Suresh Suchith B, Malireddi Aparna, Abera Mahlet, Noor Khutaija, Ansar Mehwish, Boddeti Sruthi, Nath Tuheen Sankar
Internal Medicine, Montefiore St. Luke's Cornwall, Newburgh, USA.
Internal Medicine, Andhra Medical College, Visakhapatnam, IND.
Cureus. 2024 Nov 6;16(11):e73150. doi: 10.7759/cureus.73150. eCollection 2024 Nov.
Parkinson's disease (PD) afflicted more than 8.5 million people globally in 2019, as the prevalence of the condition more than doubled during the preceding 25 years. Both non-motor symptoms, such as mood disorders and cognitive impairment, and motor symptoms, such as tremors and rigidity, are indicative of this progressive neurodegenerative disease. Recent data indicates a significant role for the gut microbiome in PD pathogenesis and progression, emphasizing the microbiota-gut-brain axis. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, this systematic review summarizes our current knowledge about the function of the gut microbiome in PD, highlighting recurrent microbial alterations and assessing microbiome-based treatment strategies. The review revealed several consistent patterns in the gut microbiota of PD patients, including reduced microbial diversity and specific taxonomic alterations, including a drop in abundance and an increase in abundance. Functional changes in the gut microbiome, such as altered short-chain fatty acid (SCFA) production and tryptophan metabolism, were also noted. These microbial changes were observed even in early-stage and drug-naïve PD patients, suggesting they are not merely a consequence of disease progression or medication use. The review highlighted potential mechanisms linking gut microbiome alterations to PD, including increased intestinal permeability, neuroinflammation, and modulation of alpha-synuclein aggregation. Probiotics, prebiotics, and fecal microbiota transplantation are a few interventions that try to modify the gut microbiome and might be possible to halt the advancement of PD and enhance patients' quality of life with the condition. Future research should focus on establishing causality through large-scale longitudinal studies, standardizing microbiome analysis methods, and exploring personalized microbiome-based therapies.
2019年,帕金森病(PD)在全球影响了超过850万人,因为在之前的25年里,该疾病的患病率增加了一倍多。非运动症状,如情绪障碍和认知障碍,以及运动症状,如震颤和僵硬,都是这种进行性神经退行性疾病的表现。最近的数据表明肠道微生物群在PD的发病机制和进展中起重要作用,强调了微生物群-肠道-脑轴。按照系统评价和Meta分析的首选报告项目(PRISMA)2020声明,本系统评价总结了我们目前关于肠道微生物群在PD中的功能的知识,突出反复出现的微生物改变并评估基于微生物群的治疗策略。该评价揭示了PD患者肠道微生物群中的几种一致模式,包括微生物多样性降低和特定的分类学改变,包括丰度下降和丰度增加。还注意到肠道微生物群的功能变化,如短链脂肪酸(SCFA)产生改变和色氨酸代谢改变。即使在早期和未用药的PD患者中也观察到了这些微生物变化,这表明它们不仅仅是疾病进展或药物使用的结果。该评价强调了将肠道微生物群改变与PD联系起来的潜在机制,包括肠道通透性增加、神经炎症和α-突触核蛋白聚集的调节。益生菌、益生元以及粪便微生物群移植是一些试图改变肠道微生物群的干预措施,可能有助于阻止PD的进展并提高患者的生活质量。未来的研究应侧重于通过大规模纵向研究确定因果关系、标准化微生物群分析方法以及探索基于个性化微生物群的疗法。