Elsevier

Ageing Research Reviews

Volume 70, September 2021, 101396
Ageing Research Reviews

Review
The neuromicrobiology of Parkinson’s disease: A unifying theory

https://doi.org/10.1016/j.arr.2021.101396Get rights and content
Under a Creative Commons license
open access

Highlights

  • Parkinson’s disease (PD) is a common progressive neurodegenerative disease with many potential aetiologies.

  • Bacteria are the new players involved in PD onset and progression.

  • Gut microbiome modulates the gut-brain axis by potentiating alpha-synuclein (ASYN) misfolding inducing prion-like PD.

  • Gut microbiome modulates the gut-brain axis inducing gut and brain inflammation leading to immune-like PD.

  • Gut microbiome modulates the gut-brain axis trough gut microbiota metabolites, such as SCFAs.

Abstract

Recent evidence confirms that PD is indeed a multifactorial disease with different aetiologies and prodromal symptomatology that likely depend on the initial trigger. New players with important roles as triggers, facilitators and aggravators of the PD neurodegenerative process have re-emerged in the last few years, the microbes. Having evolved in association with humans for ages, microbes and their products are now seen as fundamental regulators of human physiology with disturbances in their balance being increasingly accepted to have a relevant impact on the progression of disease in general and on PD in particular. In this review, we comprehensively address early studies that have directly or indirectly linked bacteria or other infectious agents to the onset and progression of PD, from the earliest suspects to the most recent culprits, the gut microbiota. The quest for effective treatments to arrest PD progression must inevitably address the different interactions between microbiota and human cells, and naturally consider the gut-brain axis. The comprehensive characterization of such mechanisms will help design innovative bacteriotherapeutic approaches to selectively shape the gut microbiota profile ultimately to halt PD progression. The present review describes our current understanding of the role of microorganisms and their endosymbiotic relatives, the mitochondria, in inducing, facilitating, or aggravating PD pathogenesis.

Keywords

Age-related Parkinson’s disease
Infection
Bacteria
Mitochondria
Gut-brain axis
Gut microbiome
Inflammation

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