Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
J Parkinsons Dis. 2024;14(7):1507-1518. doi: 10.3233/JPD-240172.
There is increasing evidence that microbial-based therapies can be useful in people with Parkinson's disease (PD). In this viewpoint, we provide a state-of-the-art review of the clinical and pre-clinical evidence for probiotics and prebiotics in PD. Currently, short-term clinical studies, including double-blind placebo-controlled randomized clinical trials, have demonstrated safety, and efficacy primarily in improving constipation-related symptoms. Pre-clinical studies consistently reported improvements in a range of biological markers and outcomes, including evidence for attenuation of gut dysfunction and neuroprotection. Bacteria from the genus Lactobacillus and Bifidobacterium have been the most frequently studied both in clinical and pre-clinical probiotics studies, while research into prebiotics is still limited and primarily involved resistant starch and fructooligosaccharides. We provide practical suggestions for clinicians on how to advise patients in the clinic regarding these popular treatments, and important caveats to be aware of. Finally, areas for further advancements are highlighted. It is envisaged that in the future, microbial-based therapies may benefit from personalization based on an enhanced understanding of a whole range of host factors and host-microbiome interactions.
越来越多的证据表明，基于微生物的疗法对帕金森病（PD）患者可能有用。在本观点中，我们对益生菌和益生元在 PD 中的临床前和临床证据进行了最新综述。目前，短期临床研究，包括双盲安慰剂对照随机临床试验，已经证明了安全性和疗效，主要是改善与便秘相关的症状。临床前研究一致报告了一系列生物标志物和结果的改善，包括对肠道功能障碍和神经保护的减弱的证据。在临床和临床前益生菌研究中，属乳酸杆菌和双歧杆菌的细菌是最常被研究的，而对益生元的研究仍然有限，主要涉及抗性淀粉和果寡糖。我们为临床医生提供了如何就这些流行的治疗方法向患者提供建议的实用建议，并提醒注意重要的注意事项。最后，强调了进一步发展的领域。预计在未来，基于微生物的疗法可能会受益于个性化治疗，这需要更深入地了解一系列宿主因素和宿主-微生物组相互作用。
