Israel Ariel, Magen Eli, Ruppin Eytan, Merzon Eugene, Vinker Shlomo, Giladi Nir
Leumit Research Institute, Leumit Health Services, Tel-Aviv 6473817, Israel.
Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical & Health Sciences, Tel Aviv University, Tel-Aviv 6997801, Israel.
Biomedicines. 2024 Nov 25;12(12):2687. doi: 10.3390/biomedicines12122687.
Parkinson's disease (PD) is a neurodegenerative disorder that progressively damages the autonomic and central nervous systems, leading to hallmark symptoms such as resting tremor, bradykinesia, and rigidity. Despite extensive research, the underlying cause of PD remains unclear, and current treatments are unable to halt the progression of the disease. In this retrospective study, based on historical electronic health records (EHR) from a national health provider covering the period from 2003 to 2023, we investigated the impact of vaccination and medication purchases on PD occurrence and severity. Using a case-control design, we compared the vaccination histories of 1446 PD patients with 7230 matched controls to assess the association between vaccination and PD onset. Additionally, we explored statistical associations between vaccination, medication purchases, and PD severity over an average of 9 years of follow-up, utilizing a machine learning algorithm to quantify disease severity based on annual antiparkinsonian medication purchases. Our analysis revealed a significant reduction in PD occurrence following tetanus-diphtheria (Td) vaccination, with an adjusted odds ratio of 0.17 (95% CI [0.04, 0.70]) for PD onset within 5 years post-vaccination. Furthermore, a time-dependent relationship was identified between the duration since vaccination and both the rate of PD onset and disease progression. Notably, we observed that antimicrobial treatments significantly influenced disease severity, consistent with the antibiotic sensitivity profile of . These findings support the hypothesis that tetanus vaccination and/or eradication may reduce PD occurrence and slow its progression, suggesting promising directions for future research in PD prevention and treatment.
帕金森病（PD）是一种神经退行性疾病，会逐渐损害自主神经系统和中枢神经系统，导致静止性震颤、运动迟缓及僵硬等标志性症状。尽管进行了广泛研究，但PD的根本病因仍不明确，目前的治疗方法无法阻止疾病进展。在这项回顾性研究中，我们基于一家全国性医疗服务机构2003年至2023年期间的历史电子健康记录（EHR），调查了疫苗接种和药物购买对PD发生及严重程度的影响。采用病例对照设计，我们比较了1446例PD患者与7230例匹配对照的疫苗接种史，以评估疫苗接种与PD发病之间的关联。此外，在平均9年的随访期间，我们利用机器学习算法根据每年抗帕金森药物购买量来量化疾病严重程度，探索了疫苗接种、药物购买与PD严重程度之间的统计学关联。我们的分析显示，破伤风-白喉（Td）疫苗接种后PD发生率显著降低，接种后5年内PD发病的校正比值比为0.17（95%置信区间[0.04, 0.70]）。此外，还确定了自接种疫苗以来的持续时间与PD发病率和疾病进展之间的时间依赖性关系。值得注意的是，我们观察到抗菌治疗对疾病严重程度有显著影响，这与……的抗生素敏感性谱一致。这些发现支持了破伤风疫苗接种和/或……根除可能降低PD发生率并减缓其进展的假设，为未来PD预防和治疗研究指明了有前景的方向。
