Miyaue Noriyuki, Yamamoto Haruto, Liu Shuang, Ito Yuko, Yamanishi Yuki, Ando Rina, Suzuki Yasuyuki, Mogi Masaki, Nagai Masahiro
Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
NPJ Parkinsons Dis. 2025 Mar 18;11(1):49. doi: 10.1038/s41531-025-00903-6.
Multiple factors affect the absorption of orally administered levodopa, the gold standard for the treatment of Parkinson's disease (PD). Enterococcus faecalis (E. faecalis) expresses the enzyme tyrosine decarboxylase (tyrDC), which metabolizes levodopa into dopamine and thereby may influence its absorption in patients with PD. This study investigated the association between fecal E. faecalis and tyrDC gene levels and the pharmacokinetics of orally administered levodopa in 21 patients with PD. Our results revealed a significant association between elevated fecal levels of E. faecalis and tyrDC gene levels and reduced peak plasma levodopa concentrations. Additionally, among patients receiving levodopa-carbidopa intestinal gel treatment, strong positive correlations were observed between E. faecalis and tyrDC gene levels in fecal samples and those from the tip of the jejunal tube. Further prospective studies are required to explore the potential role of gut microbiota as a therapeutic target in patients with PD.
多种因素会影响口服左旋多巴（治疗帕金森病（PD）的金标准）的吸收。粪肠球菌（E. faecalis）表达酪氨酸脱羧酶（tyrDC），该酶可将左旋多巴代谢为多巴胺，从而可能影响PD患者对其的吸收。本研究调查了21例PD患者粪便中粪肠球菌和tyrDC基因水平与口服左旋多巴药代动力学之间的关联。我们的结果显示，粪便中粪肠球菌水平升高与tyrDC基因水平升高以及血浆左旋多巴峰值浓度降低之间存在显著关联。此外，在接受左旋多巴-卡比多巴肠凝胶治疗的患者中，粪便样本和空肠管尖端样本中的粪肠球菌与tyrDC基因水平之间观察到强正相关。需要进一步的前瞻性研究来探索肠道微生物群作为PD患者治疗靶点的潜在作用。
