背景:最近的进展强调了肠道生态失调与帕金森病(PD)之间的关系。从PD患者到小鼠的微生物群移植可以诱导增加的α-突触核蛋白介导的运动缺陷。人类研究已经确定了与健康对照相比,PD患者的肠道微生物群的差异。我们进行了系统的审查,以评估肠道细菌参与PD病因的现有证据。
方法:PubMed数据库,中国国家知识基础设施数据库,和万方数据从开始到2021年6月进行搜索,以确定人类病例对照研究,这些研究调查了PD与从粪便中量化的微生物群之间的关系。我们评估了所得的研究,重点是PD患者和健康对照之间不同的细菌分类群。
结果:26项研究发现,其中53个微生物家族和98个属在PD患者和健康对照之间表现出差异。通过两项以上的研究确定的PD增加的属是双歧杆菌,Alistipes,Christensenella,肠球菌,螺旋体,双亲,Desulfovibrio,大肠杆菌/志贺氏菌,和Akkermansia,而Prevotella,Blautia,粪杆菌,镰刀菌,并且嗜血杆菌在PD患者中有3个或3个以上的较低的报告。不止一份报告表明拟杆菌,Odoribacter,副杆菌属,Butyricicocus,Butyrivibrio,梭菌属,球菌,落叶螺旋体,乳酸菌,Megasphaera,相颈杆菌,罗斯布里亚,Ruminococus,链球菌,和克雷伯菌在两个方向上都发生了改变。
结论:我们的综述表明,肠道微生物组参与PD的病因学可能涉及产生短链脂肪酸(SCFAs)的细菌的改变和推定的肠道病原体的增加。产生SCFA的细菌可能高于或低于最佳范围,“造成不平衡。考虑到双歧杆菌,乳酸菌,Akkermansia对人类健康有益,PD肠道微生物组中双歧杆菌和乳杆菌的增加可能与PD药物有关,尤其是COMT抑制剂,而高水平的Akkermansia可能与衰老有关。
Recent advances have highlighted the relationships between gut dysbiosis and Parkinson\'s disease (PD). Microbiota transplantation from PD patients to mice can induce increased alpha-synuclein-mediated motor deficits. Human studies have identified differences in the gut microbiota of PD patients compared to healthy controls. We undertook a systematic
review to evaluate the available evidence for the involvement of gut bacteria in the etiology of PD.
The PubMed databank, the China National Knowledge Infrastructure databank, and Wanfang Data were searched from inception until June 2021 to identify human case-control studies that investigated relationships between PD and microbiota quantified from feces. We evaluated the resulting studies focusing on bacterial taxa that were different between PD patients and healthy controls.
Twenty-six studies were found in which 53 microbial families and 98 genera exhibited differences between patients with PD and healthy controls. The genera identified by more than two studies as increased in PD were Bifidobacterium, Alistipes, Christensenella, Enterococcus, Oscillospira, Bilophila, Desulfovibrio, Escherichia/Shigella, and Akkermansia, while Prevotella, Blautia, Faecalibacterium, Fusicatenibacter, and Haemophilus had three or more reports of being lower in PD patients. More than one report demonstrated that Bacteroides, Odoribacter, Parabacteroides, Butyricicoccus, Butyrivibrio, Clostridium, Coprococcus, Lachnospira, Lactobacillus, Megasphaera, Phascolarctobacterium, Roseburia, Ruminococcus, Streptococcus, and Klebsiella were altered in both directions.
Our
review shows that the involvement of the gut microbiome in the etiology of PD may involve alterations of short-chain fatty acids (SCFAs)-producing bacteria and an increase in putative gut pathobionts. SCFAs-producing bacteria may vary above or below an \"optimal range,\" causing imbalances. Considering that Bifidobacterium, Lactobacillus, and Akkermansia are beneficial for human health, increased Bifidobacterium and Lactobacillus in the PD gut microbiome may be associated with PD medications, especially COMT inhibitors, while a high level of Akkermansia may be associated with aging.