Understanding the Role of Gut Microbes in Parkinson’s Disease: Dr Poonam Chandrashekhar Awatare

Recent research has also put forth various hypotheses establishing the role of commensal gut bacteria in the development of PD. These studies state that commensal gut bacteria have a connection with the brain and contribute to neurodevelopment, brain function, and health.This bi-directional communication between the gut and brain is often referred to as the microbiome-gut-brain axis.

Microbes in the gut lumen can promote inflammatory pathways, cause damage to enterocytes, and compromise gut epithelial barrier integrity, leading to a leaky gut and release of bacterial metabolites like lipopolysaccharides.

The bacterial metabolites can translocate from the gut lumen to the bloodstream, compromise the gut lumen, and cause systemic and neuro-inflammation in the brain.They can also cross the blood-brain barrier, enter the brain, and release various cytokines and chemokines that promote inflammation, forming the pathological foundation for PD.

Immunoreactive alpha-synuclein aggregates that are pathognomic for PD, are also found in peripheral endo-neuronal system in the intestine, supporting the theory of gut role in PD.

Misfolded alpha-synuclein may be induced by microbes at the intersection of the gut lumen and endoneurial system and may propagate to neurons in the brain through the vagus nerve. All these hypotheses suggest there might be a gut relationship for the pathogenesis of Parkinson’s disease.

Management of Parkinson’s Disease

Since PD is a neurodegenerative disease, it has no definitive treatment or cure. However, the progression of symptoms can be controlled with medical interventions. Intervening with prokinetics is one such medical management that helps reverse the gut microbe dysbiosis (reduction in the gut-friendly microbes) to improve gut health and promote the prevention of bacterial translocation, reduction of system and neuronal inflammation, and thereby, contribute to the prevention of PD.

Likewise, some precautions can help prevent PD or slow the progression of symptoms including:

• Avoiding the use of or exposure to pesticides and herbicides
• Using organic food and increasing consumption of fresh and raw green vegetables in the regular diet
• Adopting a healthy diet, avoiding canned fried foods, and regular or diet soda
• Increased intake of omega-3 and vitamin D supplements
• Maintenance of a good gut system with intake of probiotics
• Regular aerobic exercises
• Physical and emotional stress management

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