Skip to main content
Top
Published in: Journal of Neurology 9/2017

01-09-2017 | Short Commentary

Non-CNS pathogenic origin of Parkinson’s disease

Authors: Humdoon Choudhry, Lawrence C. Perlmuter

Published in: Journal of Neurology | Issue 9/2017

Login to get access

Abstract

The gut with its variety of microbiota may serve as an etiological origin of diseases. Gut microbes may also play a role in the pathogenesis of diseases beyond their simple nutritional maintenance and support. For example, gut protein aggregation, possibly aided by microbes as well as nasal influences, might be linked to disease that may move to the brain through the vagus nerve. To this end, Braak has offered a “dual-hit” hypothesis that proposes a novel etiology for Parkinson’s disease (PD). The hypothesis places the initial origin of the disease in the nose and the gastrointestinal tract (GI) after infection by an unknown pathogen that could aggregate in the gut and then eventually spread to the brain via the autonomic plexuses. Gut health functioning, therefore, may affect brain status and behavior. A protein known as alpha-synuclein accumulates in brains of people with Parkinson’s disease that is also present in the GI before the onset of motor symptoms. Therefore, the stomach, previously thought to be a stable mechanism throughout life, might explain some etiological origins of disease. Finally, the vagus nerve of the autonomic system that extends from the brain to the abdomen and exercises both sympathetic and parasympathetic roles might be associated with PD diagnosis along with Lewy body influences.
Literature
1.
go back to reference Hawkes CH, Del Tredici K, Braak H (2007) Parkinson’s disease: a dual-hit hypothesis. Neuropathol Appl Neurobiol 33(6):599–614CrossRefPubMed Hawkes CH, Del Tredici K, Braak H (2007) Parkinson’s disease: a dual-hit hypothesis. Neuropathol Appl Neurobiol 33(6):599–614CrossRefPubMed
2.
go back to reference Braak H, Rüb U, Gai WP, Del Tredici K (2003) Idiopathic Parkinson’s disease: possible routes by which vulnerable neuronal types may be subject to neuroinvasion by an unknown pathogen. J Neural Transm 110(5):517–536CrossRefPubMed Braak H, Rüb U, Gai WP, Del Tredici K (2003) Idiopathic Parkinson’s disease: possible routes by which vulnerable neuronal types may be subject to neuroinvasion by an unknown pathogen. J Neural Transm 110(5):517–536CrossRefPubMed
3.
go back to reference Braak H, Del Tredici K, Rüb U, de Vos RA, Steur ENJ, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24(2):197–211CrossRefPubMed Braak H, Del Tredici K, Rüb U, de Vos RA, Steur ENJ, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24(2):197–211CrossRefPubMed
4.
go back to reference Braak H, de Vos RA, Bohl J, Del Tredici K (2006) Gastric α-synuclein immunoreactive inclusions in Meissner’s and Auerbach’s plexuses in cases staged for Parkinson’s disease-related brain pathology. Neurosci Lett 396(1):67–72CrossRefPubMed Braak H, de Vos RA, Bohl J, Del Tredici K (2006) Gastric α-synuclein immunoreactive inclusions in Meissner’s and Auerbach’s plexuses in cases staged for Parkinson’s disease-related brain pathology. Neurosci Lett 396(1):67–72CrossRefPubMed
5.
go back to reference Shannon KM, Keshavarzian A, Dodiya HB, Jakate S, Kordower JH (2012) Is alpha-synuclein in the colon a biomarker for premotor Parkinson’s Disease? Evidence from 3 cases. Mov Disord 27(6):716–719CrossRefPubMed Shannon KM, Keshavarzian A, Dodiya HB, Jakate S, Kordower JH (2012) Is alpha-synuclein in the colon a biomarker for premotor Parkinson’s Disease? Evidence from 3 cases. Mov Disord 27(6):716–719CrossRefPubMed
6.
go back to reference Sampson TR, Debelius JW, Thron T, Janssen S, Shastri GG, Ilhan ZE, Chesselet MF (2016) Gut microbiota regulate motor deficits and neuroinflammation in a model of Parkinson’s disease. Cell 167(6):1469–1480CrossRefPubMed Sampson TR, Debelius JW, Thron T, Janssen S, Shastri GG, Ilhan ZE, Chesselet MF (2016) Gut microbiota regulate motor deficits and neuroinflammation in a model of Parkinson’s disease. Cell 167(6):1469–1480CrossRefPubMed
7.
go back to reference Mori I (2017) Viremic attack explains the dual-hit theory of Parkinson’s disease. Med Hypotheses 101:33–36CrossRefPubMed Mori I (2017) Viremic attack explains the dual-hit theory of Parkinson’s disease. Med Hypotheses 101:33–36CrossRefPubMed
8.
go back to reference Mori I (2015) Transolfactory neuroinvasion by viruses threatens the human brain. Acta Virol 59(4):338–349CrossRefPubMed Mori I (2015) Transolfactory neuroinvasion by viruses threatens the human brain. Acta Virol 59(4):338–349CrossRefPubMed
9.
go back to reference Svensson E, Horváth-Puhó E, Thomsen RW, Djurhuus JC, Pedersen L, Borghammer P, Sørensen HT (2015) Vagotomy and subsequent risk of Parkinson’s disease. Ann Neurol 78(4):522–529CrossRefPubMed Svensson E, Horváth-Puhó E, Thomsen RW, Djurhuus JC, Pedersen L, Borghammer P, Sørensen HT (2015) Vagotomy and subsequent risk of Parkinson’s disease. Ann Neurol 78(4):522–529CrossRefPubMed
10.
go back to reference Tysnes OB, Kenborg L, Herlofson K, Steding-Jessen M, Horn A, Olsen JH, Reichmann H (2015) Does vagotomy reduce the risk of Parkinson’s disease? Ann Neurol 78(6):1011–1012CrossRefPubMed Tysnes OB, Kenborg L, Herlofson K, Steding-Jessen M, Horn A, Olsen JH, Reichmann H (2015) Does vagotomy reduce the risk of Parkinson’s disease? Ann Neurol 78(6):1011–1012CrossRefPubMed
11.
go back to reference Hurley D (2015) Does vagotomy reduce the risk for Parkinson’s disease? Neurol Today 15(23):27–30CrossRef Hurley D (2015) Does vagotomy reduce the risk for Parkinson’s disease? Neurol Today 15(23):27–30CrossRef
12.
go back to reference Marras C, Lang AE, Austin PC, Lau C, Urbach DR (2016) Appendectomy in mid and later life and risk of Parkinson’s disease: a population-based study. Mov Disord 31(8):1243–1247CrossRefPubMed Marras C, Lang AE, Austin PC, Lau C, Urbach DR (2016) Appendectomy in mid and later life and risk of Parkinson’s disease: a population-based study. Mov Disord 31(8):1243–1247CrossRefPubMed
13.
go back to reference Svensson E, Horváth-Puhó E, Stokholm MG, Sørensen HT, Henderson VW, Borghammer P (2016) Appendectomy and risk of Parkinson’s disease: a nationwide cohort study with more than 10 years of follow-up. Mov Disord 31(12):1918–1922CrossRefPubMed Svensson E, Horváth-Puhó E, Stokholm MG, Sørensen HT, Henderson VW, Borghammer P (2016) Appendectomy and risk of Parkinson’s disease: a nationwide cohort study with more than 10 years of follow-up. Mov Disord 31(12):1918–1922CrossRefPubMed
14.
go back to reference Mendes A, Gonçalves A, Vila-Chã N, Moreira I, Fernandes J, Damásio J, Cavaco S (2015) Appendectomy may delay Parkinson’s disease onset. Mov Disord 30(10):1404–1407CrossRefPubMed Mendes A, Gonçalves A, Vila-Chã N, Moreira I, Fernandes J, Damásio J, Cavaco S (2015) Appendectomy may delay Parkinson’s disease onset. Mov Disord 30(10):1404–1407CrossRefPubMed
15.
go back to reference Mrabet S, Ali NB, Achouri A, Dabbeche R, Najjar T, Haouet S, Belal S (2016) Gastrointestinal dysfunction and neuropathologic correlations in Parkinson disease. J Clin Gastroenterol 50(9):e85–e90CrossRefPubMed Mrabet S, Ali NB, Achouri A, Dabbeche R, Najjar T, Haouet S, Belal S (2016) Gastrointestinal dysfunction and neuropathologic correlations in Parkinson disease. J Clin Gastroenterol 50(9):e85–e90CrossRefPubMed
16.
go back to reference Woulfe JM, Gray MT, Gray DA, Munoz DG, Middeldorp JM (2014) Hypothesis: a role for EBV-induced molecular mimicry in Parkinson’s disease. Parkinson Relat Disord 20(7):685–694CrossRef Woulfe JM, Gray MT, Gray DA, Munoz DG, Middeldorp JM (2014) Hypothesis: a role for EBV-induced molecular mimicry in Parkinson’s disease. Parkinson Relat Disord 20(7):685–694CrossRef
17.
18.
go back to reference Lee JM, Derkinderen P, Kordower JH, Freeman R, Munoz DG, Kremer T, Beach TG (2017) The search for a peripheral biopsy indicator of α-synuclein pathology for Parkinson disease. J Neuropathol Exp Neurol 76(1):2–15PubMed Lee JM, Derkinderen P, Kordower JH, Freeman R, Munoz DG, Kremer T, Beach TG (2017) The search for a peripheral biopsy indicator of α-synuclein pathology for Parkinson disease. J Neuropathol Exp Neurol 76(1):2–15PubMed
19.
go back to reference Ulusoy A, Phillips RJ, Helwig M, Klinkenberg M, Powley TL, Di Monte DA (2017) Brain-to-stomach transfer of α-synuclein via vagal preganglionic projections. Acta Neuropathol 133(3):381–393CrossRefPubMed Ulusoy A, Phillips RJ, Helwig M, Klinkenberg M, Powley TL, Di Monte DA (2017) Brain-to-stomach transfer of α-synuclein via vagal preganglionic projections. Acta Neuropathol 133(3):381–393CrossRefPubMed
20.
go back to reference Braak H, Del Tredici K (2017) Neuropathological staging of brain pathology in sporadic Parkinson’s disease: separating the wheat from the chaff. J Parkinson’s Dis 7(s1):S73–S87 Braak H, Del Tredici K (2017) Neuropathological staging of brain pathology in sporadic Parkinson’s disease: separating the wheat from the chaff. J Parkinson’s Dis 7(s1):S73–S87
Metadata
Title
Non-CNS pathogenic origin of Parkinson’s disease
Authors
Humdoon Choudhry
Lawrence C. Perlmuter
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 9/2017
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-017-8588-7

Other articles of this Issue 9/2017

Journal of Neurology 9/2017 Go to the issue