Nishiwaki Hiroshi, Hamaguchi Tomonari, Ito Mikako, Ishida Tomohiro, Maeda Tetsuya, Kashihara Kenichi, Tsuboi Yoshio, Ueyama Jun, Shimamura Teppei, Mori Hiroshi, Kurokawa Ken, Katsuno Masahisa, Hirayama Masaaki, Ohno Kinji
Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
mSystems. 2020 Dec 8;5(6):e00797-20. doi: 10.1128/mSystems.00797-20.
Gut dysbiosis has been repeatedly reported in Parkinson's disease (PD) but only once in idiopathic rapid-eye-movement sleep behavior disorder (iRBD) from Germany. Abnormal aggregation of α-synuclein fibrils causing PD possibly starts from the intestine, although this is still currently under debate. iRBD patients frequently develop PD. Early-stage gut dysbiosis that is causally associated with PD is thus expected to be observed in iRBD. We analyzed gut microbiota in 26 iRBD patients and 137 controls by 16S rRNA sequencing (16S rRNA-seq). Our iRBD data set was meta-analyzed with the German iRBD data set and was compared with gut microbiota in 223 PD patients. Unsupervised clustering of gut microbiota by LIGER, a topic model-based tool for single-cell RNA sequencing (RNA-seq) analysis, revealed four enterotypes in controls, iRBD, and PD. Short-chain fatty acid (SCFA)-producing bacteria were conserved in an enterotype observed in controls and iRBD, whereas they were less conserved in enterotypes observed in PD. Genus and family were consistently increased in both iRBD in two countries and PD in five countries. Short-chain fatty acid (SCFA)-producing bacteria were not significantly decreased in iRBD in two countries. In contrast, we previously reported that recognized or putative SCFA-producing genera , , and were consistently decreased in PD in five countries. In α-synucleinopathy, increase of mucin-layer-degrading genus is observed at the stage of iRBD, whereas decrease of SCFA-producing genera becomes obvious with development of PD. Twenty studies on gut microbiota in PD have been reported, whereas only one study has been reported on iRBD from Germany. iRBD has the highest likelihood ratio to develop PD. Our meta-analysis of iRBD in Japan and Germany revealed increased mucin-layer-degrading genus in iRBD. Genus may increase the intestinal permeability, as we previously observed in PD patients, and may make the intestinal neural plexus exposed to oxidative stress, which can lead to abnormal aggregation of prion-like α-synuclein fibrils in the intestine. In contrast to PD, SCFA-producing bacteria were not decreased in iRBD. As SCFA induces regulatory T (Treg) cells, a decrease of SCFA-producing bacteria may be a prerequisite for the development of PD. We propose that prebiotic and/or probiotic therapeutic strategies to increase the intestinal mucin layer and to increase intestinal SCFA potentially retard the development of iRBD and PD.
帕金森病(PD)中反复报道了肠道微生物群失调,但在德国的特发性快速眼动睡眠行为障碍(iRBD)中仅报道过一次。导致PD的α-突触核蛋白原纤维异常聚集可能始于肠道,尽管目前仍存在争议。iRBD患者经常发展为PD。因此,预计在iRBD中会观察到与PD有因果关系的早期肠道微生物群失调。我们通过16S rRNA测序(16S rRNA-seq)分析了26例iRBD患者和137名对照的肠道微生物群。我们的iRBD数据集与德国的iRBD数据集进行了荟萃分析,并与223例PD患者的肠道微生物群进行了比较。使用LIGER(一种基于主题模型的单细胞RNA测序(RNA-seq)分析工具)对肠道微生物群进行无监督聚类,揭示了对照、iRBD和PD中的四种肠型。产生短链脂肪酸(SCFA)的细菌在对照和iRBD中观察到的一种肠型中是保守的,而在PD中观察到的肠型中则不太保守。在两个国家的iRBD和五个国家的PD中,属和科均持续增加。在两个国家的iRBD中,产生短链脂肪酸(SCFA)的细菌没有显著减少。相比之下,我们之前报道过,在五个国家的PD中,公认的或假定的产生SCFA的属、和持续减少。在α-突触核蛋白病中,在iRBD阶段观察到粘蛋白层降解属的增加,而随着PD的发展,产生SCFA的属的减少变得明显。关于PD肠道微生物群的研究已有20项报道,而关于德国iRBD的研究仅报道过1项。iRBD发展为PD的可能性最高。我们对日本和德国的iRBD进行的荟萃分析显示,iRBD中粘蛋白层降解属增加。正如我们之前在PD患者中观察到的,属可能会增加肠道通透性,并可能使肠道神经丛暴露于氧化应激下,这可能导致肠道中朊病毒样α-突触核蛋白原纤维的异常聚集。与PD不同,iRBD中产生SCFA的细菌没有减少。由于SCFA诱导调节性T(Treg)细胞,产生SCFA的细菌减少可能是PD发展的先决条件。我们建议,增加肠道粘蛋白层和增加肠道SCFA的益生元和/或益生菌治疗策略可能会潜在地延缓iRBD和PD的发展。
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