Department of Neurology, The First Affiliated Hospital, Multi-Omics Research Center for Brain Disorders, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
The First Affiliated Hospital, Clinical Research Center for Immune-Related Encephalopathy of Hunan Province, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Front Immunol. 2023 Jan 25;14:1103053. doi: 10.3389/fimmu.2023.1103053. eCollection 2023.
Parkinson's disease (PD) is a neurodegenerative disorder that frequently occurs in the older population. Previous epidemiological studies have suggested an association between PD and autoimmune diseases (AIDs). However, some studies have shown conflicting results. This study aimed to summarize existing epidemiological studies on the association between PD with AIDs and to conduct a meta-analysis of combinable results. Four electronic databases (PubMed, Embase, Web of Science Core Collection, and MEDLINE) were searched from each database's inception date until December 12, 2022. All studies that explored the relationship between PD and AIDs were included for quantitative analysis and qualitative review. The pooled relative risk with 95% confidence intervals (CIs) was calculated using a random or fixed effects model. A total of 46 observational studies involving 873,643 patients and 13,402,821 controls were included; ultimately, 38 studies were included in the meta-analysis. The risk of PD combined with AIDs was significantly higher (odds ratio [OR]=1.55, 95% CI: 1.33-1.81), and subgroup analysis found no significant differences in risk by study type, gender, age, and race. Regarding the AID types, the results showed an increased risk of PD combined with bullous pemphigoid (OR=2.67, 95% CI: 2.15-3.31), inflammatory bowel disease (OR=1.30, 95% CI: 1.18-1.45), Crohn's disease (OR=1.30, 95% CI: 1.20-1.42), ulcerative colitis (OR=1.31, 95% CI: 1.14-1.50), Sjögren's syndrome (OR=1.61, 95% CI: 1.24-2.09), and Graves' disease (OR=1.45, 95% CI: 1.24-1.70) than controls. However, there appeared to be no significant association between PD and systemic lupus erythematosus (OR=0.82, 95% CI: 0.66-1.03), multiple sclerosis (OR=2.02, 95% CI: 0.87-4.70), rheumatoid arthritis (OR=0.79, 95% CI: 0.61-1.03), or celiac disease (OR=1.16, 95% CI: 0.79-1.69). This study supports the existence of a strong link between AIDs and PD. When PD and AIDs are identified, clinicians need to be aware of the possibility of coexistence. However, there are some limitations of this study, such as the apparent heterogeneity of some of the results and the fact that most of the included study types were retrospective. Therefore, future larger prospective cohort studies are needed to further explore the interaction between PD and AIDs.
INPLASY, identifier INPLASY202280088.
总结帕金森病（PD）与自身免疫性疾病（AIDs）之间关联的现有流行病学研究，并对可合并结果进行荟萃分析。
检索 PubMed、Embase、Web of Science 核心合集和 MEDLINE 从每个数据库的创建日期到 2022 年 12 月 12 日的文献，纳入探索 PD 与 AIDs 之间关系的研究进行定量分析和定性综述。采用随机或固定效应模型计算合并的相对风险及其 95%置信区间（CIs）。
共纳入 46 项观察性研究，涉及 873643 名患者和 13402821 名对照者，最终有 38 项研究纳入荟萃分析。PD 合并 AIDs 的风险显著增加（比值比[OR] = 1.55，95%CI：1.33-1.81），亚组分析显示研究类型、性别、年龄和种族对风险无显著差异。关于 AID 类型，结果显示 PD 合并大疱性类天疱疮（OR = 2.67，95%CI：2.15-3.31）、炎症性肠病（OR = 1.30，95%CI：1.18-1.45）、克罗恩病（OR = 1.30，95%CI：1.20-1.42）、溃疡性结肠炎（OR = 1.31，95%CI：1.14-1.50）、干燥综合征（OR = 1.61，95%CI：1.24-2.09）和格雷夫斯病（OR = 1.45，95%CI：1.24-1.70）的风险高于对照者。然而，PD 似乎与系统性红斑狼疮（OR = 0.82，95%CI：0.66-1.03）、多发性硬化症（OR = 2.02，95%CI：0.87-4.70）、类风湿关节炎（OR = 0.79，95%CI：0.61-1.03）或乳糜泻（OR = 1.16，95%CI：0.79-1.69）之间无显著关联。
该研究支持 AIDs 与 PD 之间存在很强的关联。当 PD 和 AIDs 被识别时，临床医生需要意识到它们可能同时存在。但是，本研究存在一些局限性，例如部分结果存在明显的异质性，并且纳入的大多数研究类型均为回顾性。因此，未来需要更大的前瞻性队列研究来进一步探索 PD 与 AIDs 之间的相互作用。
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