1. Fecal markers of intestinal inflammation and intestinal permeability are elevated in Parkinson's disease
- Author
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Jan Bürmann, Marcus M. Unger, Andreas Schwiertz, Ulrich Dillmann, Jörg Spiegel, David Grundmann, Klaus Faßbender, and Karl-Herbert Schäfer
- Subjects
Adult ,Male ,0301 basic medicine ,Cholera Toxin ,medicine.medical_specialty ,Inflammation ,Severity of Illness Index ,Gastroenterology ,Inflammatory bowel disease ,Permeability ,Pathogenesis ,Feces ,03 medical and health sciences ,fluids and secretions ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Intestinal Mucosa ,Protein Precursors ,Aged ,Intestinal permeability ,Haptoglobins ,biology ,Lactoferrin ,business.industry ,Zonulin ,Parkinson Disease ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,030104 developmental biology ,Neurology ,Case-Control Studies ,alpha 1-Antitrypsin ,biology.protein ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,medicine.symptom ,Calprotectin ,business ,Leukocyte L1 Antigen Complex ,Dysbiosis ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Background/Objective Intestinal inflammation and increased intestinal permeability (both possibly fueled by dysbiosis) have been suggested to be implicated in the multifactorial pathogenesis of Parkinson's disease (PD). The objective of the current study was to investigate whether fecal markers of inflammation and impaired intestinal barrier function corroborate this pathogenic aspect of PD. Methods In a case-control study, we quantitatively analyzed established fecal markers of intestinal inflammation (calprotectin and lactoferrin) and fecal markers of intestinal permeability (alpha-1-antitrypsin and zonulin) in PD patients (n = 34) and controls (n = 28, group-matched for age) by enzyme-linked immunosorbent assay. The study design controlled for potential confounding factors. Results Calprotectin, a fecal marker of intestinal inflammation, and two fecal markers of increased intestinal permeability (alpha-1-antitrypsin and zonulin) were significantly elevated in PD patients compared to age-matched controls. Lactoferrin, as a second fecal marker of intestinal inflammation, showed a non-significant trend towards elevated concentrations in PD patients. None of the four fecal markers correlated with disease severity, PD subtype, dopaminergic therapy, or presence of constipation. Conclusions Fecal markers reflecting intestinal inflammation and increased intestinal permeability have been primarily investigated in inflammatory bowel disease so far. Our data indicate that calprotectin, alpha-1-antitrypsin and zonulin could be useful non-invasive markers in PD as well. Even though these markers are not disease-specific, they corroborate the hypothesis of an intestinal inflammation as contributing factor in the pathogenesis of PD. Further investigations are needed to determine whether calprotectin, alpha-1-antitrypsin and zonulin can be used to define PD subgroups and to monitor the effect of interventions in PD.
- Published
- 2018
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