Department of Neurology, University Medical Center Groningen, University of Groningen, The Netherlands.
Behavioral and Cognitive Neurosciences, University of Groningen, The Netherlands.
J Parkinsons Dis. 2019;9(s2):S371-S379. doi: 10.3233/JPD-191802.
Faecal microbiome transplantation (FMT) is an attractive technique, because the administration is relatively simple and in general has a mild adverse effect pattern. Moreover, FMT consists of a broad mixture, which could be beneficial, because at this moment it is not known what type of changes in the microbiome are needed. However, except from a few cases no clinical data in Parkinson's disease (PD) is available yet. There is some indication that FMT might be beneficial in severe constipated PD patients, but the clinical data to support this are very scarce. So, actually there are no good data in the public domain to support FMT at this moment in PD patients. FMT at this moment is a black box with too many unanswered questions, also with respect to safety concerns. Only the administration of species of Lactobacillus and Bifidobacterium over a time period of four to twelve weeks has repeatedly proven to be effective in treating constipation in PD. Also, no solid clinical data are available about the possible effects of probiotic treatment on motor symptoms or progression of PD. Therefore, also probiotic treatments in PD should wait until better clinical data become available, in order to select the right target populations and to have good estimates of the clinical effects to be expected.
粪便微生物群移植（FMT）是一种有吸引力的技术，因为其给药相对简单，并且通常具有温和的不良反应模式。此外，FMT 由广泛的混合物组成，这可能是有益的，因为目前尚不清楚需要对微生物群进行何种类型的改变。然而，除了少数情况外，目前在帕金森病（PD）中尚无临床数据。有一些迹象表明 FMT 可能对严重便秘的 PD 患者有益，但支持这一点的临床数据非常有限。因此，实际上目前在 PD 患者中没有良好的公开数据支持 FMT。目前，FMT 是一个黑盒子，有太多未解答的问题，也存在安全方面的担忧。只有在四到十二周的时间内给予乳酸菌和双歧杆菌等物种，才能反复证明对 PD 患者的便秘有效。此外，关于益生菌治疗对运动症状或 PD 进展的可能影响，也没有确凿的临床数据。因此，PD 中的益生菌治疗也应等到有更好的临床数据可用，以便选择合适的目标人群，并对预期的临床效果有良好的估计。
