01 January 1970 2 4K Report

Immune system and Inflammation impact on the Gut-Brain axis !

The Gut/Immune/Nervous (GIN) communication

New insights into how immune system and inflammation play a role in Parkinson's Disease

Nov. 2019

https://www.news-medical.net/news/20191114/New-insights-into-how-immune-system-and-inflammation-play-a-role-in-PD.aspx

New research indicates that the earliest stages of Parkinson's disease (PD) may occur in the gut with a likely relation to inflammatory bowel disease (IBD).

Parkinsonism is not just a brain disorder, but a group of diseases that may have their onset in the GIT. It is strongly suggested that individuals with an increased tendency for peripheral inflammation have a higher risk to acquire PD. Given the potentially critical role of gut pathology in the pathogenesis of PD, IBD may impact PD risk.

Peripheral immune system alterations may play a role in PD, which has the potential for new therapeutic strategies. Understanding and appreciating the importance of the so-called gut-brain axis, the connection between gut and the brain in PD, has grown rapidly in recent years.

The inflammatory processes have naturally led to discussion of an association between IBD and PD since the two share some basic characteristics. IBD is currently considered an inappropriate immune response to the microbiota in the intestines, characterized by chronic pro-inflammatory immune activity, a trait now also suggested to be a fundamental element of neurodegenerative disorders.

Highlighting the relevance of the immune system, large genome-wide association studies (GWAS) and pathway analyses identified 17 shared loci between PD and seven autoimmune diseases including celiac disease, rheumatoid arthritis (RA), type 1 diabetes, multiple sclerosis, psoriasis, ulcerative colitis and Crohn's disease.

Many epidemiological and genetic studies have found that there seems to be an increased risk of developing PD among people with IBD. The association between IBD and PD may simply be that IBD is just one type of intestinal inflammation, so it is not IBD specifically that increases the PD risk but perhaps intestinal or peripheral inflammation in a broader sense.

Inflammation of the gut is only one of many symptoms on the list of changes in the gut and is associated with neural structures in PD patients. Thus, IBD might be just one of many sources of intestinal inflammation.

While IBD patients are more likely to get PD, the risk is still very small. Yet, for a given IBD patient, the probability of not getting the diagnosis is 95%-97%.

Future pharmacological therapies aiming at slowing or stopping PD progression should not only target patients well into the course of the disease, but also be administered to patients in the very early phases of the disease or at risk for developing PD.

Clinicians should be aware of early Parkinsonian symptoms in IBD patients but also in patients with chronic inflammatory disorders.

A focus on the potential role of the immune system and of systemic inflammation these neurological diseases is encouraged.

A clear knowledge of the mechanisms implicated in Gut/Immune/Nervous communication could help improve the prognostic and therapeutic tools leading to better quality of life for patients, reducing the exacerbation of PD symptoms, and delaying the progression of the disease.

Parkinson's disease is a slowly progressive disorder that affects movement, muscle control and balance. It is the second most common age-related neurodegenerative disorder affecting about 3% of the population by the age of 65 and up to 5% of individuals over 85 years of age. During the 20th century, PD was thought to be primarily a brain disorder, however, research has shown that it may actually begin in the enteric nervous system, the part of the autonomic nervous system that controls the gastrointestinal organs.

Source: Brudek, T. et al. (2019) Inflammatory Bowel Diseases and Parkinson’s Disease. Journal of Parkinson's Disease. doi.org/10.3233/JPD-191729

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