Uyar Gizem Özata, Yildiran Hilal
Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Besevler, Ankara, Turkey.
Biosci Microbiota Food Health. 2019;38(4):115-127. doi: 10.12938/bmfh.19-002. Epub 2019 Jun 29.
Parkinson's disease (PD) is a neurodegenerative disease characterized by motor impairment and the accumulation of alpha-synucleinopathy (α-syn), which can affect different levels of the brain-gut axis. There is a two-way communication between the gastrointestinal tract, and brain that includes the gut microbiota. This bidirectional communication between the gut microbiota and the brain includes many pathways, such as immune mechanisms, the vagus nerve, and microbial neurometabolite production. The common cause of constipation in PD is thought to be the accumulation of α-syn proteins in the enteric nervous system. Recent studies have focused on changes in microbial metabolites and gut microbiota dysbiosis. Microbiota dysbiosis is associated with increased intestinal permeability, intestinal inflammation, and neuroinflammation. Many factors, such as unbalanced nutrition, antibiotic use, age, and infection, result in alteration of microbial metabolites, triggering α-syn accumulation in the intestinal mucosa cells. Increased evidence indicates that the amount, type, and balance of dietary macronutrients (carbohydrates, proteins, and fats); high consumption of vegetables, fruits, and omega-3 fatty acids; and healthy diet patterns such as the Mediterranean diet may have a great protective impact on PD. This review focuses on the potential benefits of prebiotics, probiotics, and synbiotics to regulate microbiota dysbiosis along with the effect of diet on the gut microbiota in PD.
帕金森病（PD）是一种神经退行性疾病，其特征为运动障碍和α-突触核蛋白病（α-syn）的积累，可影响脑-肠轴的不同层面。胃肠道与包括肠道微生物群在内的大脑之间存在双向沟通。肠道微生物群与大脑之间的这种双向沟通包括许多途径，如免疫机制、迷走神经和微生物神经代谢产物的产生。PD患者便秘的常见原因被认为是肠神经系统中α-syn蛋白的积累。最近的研究集中在微生物代谢产物的变化和肠道微生物群失调上。微生物群失调与肠道通透性增加、肠道炎症和神经炎症有关。许多因素，如营养不均衡、使用抗生素、年龄和感染，都会导致微生物代谢产物的改变，引发α-syn在肠黏膜细胞中的积累。越来越多的证据表明，膳食宏量营养素（碳水化合物、蛋白质和脂肪）的数量、类型和平衡；蔬菜、水果和ω-3脂肪酸的高摄入量；以及地中海饮食等健康饮食模式可能对PD具有很大的保护作用。本综述重点关注益生元、益生菌和合生元在调节微生物群失调方面的潜在益处，以及饮食对PD患者肠道微生物群的影响。
