Bedarf Janis Rebecca, Romano Stefano, Heinzmann Silke Sophie, Duncan Anthony, Traka Maria H, Ng Duncan, Segovia-Lizano Daniella, Simon Marie-Christine, Narbad Arjan, Wüllner Ullrich, Hildebrand Falk
Departent of Movement Disorders (PSB), Centre of Neurology, University Hospital Bonn, Bonn, Germany.
German Centre for Neurodegenerative Diseases, DZNE Bonn, Bonn, Germany.
NPJ Parkinsons Dis. 2025 Apr 4;11(1):66. doi: 10.1038/s41531-025-00885-5.
Current treatment of Parkinson's Disease (PD) remains symptomatic, and disease-modifying approaches are urgently required. A promising approach is to modify intestinal microbiota and key metabolites of bacterial fermentation: short-chain fatty acids (SCFA), which are decreased in PD. A prospective, controlled pilot study (DRKS00034528) was conducted on 11 couples (PD patient plus healthy spouse as control (CO)). Participants followed a 4-week diet rich in dietary fibre, including intake of the prebiotic Lactulose. Gut metagenomes, faecal and urinary metabolites, and clinical characteristics were assessed. The dietary intervention significantly augmented faecal SCFA and increased Bifidobacteria spp., reducing PD-related gastrointestinal symptoms. The pre-existing bacterial dysbiosis in PD (depletion of Blautia, Dorea, Erysipelatoclostridium) persisted. Bacterial metabolite composition in faeces and urine positively changed with the intervention: Brain-relevant gut metabolic functions involved in neuroprotective and antioxidant pathways, including S-adenosyl methionine, glutathione, and inositol, improved in PD. These promising results warrant further investigation in larger cohorts.
帕金森病（PD）目前的治疗仍以对症治疗为主，迫切需要能够改变疾病进程的治疗方法。一种有前景的方法是调节肠道微生物群以及细菌发酵的关键代谢产物：短链脂肪酸（SCFA），其在帕金森病患者体内含量降低。我们对11对夫妇（帕金森病患者及其作为对照（CO）的健康配偶）开展了一项前瞻性对照试验研究（DRKS00034528）。参与者遵循了为期4周的富含膳食纤维的饮食方案，包括摄入益生元乳果糖。对肠道宏基因组、粪便和尿液代谢产物以及临床特征进行了评估。饮食干预显著增加了粪便中的短链脂肪酸含量，并增加了双歧杆菌属的数量，减轻了与帕金森病相关的胃肠道症状。帕金森病患者中先前存在的细菌生态失调（Blautia、Dorea、Erysipelatoclostridium菌属减少）仍然存在。粪便和尿液中的细菌代谢产物组成随着干预而发生了积极变化：参与神经保护和抗氧化途径的与大脑相关的肠道代谢功能，包括S-腺苷甲硫氨酸、谷胱甘肽和肌醇，在帕金森病患者中得到了改善。这些有前景的结果值得在更大规模的队列中进一步研究。
