以作为未来（最好是协同）研究的指南。
