Neuropathology studies have shown that the Parkinson's disease, one of the most common neurodegenerative disorders, may start from the gut enteric nervous system and then spread to the central dopaminergic neurons through the gut-brain axis.
Metabolomic analysis revealed different gut microbiomes and gut metabolites in patients with Parkinson disease compared with unaffected controls.
Currently, although dopaminergic treatments and deep brain stimulation can provide some symptomatic benefits for motor symptoms of the disease, but as the disease progresses, these medications become less effective, while at the same time amplifying Parkinson's symptoms (tremor, hallucinations).
Patients whose disease begins in the gut may benefit most from interventions that target the gut microenvironments. In this review, the authors summarize the currently available evidence for targeting the gut microbiota in Parkinson disease.
Probiotics such as Lactobacillus rhamnosus GG, Bifidobacterium animalis lactis, Lacobacillus plantarum PS128 , Clostridium butyricum, Bifidobacterium bifidum, L. fermentum, Lactobacillus reuteri, lactis Probio-M8, and Lactobacillus acidophilus. Nota Bene: L. acidophilus, B. bifidum, L. reuteri, L. fermentum reduced gene expressions of inflammatory markers (IL-1, IL-8, TNF-α) and increased expressions of TGF-β and PPAR-γ in the blood of participants. Abnormal insulin-related signaling pathway was observed in people with Parkinson disease and PPAR-γ plays a vital role in the regulation of many signaling pathways, including regulating insulin sensitivity, carbohydrate and lipid homoeostasis and mitochondrial biogenesis.
Prebiotics: Prebiotics are non-digestible food ingredients, generally attributed to dietary fibers, that selectively stimulate the growth or activity of some genera of microorganisms to beneficially affect the host's health. One recent open-label clinical trial with 87 participants showed improvement of non-motor symptom scores, reduced fecal inflammatory marker of calprotectin and increased fecal butyrate in patients with PD who received prebiotic supplement with resistant starch compared to those without prebiotic intervention.
Fecal microbiota transplantation: Indeed it's hard to identify the characteristics of a "good" fecal microbiata in the case of Parkinson. Increased abundance of Blautia and Prevotella and lower abundance of Bacteroidetes may be of some interest.
Live biotherapeutic products: Two gut bacterial strains, Parabacteroides distasonis (MRX0005) and Megasphaera massiliensis (MRX0029) may help patients. Genetically modified strains are studied on animal models