Department of Neurology, Affiliated Hospital of Hebei University, Baoding, China.
Front Cell Infect Microbiol. 2021 Mar 8;11:619354. doi: 10.3389/fcimb.2021.619354. eCollection 2021.
Parkinson's disease (PD) is the most common movement disorder in the world, affecting 1-2 per 1,000 of the population. The main pathological changes of PD are damage of dopaminergic neurons in substantia nigra of the central nervous system and formation of Lewy bodies. These pathological changes also occur in the intestinal tract and are strongly associated with changes in intestinal flora. By reviewing the research progress in PD and its association with intestinal flora in recent years, this review expounded the mechanism of action between intestinal flora and PD as well as the transmission mode of α - synuclein in neurons. In clinical studies, β diversity of intestinal flora in PD patients was found to change significantly, with and Verrucomicrobiaceae being significantly increased and Lachnospiraceae and Prevotellaceae being significantly decreased. In addition, a longer PD course was associated with fewer bacteria and probiotics producing short chain fatty acids, but more pathogenic bacteria. Moreover, the motor symptoms of PD patients may be related to Enterobacteriaceae and bacteria. Most importantly, catechol-O-methyltransferase inhibitors and anticholinergic drugs could change the intestinal flora of PD patients and increase the harmful flora, whereas other anti-PD drugs such as levodopa, dopamine agonist, monoamine oxidase inhibitors, and amantadine did not have these effects. Probiotics, prebiotics, and synbiotics treatment had some potential values in improving the constipation of PD patients, promoting the growth of probiotics, and improving the level of intestinal inflammation. At present, there were only a few case studies and small sample studies which have found certain clinical efficacy of fecal microbiome transplants. Further studies are necessary to elaborate the relationship of PD with microbes.
帕金森病（PD）是世界上最常见的运动障碍，每 1000 人中就有 1-2 人受到影响。PD 的主要病理变化是中枢神经系统黑质多巴胺能神经元的损伤和路易体的形成。这些病理变化也发生在肠道，并与肠道菌群的变化密切相关。通过回顾近年来 PD 及其与肠道菌群的研究进展，本文阐述了肠道菌群与 PD 之间的作用机制以及α-突触核蛋白在神经元中的传递方式。在临床研究中，发现 PD 患者肠道菌群的β多样性发生了显著变化，和 Verrucomicrobiaceae 显著增加，Lachnospiraceae 和 Prevotellaceae 显著减少。此外，PD 病程较长与细菌数量减少和产生短链脂肪酸的益生菌减少，但致病性细菌增多有关。而且，PD 患者的运动症状可能与肠杆菌科和细菌有关。最重要的是，儿茶酚-O-甲基转移酶抑制剂和抗胆碱能药物会改变 PD 患者的肠道菌群，增加有害菌群，而其他抗 PD 药物如左旋多巴、多巴胺激动剂、单胺氧化酶抑制剂和金刚烷胺则没有这些作用。益生菌、益生元和合生元治疗在改善 PD 患者便秘、促进益生菌生长和改善肠道炎症水平方面具有一定的潜在价值。目前，只有少数病例研究和小样本研究发现粪便微生物群移植具有一定的临床疗效。需要进一步的研究来阐述 PD 与微生物的关系。
