帕金森病的脑-肠-微生物轴:历史回顾与未来展望。

Brain-gut-microbiota axis in Parkinson's disease: A historical review and future perspective.

机构信息

Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

Department of Rehabilitation Medicine, the Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou 215228, China.

出版信息

Brain Res Bull. 2022 Jun 1;183:84-93. doi: 10.1016/j.brainresbull.2022.02.015. Epub 2022 Mar 1.

Abstract

Parkinson's disease (PD) is the second most common degenerative disease of the central nervous system (CNS) after Alzheimer's disease. In addition to the typical motor symptoms, the clinical manifestations of patients with PD include gastrointestinal symptoms, which even precede the motor symptoms. Recent research has found that the gut microbiota regulates the brain-gut axial interaction through immune, endocrine, and direct neural mechanisms, supporting the hypothesis that the pathological process of PD spreads from the gut to the brain. In this review article, we highlight the landmark findings in the field of PD, with particular attention to the brain-gut-microbiota axis. We summarize the changes and their clinical effects on the gut microbiota and metabolites observed in PD. The intestinal microbiota may contain appropriate targets for the prevention and treatment of PD. Clinical cohort studies suggest that certain intestinal microbes have protective or pathogenic effects on the progression of PD. A better understanding of the interaction between the gut-brain axis, the gut microbiota, and PD has the potential to lead to new diagnostic and therapeutic approaches. Animal experiments suggest that fecal microbiota transplantation (FMT) is helpful for treating PD, and FMT is expected to be an effective treatment for PD in the future.

摘要

帕金森病(PD)是仅次于阿尔茨海默病的中枢神经系统(CNS)第二大常见退行性疾病。除了典型的运动症状外,PD 患者的临床表现还包括胃肠道症状,甚至早于运动症状。最近的研究发现,肠道微生物群通过免疫、内分泌和直接神经机制调节脑-肠轴相互作用,支持 PD 病理过程从肠道传播到大脑的假说。在这篇综述文章中,我们重点介绍了 PD 领域的里程碑式发现,特别关注脑-肠-微生物群轴。我们总结了 PD 中观察到的肠道微生物群和代谢物的变化及其对临床的影响。肠道微生物群可能包含 PD 预防和治疗的合适靶点。临床队列研究表明,某些肠道微生物对 PD 的进展具有保护或致病作用。更好地理解肠道-大脑轴、肠道微生物群和 PD 之间的相互作用,有可能为诊断和治疗提供新方法。动物实验表明,粪便微生物群移植(FMT)有助于治疗 PD,并且 FMT 有望成为未来 PD 的有效治疗方法。

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