Szandruk-Bender Marta, Wiatrak Benita, Szeląg Adam
Department of Pharmacology, Wroclaw Medical University, Mikulicza-Radeckiego 2, 50-345 Wrocław, Poland.
J Clin Med. 2022 Jun 27;11(13):3704. doi: 10.3390/jcm11133704.
Recently, a growing body of research has linked gut microbiota dysbiosis to central nervous system diseases, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD), and has suggested that AD and PD pathology may take its origin from chronic inflammation in the gastrointestinal tract. Thus, this study aimed to elucidate whether inflammatory bowel disease (IBD) is associated with a higher risk of developing AD and PD as compared to the non-IBD population by conducting a meta-analysis. A thorough search of Pubmed and Embase databases was performed to identify all relevant articles. The quality of included studies was assessed using the Newcastle-Ottawa Scale. The odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed using a fixed-effect model. To assess publication bias and heterogeneity among the studies, Egger’s test and L’Abbé plots were used, respectively. A total of eight eligible studies were included in this meta-analysis. No significant heterogeneity or significant publication bias was detected. The risk of developing AD in IBD patients was higher than in non-IBD patients (OR = 0.37; 95% CI = 0.14−1.00; p = 0.05), and there was a relationship between the occurrence of AD and Crohn’s disease or ulcerative colitis (OR = 0.11; 95% CI = 0.04−0.30; p < 0.0001, OR = 0.14; 95% CI = 0.04−0.49; p = 0.0024, respectively). The risk of developing both of the most common neurodegenerative diseases, AD and PD, was also significantly higher in patients diagnosed with Crohn’s disease or ulcerative colitis (OR = 0.21; 95% CI = 0.09−0.49; p = 0.0003, OR = 0.25; 95% CI = 0.13−0.51; p = 0.0001, respectively). This meta-analysis revealed a higher risk of AD and PD among CD and UC patients compared to the general population. It may suggest a key role for the gut microbiota in the pathogenesis of not only Crohn’s disease and ulcerative colitis but also AD and PD. The identification of this potential risk may provide earlier preventive measures to be implemented to reduce comorbidity and mortality rate.
最近，越来越多的研究将肠道微生物群失调与中枢神经系统疾病联系起来，如阿尔茨海默病（AD）和帕金森病（PD），并表明AD和PD的病理可能起源于胃肠道的慢性炎症。因此，本研究旨在通过进行荟萃分析，阐明与非炎症性肠病（IBD）人群相比，炎症性肠病（IBD）是否与发生AD和PD的更高风险相关。对PubMed和Embase数据库进行了全面检索，以识别所有相关文章。使用纽卡斯尔-渥太华量表评估纳入研究的质量。采用固定效应模型分析95%置信区间（CI）的比值比（OR）。分别使用Egger检验和L’Abbé图评估研究中的发表偏倚和异质性。本荟萃分析共纳入八项符合条件的研究。未检测到显著的异质性或显著的发表偏倚。IBD患者发生AD的风险高于非IBD患者（OR = 0.37；95%CI = 0.14−1.00；p = 0.05），AD的发生与克罗恩病或溃疡性结肠炎之间存在关联（OR分别为0.11；95%CI = 0.04−0.30；p < 0.0001，OR = 0.14；95%CI = 0.04−0.49；p = 0.0024）。在诊断为克罗恩病或溃疡性结肠炎的患者中，发生两种最常见神经退行性疾病AD和PD的风险也显著更高（OR分别为0.21；95%CI = 0.09−0.49；p = 0.0003，OR = 0.25；95%CI = 0.13−0.51；p = 0.0001）。本荟萃分析显示，与普通人群相比，克罗恩病和溃疡性结肠炎患者发生AD和PD的风险更高。这可能表明肠道微生物群不仅在克罗恩病和溃疡性结肠炎的发病机制中起关键作用，而且在AD和PD的发病机制中也起关键作用。识别这种潜在风险可能有助于采取早期预防措施，以降低合并症和死亡率。
