Guo Mengqi, Gao Han, Wang Yuan, Xiang Yuanyuan
Department of Neurology, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Neurology, Shandong First Medical University, Jinan, Shandong, China.
Front Neurosci. 2025 Jun 13;19:1574512. doi: 10.3389/fnins.2025.1574512. eCollection 2025.
As a common neurodegenerative disease, Parkinson's disease (PD) is typified by -synuclein (-syn) aggregation and progressive degeneration of dopaminergic neurons within the substantia nigra. Clinical manifestations encompass motor symptoms and non-motor aspects that severely impair quality of life. Existing treatments mainly address symptoms, with no effective disease-modifying therapies available. The gut microbiota refers to the community of microorganisms that colonize the intestinal tract. The gut microbiota, gut, and brain are all connected via a complicated, mutual communication pathway known as the "gut microbiota-gut-brain axis." Gut microbiota dysbiosis is strongly linked to the onset and course of PD, according to growing data. In individuals with PD, gut dysbiosis correlates with clinical phenotype, disease duration, severity, and progression rates. Mechanistically, gut dysbiosis contributes to PD through enhanced intestinal permeability, increased intestinal inflammation and neuroinflammation, abnormal -syn aggregation, oxidative stress, and reduced neurotransmitter synthesis. Therefore, focusing on the gut microbiota is regarded as a potentially effective treatment strategy. Fecal microbiota transplantation (FMT) is an emerging approach to modulate gut microbiota, with the goal of recovering microbiota diversity and function by transferring functional intestinal flora from healthy individuals into patients' gastrointestinal tracts. FMT is expected to become a promising therapy of PD and has a broad research and application prospect. Evidence suggests that FMT may restore gut microbiota, ease clinical symptoms, and provide potential neuroprotective benefits. However, the precise therapeutic mechanisms of FMT in PD remain uncertain, necessitating further research to clarify its effectiveness. This review examines alterations in gut microbiota linked to PD, mechanisms through which gut dysbiosis influences the disease, and the latest advancements in FMT research for treating PD, setting the stage for its clinical application.
作为一种常见的神经退行性疾病,帕金森病(PD)的典型特征是α-突触核蛋白(α-syn)聚集以及黑质内多巴胺能神经元的进行性退化。临床表现包括运动症状和非运动方面,严重损害生活质量。现有的治疗主要针对症状,尚无有效的疾病修饰疗法。肠道微生物群是指定植于肠道的微生物群落。肠道微生物群、肠道和大脑都通过一条复杂的相互交流途径相连,这条途径被称为“肠道微生物群-肠道-脑轴”。越来越多的数据表明,肠道微生物群失调与帕金森病的发病和病程密切相关。在帕金森病患者中,肠道失调与临床表型、疾病持续时间、严重程度和进展速度相关。从机制上讲,肠道失调通过增强肠道通透性、增加肠道炎症和神经炎症、异常的α-突触核蛋白聚集、氧化应激以及减少神经递质合成等方式导致帕金森病。因此,关注肠道微生物群被认为是一种潜在有效的治疗策略。粪便微生物群移植(FMT)是一种新兴的调节肠道微生物群的方法,其目标是通过将健康个体的功能性肠道菌群转移到患者的胃肠道中来恢复微生物群的多样性和功能。FMT有望成为一种有前景的帕金森病治疗方法,具有广阔的研究和应用前景。有证据表明,FMT可能恢复肠道微生物群,缓解临床症状,并提供潜在的神经保护益处。然而,FMT在帕金森病中的精确治疗机制仍不确定,需要进一步研究以阐明其有效性。本综述探讨了与帕金森病相关的肠道微生物群变化、肠道失调影响该疾病的机制以及FMT治疗帕金森病的最新研究进展,为其临床应用奠定基础。