Abstract
Parkinson’s disease (PD) is a multifactorial neurodegenerative disorder that currently affects 1% of the population over the age of 60 years, and for which no disease-modifying treatments exist. Neurodegeneration and neuropathology in different brain areas are manifested as both motor and non-motor symptoms in patients. Recent interest in the gut–brain axis has led to increasing research into the gut microbiota changes in PD patients and their impact on disease pathophysiology. As evidence is piling up on the effects of gut microbiota in disease development and progression, another front of action has opened up in relation to the potential usage of microbiota-based therapeutic strategies in treating gastrointestinal alterations and possibly also motor symptoms in PD. This review provides status on the different strategies that are in the front line (i.e., antibiotics; probiotics; prebiotics; synbiotics; dietary interventions; fecal microbiota transplantation, live biotherapeutic products), and discusses the opportunities and challenges the field of microbiome research in PD is facing.
Highlights
Parkinson’s disease (PD) is the second most common chronic, progressive neurodegenerative disorder after Alzheimer’s disease (AD), affecting 1% of the population over the age of 60 years [1,2]
Evidence from human studies reporting that TLR2 and TLR4 expression is increased in blood and brain samples of PD patients [180], and from animal studies in TLR4-KO mice treated with rotenone [172], strengthen the important role that TLR4 may play in intestinal and brain inflammation
In line with this exciting new field in biomedical research, the gut microbiota has become an increasingly attractive research area in the quest to better understand the pathogenesis of PD and several studies have shown that PD patients have abnormal gut microbiota
Summary
Parkinson’s disease (PD) is the second most common chronic, progressive neurodegenerative disorder after Alzheimer’s disease (AD), affecting 1% of the population over the age of 60 years [1,2]. The most commonly used treatments are dopamine agonists like Levodopa (L-dopa) for dopamine replacement therapy and resulting in an improvement of motor symptoms in the early stage of the disease [36]. They do not influence the rate of clinical disease progression and eventually they cause serious side effects such as motor complications and dyskinesias. It has been shown that alterations in gut microbiota composition and function can lead to dysbiosis, which has been linked to the etiology of multiples GI [51] and non-GI diseases such as anxiety, depression [52], autism [53], spectrum disorders [54], AD [55], and for the interest of this review, PD [24]. The focus of this review is to present in a comprehensive way the currently available evidence of therapeutic strategies modulating the gut microbiota in PD, and discuss the limitations and expectations this emerging field of research is facing
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