Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China.
Hospital Administration Office, Southern Medical University, Guangzhou, China.
CNS Neurosci Ther. 2023 Jan;29(1):140-157. doi: 10.1111/cns.13990. Epub 2022 Oct 25.
Recent advances have highlighted the relationships between gut dysbiosis and Parkinson's disease (PD). Microbiota transplantation from PD patients to mice can induce increased alpha-synuclein-mediated motor deficits. Human studies have identified differences in the gut microbiota of PD patients compared to healthy controls. We undertook a systematic review to evaluate the available evidence for the involvement of gut bacteria in the etiology of PD.
The PubMed databank, the China National Knowledge Infrastructure databank, and Wanfang Data were searched from inception until June 2021 to identify human case-control studies that investigated relationships between PD and microbiota quantified from feces. We evaluated the resulting studies focusing on bacterial taxa that were different between PD patients and healthy controls.
Twenty-six studies were found in which 53 microbial families and 98 genera exhibited differences between patients with PD and healthy controls. The genera identified by more than two studies as increased in PD were Bifidobacterium, Alistipes, Christensenella, Enterococcus, Oscillospira, Bilophila, Desulfovibrio, Escherichia/Shigella, and Akkermansia, while Prevotella, Blautia, Faecalibacterium, Fusicatenibacter, and Haemophilus had three or more reports of being lower in PD patients. More than one report demonstrated that Bacteroides, Odoribacter, Parabacteroides, Butyricicoccus, Butyrivibrio, Clostridium, Coprococcus, Lachnospira, Lactobacillus, Megasphaera, Phascolarctobacterium, Roseburia, Ruminococcus, Streptococcus, and Klebsiella were altered in both directions.
Our review shows that the involvement of the gut microbiome in the etiology of PD may involve alterations of short-chain fatty acids (SCFAs)-producing bacteria and an increase in putative gut pathobionts. SCFAs-producing bacteria may vary above or below an "optimal range," causing imbalances. Considering that Bifidobacterium, Lactobacillus, and Akkermansia are beneficial for human health, increased Bifidobacterium and Lactobacillus in the PD gut microbiome may be associated with PD medications, especially COMT inhibitors, while a high level of Akkermansia may be associated with aging.
最近的研究进展强调了肠道菌群失调与帕金森病(PD)之间的关系。将 PD 患者的微生物群移植到小鼠中可以诱导增加的α-突触核蛋白介导的运动缺陷。人类研究已经确定了 PD 患者与健康对照组的肠道微生物群存在差异。我们进行了一项系统评价,以评估肠道细菌参与 PD 病因的现有证据。
从 1980 年数据库成立到 2021 年 6 月,我们在 PubMed 数据库、中国国家知识基础设施数据库和万方数据库中搜索了人类病例对照研究,这些研究调查了粪便中量化的 PD 与微生物群之间的关系。我们评估了这些研究,重点关注 PD 患者与健康对照组之间存在差异的细菌分类群。
共发现 26 项研究,其中 53 个微生物科和 98 个属在 PD 患者和健康对照组之间存在差异。有两项以上研究表明在 PD 中增加的属为双歧杆菌、Alistipes、Christensenella、肠球菌、Oscillospira、双岐杆菌、脱硫弧菌、大肠杆菌/志贺氏菌和阿克曼氏菌,而普雷沃特氏菌、布劳特氏菌、粪杆菌、Fusicatenibacter 和嗜血杆菌在 PD 患者中则有三项或更多报告较低。超过一项报告表明,拟杆菌、恶臭杆菌、副拟杆菌、丁酸梭菌、丁酸弧菌、梭菌、粪球菌、lachnospira、乳杆菌、巨球形菌、Phascolarctobacterium、玫瑰菌、真杆菌、链球菌和克雷伯氏菌在两个方向都发生了改变。
我们的综述表明,肠道微生物组在 PD 发病机制中的参与可能涉及短链脂肪酸(SCFA)产生菌的改变和潜在肠道共生菌的增加。SCFA 产生菌的含量可能高于或低于“最佳范围”,导致失衡。考虑到双歧杆菌、乳杆菌和阿克曼氏菌对人体健康有益,PD 肠道微生物组中双歧杆菌和乳杆菌的增加可能与 PD 药物有关,特别是 COMT 抑制剂,而阿克曼氏菌水平较高可能与衰老有关。