帕金森病的治疗与肠道微生物群:双向联系的证据
Therapies for Parkinson's disease and the gut microbiome: evidence for bidirectional connection.
作者信息
Hey Grace, Nair Navya, Klann Emily, Gurrala Anjela, Safarpour Delaram, Mai Volker, Ramirez-Zamora Adolfo, Vedam-Mai Vinata
机构信息
University of Florida, Department of Neurology and Fixel Institute, Gainesville, FL, United States.
University of Florida, Department of Epidemiology and Emerging Pathogens Institute, Gainesville, FL, United States.
出版信息
Front Aging Neurosci. 2023 May 30;15:1151850. doi: 10.3389/fnagi.2023.1151850. eCollection 2023.
The gut brain axis (GBA), a bidirectional communication pathway has often been linked to health and disease, and gut microbiota (GM), a key component of this pathway shown to be altered in Parkinson's disease (PD), are suggested to contribute to the pathogenesis of PD. There are few studies that report the impact of oral medication therapy on GM, however, there are even fewer studies that discuss the impact of other treatments such as device assisted therapies (DAT) including deep brain stimulation (DBS), levodopa-carbidopa intestinal gel infusion (LCIG) and photobiomodulation (PBM) and how these might impact GM. Here, we review the literature and summarize findings of the potential contributions of GM to the heterogenous clinical response to pharmaceutical therapies among individuals with PD. We also discuss the potential interactions between the GM and DATs such as DBS and LCIG and present evidence for alterations in GM in response to DATs. Given the complexity and highly individual nature of the GM of patients with PD and the potential influence that other external factors such as diet, lifestyle, medications, stage of the disease and other comorbidities, further investigations into the response of GM to therapies are worthy of future study in prospective, controlled trials as well as medication naïve individuals. Such detailed studies will help us further comprehend the relationship between GM in PD patients, and will help investigate the potential of targeting GM associated changes as a treatment avenue for PD.
肠脑轴(GBA)是一条双向通信通路,常与健康和疾病相关联,而肠道微生物群(GM)作为该通路的关键组成部分,在帕金森病(PD)中显示发生了改变,被认为与PD的发病机制有关。很少有研究报道口服药物治疗对GM的影响,然而,讨论其他治疗方法(如包括深部脑刺激(DBS)、左旋多巴-卡比多巴肠凝胶输注(LCIG)和光生物调节(PBM)在内的设备辅助治疗(DAT))的影响以及这些治疗如何影响GM的研究更少。在这里,我们回顾了文献并总结了GM对PD患者药物治疗异质性临床反应潜在贡献的研究结果。我们还讨论了GM与DBS和LCIG等DAT之间的潜在相互作用,并提供了GM对DAT反应改变的证据。鉴于PD患者GM的复杂性和高度个体性,以及饮食、生活方式、药物、疾病阶段和其他合并症等其他外部因素的潜在影响,对GM对治疗反应的进一步研究值得在未来的前瞻性对照试验以及未接受过药物治疗的个体中进行。此类详细研究将有助于我们进一步理解PD患者GM之间的关系,并有助于研究针对GM相关变化作为PD治疗途径的潜力。