de Guilhem de Lataillade Adrien, Lebouvier Thibaud, Noble Wendy, Leclair-Visonneau Laurène, Derkinderen Pascal
Université de Nantes, Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Nantes, France.
CHU Nantes, Department of Neurology, Nantes, F-44093, France.
Free Neuropathol. 2020 Aug 28;1:26. doi: 10.17879/freeneuropathology-2020-2920. eCollection 2020 Jan.
An accumulating body of literature has emerged in the past 25 years to show that Parkinson's disease (PD) is not only a disorder of the brain but also of the gastrointestinal tract and more generally of the gut-brain axis. Gastrointestinal symptoms occur in almost every PD patient at some point and in nearly every case examined pathologically autopsy studies find alpha-synuclein deposits, the pathological hallmarks of PD, in the enteric nervous system. This concept of 'enteric synucleinopathy' led to the hypothesis that the enteric nervous system might play a pivotal role in the initiation and spreading of PD. Although this hypothesis opens up interesting perspectives on the pathogenesis of neurodegenerative disorders, some important questions are still pending. The present opinion paper describes and compares the physiological and pathophysiological properties of alpha-synuclein in the brain and the enteric nervous system. We conclude that the existing data supports the existence of pathological alpha-synuclein species in the gut in PD. We also discuss if gut-brain interactions are important in other neurodegenerative disorders.
在过去25年里，越来越多的文献表明，帕金森病（PD）不仅是一种脑部疾病，也是一种胃肠道疾病，更广泛地说是一种肠脑轴疾病。几乎每个帕金森病患者在某个阶段都会出现胃肠道症状，并且在几乎每例经病理检查的尸检研究中，都在肠神经系统中发现了α-突触核蛋白沉积，这是帕金森病的病理标志。这种“肠道突触核蛋白病”的概念引发了一种假说，即肠神经系统可能在帕金森病的发病和传播中起关键作用。尽管这一假说为神经退行性疾病的发病机制开辟了有趣的视角，但一些重要问题仍悬而未决。本观点论文描述并比较了α-突触核蛋白在大脑和肠神经系统中的生理和病理生理特性。我们得出结论，现有数据支持帕金森病患者肠道中存在病理性α-突触核蛋白。我们还讨论了肠脑相互作用在其他神经退行性疾病中是否重要。
