Benvenuti Laura, Di Salvo Clelia, Bellini Gabriele, Seguella Luisa, Rettura Francesco, Esposito Giuseppe, Antonioli Luca, Ceravolo Roberto, Bernardini Nunzia, Pellegrini Carolina, Fornai Matteo
Unit of Pharmacology and Pharmacovigilance, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Front Pharmacol. 2024 Jun 21;15:1407925. doi: 10.3389/fphar.2024.1407925. eCollection 2024.
Parkinson's disease (PD) is a common and slow-progressing neurodegenerative disorder characterized by motor and non-motor symptoms, including gastrointestinal (GI) dysfunctions. Over the last years, the microbiota-gut-brain (MGB) axis is emerging as a bacterial-neuro-immune ascending pathway that contributes to the progression of PD. Indeed, PD patients are characterized by changes in gut microbiota composition, alterations of intestinal epithelial barrier (IEB) and enteric neurogenic/inflammatory responses that, besides determining intestinal disturbances, contribute to brain pathology. In this context, despite the causal relationship between gut dysbiosis, impaired MGB axis and PD remains to be elucidated, emerging evidence shows that MGB axis modulation can represent a suitable therapeutical strategy for the treatment of PD. This review provides an overview of the available knowledge about the beneficial effects of gut-directed therapies, including dietary interventions, prebiotics, probiotics, synbiotics and fecal microbiota transplantation (FMT), in both PD patients and animal models. In this context, particular attention has been devoted to the mechanisms by which the modulation of MGB axis could halt or slow down PD pathology and, most importantly, how these approaches can be included in the clinical practice.
帕金森病（PD）是一种常见的、进展缓慢的神经退行性疾病，其特征为运动和非运动症状，包括胃肠（GI）功能障碍。在过去几年中，微生物群-肠-脑（MGB）轴作为一条细菌-神经-免疫上行通路逐渐显现，它在帕金森病的进展中发挥作用。实际上，帕金森病患者的特征是肠道微生物群组成发生变化、肠上皮屏障（IEB）改变以及肠道神经源性/炎症反应改变，这些变化除了导致肠道紊乱外，还会促成脑部病变。在这种情况下，尽管肠道菌群失调、MGB轴受损与帕金森病之间的因果关系仍有待阐明，但新出现的证据表明，调节MGB轴可能是治疗帕金森病的一种合适的治疗策略。本综述概述了关于肠道定向治疗（包括饮食干预、益生元、益生菌、合生元和粪便微生物群移植（FMT））对帕金森病患者和动物模型有益作用的现有知识。在这种背景下，特别关注了调节MGB轴可以阻止或减缓帕金森病病理进程的机制，以及最重要的是，这些方法如何能够纳入临床实践。
