Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch 7602, South Africa.
Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch 7602, South Africa.
Biomolecules. 2020 Dec 29;11(1):30. doi: 10.3390/biom11010030.
Neuronal lesions in Parkinson's disease (PD) are commonly associated with α-synuclein (α-Syn)-induced cell damage that are present both in the central and peripheral nervous systems of patients, with the enteric nervous system also being especially vulnerable. Here, we bring together evidence that the development and presence of PD depends on specific sets of interlinking factors that include neuroinflammation, systemic inflammation, α-Syn-induced cell damage, vascular dysfunction, iron dysregulation, and gut and periodontal dysbiosis. We argue that there is significant evidence that bacterial inflammagens fuel this systemic inflammation, and might be central to the development of PD. We also discuss the processes whereby bacterial inflammagens may be involved in causing nucleation of proteins, including of α-Syn. Lastly, we review evidence that iron chelation, pre-and probiotics, as well as antibiotics and faecal transplant treatment might be valuable treatments in PD. A most important consideration, however, is that these therapeutic options need to be validated and tested in randomized controlled clinical trials. However, targeting underlying mechanisms of PD, including gut dysbiosis and iron toxicity, have potentially opened up possibilities of a wide variety of novel treatments, which may relieve the characteristic motor and nonmotor deficits of PD, and may even slow the progression and/or accompanying gut-related conditions of the disease.
帕金森病(PD)中的神经元病变通常与α-突触核蛋白(α-Syn)诱导的细胞损伤有关,这些损伤存在于患者的中枢和周围神经系统中,其中肠神经系统尤其容易受到影响。在这里,我们汇集了证据表明 PD 的发展和存在取决于一系列特定的相互关联的因素,包括神经炎症、全身炎症、α-Syn 诱导的细胞损伤、血管功能障碍、铁失调以及肠道和牙周微生物失调。我们认为有大量证据表明细菌内毒素会引发这种全身炎症,并且可能是 PD 发展的核心。我们还讨论了细菌内毒素可能参与导致包括α-Syn 在内的蛋白质成核的过程。最后,我们回顾了铁螯合、益生菌、抗生素和粪便移植治疗可能对 PD 有价值的证据。然而,一个非常重要的考虑因素是,这些治疗选择需要在随机对照临床试验中进行验证和测试。然而,针对 PD 的潜在机制,包括肠道微生物失调和铁毒性,为广泛的新型治疗方法提供了可能性,这些方法可能缓解 PD 的特征性运动和非运动缺陷,甚至可能减缓疾病的进展和/或伴随的肠道相关疾病。
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