How your gut might hold clues to Parkinson's disease

1. Gut Microbiome Imbalance (Dysbiosis):
Research shows Parkinson's disease patients have a different gut microbial profile which distinguished them from regular individuals with healthy intestine composition. The condition resulting from these imbalances of good and bad bacteria goes by the medical terms dysbiosis and Leak Gut.

The bacterial population in Parkinson's disease patients shows decreased Prevotella levels and elevated counts of both Bifidobacterium dentium plus Escherichia coli along with Klebsiella pneumoniae which have potential inflammatory effects.
Studies demonstrate that the aggregation of alpha-synuclein protein occurs when Desulfovibrio bacteria strains interact with Parkinson's patient brain tissue.


2. The Role of Alpha-Synuclein:

Throughout Parkinson's patients' bodies alpha-synuclein accumulates as the disease's hallmark protein since this protein exists both throughout brain tissue and in the enteric nervous system (ENS).
According to several researchers alpha-synuclein begins as a gut-based pathology which travels to the brain through the vagus nerve that connects the gut to brain structures.

The "gut-first" theory becomes stronger by two key findings which indicate gastrointestinal afflictions emerge before Parkinson disease symptoms become noticeable and people who undergo vagotomy procedures show reduced PD vulnerability.


3. Inflammation and Immune Response:

The inflammation triggered in this area contributes toward brain neuroinflammation which plays a vital role in the advancement of Parkinson's disease.

Metabolites made by gut bacteria travel to brain tissue to affect tissue damage as well as increase inflammation. Gut bacteria activate immune cells which later migrate to the brain to possibly cause damage to brain cells.

Gastrointestinal Symptoms in Parkinson's:

Gastrointestinal problems affect many Parkinson's disease patients causing severe disability because they represent major nonmotor symptoms in this condition. These can include:

The condition of constipation appears very frequently in patients now and usually develops before the onset of motor symptoms.

** Difficulty swallowing (dysphagia)
** Delayed stomach emptying (gastroparesis)
** Nausea and vomiting
** Bloating and abdominal discomfort

The symptoms arise from Parkinson's disease affecting the ENS and from pharmacological treatment of Parkinson's disease. The medications taken by these patients might experience reduced absorption because of this.


5. Diagnostic and Therapeutic Potential:

Parkinson's patients demonstrate specific gut microbial patterns which may become useful biomarkers for future diagnostic purposes.
The therapeutic value of gut microbiome treatment represents a promising approach for Parkinson's disease care. Strategies being explored include:
The use of probiotics together with prebiotics represents a strategy to enhance healthy gut bacterial growth.
A) Fecal microbiota transplantation (FMT) involves transferring stool from a healthy donor to a patient to achieve recovery of their gut microbiome balance.
Canadians who follow high-fiber or vegetarian diets tend to experience reduced inflammation through their managed gut microbiome.

(Dr Virajrao Kore, Consultant Geriatrician, Ruby Hall Clinic, Pune)