Probiotics for dysbiosis in Parkinson's disease

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Cover Wallen ZD, Appah M, Dean Mn, et al. Characteristic dysbiosis of the intestinal microbioma at PD: Evidence of an over -unimination of opportunistic pathogens. NPJ Parkinsons Dis. 2020; 6: 11. Design A case-control study on intestinal microbiom-wide Associations of people with Parkinson's disease (PD) compared to neuro-healthy checks. Participants in the study were presented with two data records. Data record 1 comprised 197 Parkinson's cases and 130 neuro-lovers control persons with participants from Albany, New York, Seattle, Washington and Atlanta, Georgia. Data record 2 comprised 323 Parkinson's cases and 184 neuro-complications control persons from Birmingham, Alabama. Primary result measurements The primary result of this study was the abundance of gastrointestinal microbes and at the same time pattern microbial genera. ...
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reference

Wallen ZD, Appah M, Dean Mn, et al. Characteristic dysbiosis of the intestinal microbioma at PD: Evidence of an over -unimination of opportunistic pathogens. npj Parkinsonson's dis. 2020; 6: 11.

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A case-control study on intestinal microbiom-wide Associations of people with Parkinson's disease (PD) compared to neuro-healthy checks.

participant

Two data records were presented in the study. Data record 1 comprised 197 Parkinson's cases and 130 neuro-lovers control persons with participants from Albany, New York, Seattle, Washington and Atlanta, Georgia. Data record 2 comprised 323 Parkinson's cases and 184 neuro-complications control persons from Birmingham, Alabama.

Primary result measurements

The primary result of this study was the abundance of gastrointestinal microbes and patterns at the same time.

The researchers analyzed all data with and without disruptive factors, including geography, gender, age, constipation in the past 3 months, gastrointestinal complaints, daily fruit and vegetable consumption, body mass index (BMI), alcohol consumption, weight loss and Parkinson's medication.

important knowledge

The researchers discovered 3 cluster, which included 15 different genera in people with Parkinson's, but not with neuro -healthy control persons, which indicates that they are associated with Parkinson's microbes.

cluster 1: Those with PD had a wealth of porphyromonas , Prevotella and Corynebacterium_1 genera compared to controls. Although these microbes are in normal numbers, if they are overgrown in the intestine, they can contribute to the progress of the disease. The authors suggest that the microbes increased at PD could act as opportunistic pathogens.

cluster 2 contained 10 genera that occurred in the 2 cohorts of participants with PD compared to the controls in a lower frequency. The majority of the genera in cluster 2 were anaerobic, gramp -positive bacteria in the ruminococcaceae and Lachnospiraceae families who are known to produce butyrat and other short -chain fatty acids in the intestine.

cluster 3 is the strangest. Although those with PD do not take probiotic nutritional supplements, they had a higher wealth of lactobacilli and bifidobacteria spp.

"The relative frequencies in PD cases (blue) and controls (orange) were applied as a log10 scale on the Y axis. The sample size was 201 cases and 132 checks in data record 1 and 323 cases and 184 checks in data set 2. Each point represents a sample, applied according to the relative frequency of the genus. The confidence interval of the Median. Extend mustache hairs are outliers. " Reprint under Creative Commons 4.0 license.

practice implications

intestinal dysbiosis increasingly occurs in Parkinson's disease. 1-3 While it is tempting to concentrate on the brain in a neurological disease, it is clear that the intestine influences the course of the disease. 1 From a clinical point of view, this study suggests that doctors with Parkinson should address.

What the intestine inhabits and forms the microbioma is mainly influenced by nutrition. Prebiotics, such as those contained in fruit, vegetables, mushrooms and legumes, lead to an increased production of Butyrat, an anti -inflammatory short -chain fatty acid (SFCA). Dearm microbes ferment indigestible oligosaccharides, including onions, leeks, asparagus, artichokes and beets, to produce buty council. However, the endogenous butyrat production depends on the right microbial ways to ferment the fibers, and this study showed that these SCFA-producing microbes are poor in people with Parkinson's (cluster 2).

A strategy to increase butrate includes increasing the amount of fruit and vegetables in the nutrition of people with Parkinson's. In fact, research results indicate that a Mediterranean diet can reduce the risk of Parkinson's or delay the outbreak of the disease. 6-9 Regardless of this can increase a ketogenic diet hydroxybutyrat, and 2 small studies indicate that some people with Parkinson's (but not all) are well on a ketogenic diet Address. 10.11 It is also possible that some people with Parkinson's will need additional butyrat, since only a few SCFA-producing bacteria colonize their large intestine; However, this remains speculative because there are no studies that confirm this presumption.

The increased number of bifidobacterium and lactobacilli indicate that the administration of these special probiotics in people with Parkinson's is not indicated and can actually influence the amount of levodopa medication that is required for symptom control.

Another strategy for increasing the butrate is to prescribe probiotics that contain butyrat-producing microbes. However, free -selling probiotics usually do not contain any lactobacilli spp and bifidobacterium SPP, both of which were more common in the current study in patients with PD. Usually your presence is associated with a cheaper environment for the thrive of the butyrat-producing bacteria. The authors claim that the high occurrence of these popular probiotics could be due to the use of PD medication, including Levodopa. In fact, lactobacilli SPP convert levodopa in dopamine, so that it can be seen as an energy substrate of this genre. The more levodopa/carbidopa one person, the more lactobacilli SPP grow to metabolize it, which then requires the administration of ever higher amounts of levodopa/carbidopa. The absorption of plants and dairy products can also increase lactobacilli and bifidobacterium spp. Alternatively, the lactobacilli and bifidobacterium could be compensatory if the intestine increases its frequency in order to counteract the little SCFA-producing species that occur in the intestine of patients with PD.

The increased number of bifidobacterium and lactobacilli indicate that the administration of these special probiotics in people with Parkinson's is not indicated and that the amount of levodopa medication that is required for symptom control can actually affect. However, there is an earlier study that shows that probiotics (in fermented milk) can reduce constipation in people with Parkinson's 12 - perhaps because lactobacilli increases dopamine that is responsible for intestinal contraction. Regardless of this, the administration of probiotics must be carefully weighed in these patients.

Several recent research studies have shown the effects of non -antibiotic medicines on the microbiom. While PD medication did not affect the excessive growth of pathogenic microbes, these drugs may have reduced the SCFA-producing microbes and the bifidobacterium and lactobacilli spp . It is important to recognize that all drugs and herbs have microbiomical relationships must be taken into account. While we learn how dysbiosis plays a role in Parkinson's, clinicians should be willing to change their long -cherished beliefs about what is useful or possibly harmful in their approach to dysbiosis in this population.

  1. Mulak A, Bonaz B. Brain-Darm microbiota axis in Parkinson's disease. world J Gastroenterol WJG . 2015; 21 (37): 10609-10620.
  2. González-Arancibia C, Urrutia-Piñones J, Illanes-González J, et al. Do your intestinal microbes affect your brain dopamine? Psychopharmacology (Berl) . 2019; 236 (5): 1611-1622.
  3. Sonne MF, Shen YQ. Dysbiosis of the intestinal microbiota and microbial metabolites in Parkinson's disease. aging res rev . 2018; 45:
  4. Holscher Hd. Fillers and prebiotics and the gastrointestinal microbiota. intestinal microbe . 2017; 8 (2): 172-184.
  5. Grembecka M. Sugar alcohols - their role in the modern world of sweeteners: an overview. EUR Food RE Technol . 2015; 241 (1): 1-14.
  6. McCarty Mf. Does a vegan diet reduce the risk of Parkinson's risk? medium hypotheses . 2001; 57 (3): 318-323.
  7. Lange KW, Nakamura Y, Chen N, et al. Nutrition and medical food in Parkinson's disease. food sci hum wellness . 2019; 8 (2): 83-95.
  8. Mischley LK. Nutrition and non-motor symptoms of Parkinson's disease. int. Rev. Neurobiol . 2017; 134: 1143-1161.
  9. Alcalay Rn, Gu Y, Mejia-Santana H, Cote L, Marder KS, Scarmeas N. The connection between compliance with the Mediterranean diet and Parkinson's disease. 2012; 27: 771-774.
  10. Elbarbry F, Nguyen V, Mirka A, Zwickey H, Rosenbaum R. A new validated HPLC method for determining Levodopa: Application to investigate the effects of ketogenic diet on the pharmacokinetics of Levodopa in Parkinson's participants. biomed chromatogr . 2019; 33 (1): E4382.
  11. Phillips MCL, Murtagh DKJ, Gilbertson LJ, Asztely FJS, Lynch CDP. Low -fat versus ketogenic nutrition at Parkinson's: a randomized controlled pilot study. movement disord . 2018; 33 (8): 1306-1314.
  12. Barichella M., Pacchetti C., Bolliri C. et al. Probiotics and prebiotic fiber in the event of constipation in connection with Parkinson's disease: an RCT. neurology . 2016; 87 (12): 1274-1280.
  13. Cussotto S, Stamm Cr, Fouhy F, et al. Different effects of psychotropic drugs on the composition of the microbiome and gastrointestinal function. Psychopharmacology (Berl) . 2019; 236 (5): 1671-1685.
  14. Maier L., Pruteanu M., Kuhn M. et al. Extensive effects of non-antibiotic drugs on human intestinal bacteria. nature . 2018; 555 (7698): 623-628.