Wednesday, 21 November, 2018

Parkinson's disease 'may' start in gut

Image credit Funding Neuro Image credit Funding Neuro
Celia Hoffman | 03 November, 2018, 20:30

Having your appendix removed could lower the risk of getting Parkinson's disease by 20 percent, says a team of researchers in a new study.

Researchers at the Van Andel Research Institute, in MI, looked at data on 1.7 million people over half a century.

"Our studies suggest that the appendix might be a tissue site that plays a role in the early events or initiation of Parkinson's disease". These aggregations are called Lewy bodies, and they're made up largely of a protein called alpha synuclein.

"If it were to enter the brain, it can seed and spread from there and have neurotoxic effects that could eventually lead to Parkinson's disease", she said. This builds on previous research indicating that, for some, Parkinson's starts in the gut.

Study coauthor Viviane Labrie, an assistant professor at the Van Andel Research Institute in MI, doesn't go quite as far, telling CNN the disease is a multisystem disorder, "so there's likely to be many sites of origin in terms of where Parkinson's disease starts, the [gastrointestinal tract] being one of them".

Knowing that people with Parkinson's also suffer from gastrointestinal disorders like constipation at least 10 years before the disease's better known symptoms like tremors, stiffness, and poor balance appear, researchers chose to take a closer look at the appendix and its potential role. There have even been promising signs that Parkinson's may be on the ever-growing list of conditions treatable by that most disgusting of miracle remedies, fecal transplants.

"Despite having a reputation as largely unnecessary, the appendix actually plays a major part in our immune systems, in regulating the makeup of our gut bacteria and now, as shown by our work, in Parkinson's disease", senior author Viviane Labrie from Van Andel Research Institute in MI told The Guardian. Labrie said that the appendix was just one possible place for the disease to start, but there are likely other origin points. And while the relationship between the appendix and Parkinson's is unknown, it may be that the appendix is a source of seeding-competent aggregates of alpha-synuclein which could migrate into the central nervous system through the vagal nerve, she added. He said he found the study results convincing.

In the Swedish registry, the researchers identified 551,647 people who had an appendectomy, matching each person to two control individuals who didn't have an appendectomy. All told, it comprises 92 million person-years of data. They imaged 48 appendixes taken from people without Parkinson's.

In the meantime, researchers are making progress on treating Parkinson's, which affects 1 million Americans, via other methods.

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Commenting on the study, Claire Bale, Head of Research at Parkinson's United Kingdom, said: "The finding that removing the appendix early in life can reduce risk of Parkinson's suggests that it may play a contributing role in the loss of brain cells".

Alpha-synuclein is known for its ability to move around the body.

That meant that Parkinson's risk had dropped by 19.3 percent among those who had had their appendix removed. She explained that drug therapies could target this finding to prevent Parkinson's disease.

Their study was published Wednesday in the journal Science Translational Medicine.

The proteins themselves aren't the sole culprit behind the disease, though. It's only in the rare cases that they escape to the brain that Parkinson's occurs.

About one in 40 Britons develops Parkinson's, a condition in which the brain becomes increasingly degraded.

More research is needed to clarify that connection between the microbiome, the appendix and Parkinson's, but Labrie suggested that the immune system may play an important role. It's another piece of evidence that an environmental trigger of some sort - perhaps pesticides - helps to kick off the disease, thought what that might be is unknown.

The find gives Parkinson's researchers a new focus for their work, and it also hints at a new path for treatments. Potentially, the protein can travel up the vagus nerve connecting the gastrointestinal tract and the brain.

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