Evidence for immune system alterations in peripheral biological fluids in Parkinson’s disease
Open accessAbstract
Immune-related alterations in Parkinson's disease (PD) can be monitored by assessing peripheral biological fluids that show that specific inflammatory pathways contribute to a chronic pro-inflammatory status. This pro-inflammatory activity is hypothesized to be already present in the prodromal stages of PD. These pathways maintain and reinforce chronic neurodegeneration by stimulating cell activation and proliferation what triggers the pro-inflammatory status as well. The gut microbiome possibly contributes to inflammatory pathways and shows specific differences in fecal samples from PD compared to healthy controls. In PD, Bacteroides abundance correlates with inflammatory markers in blood and motor impairment. Increased pro-inflammatory and decreased anti-inflammatory bacterial colonization can lead to changes in the metabolic pathways of amino acids, inducing increased membrane permeability, described as a leaky gut, enabling advanced contact between immune cells and gut microbiome and potentially a spreading of neuroinflammation through the body via the blood. Increased cytokine blood levels in PD are correlated with disease severity, motor symptoms, and clinical phenotypes. α-synuclein is a central player in PD-associated inflammation, inducing specific T-cell activity and triggering microglial activation in the central nervous system (CNS). Misfolded α-synuclein propagation possibly results in the spreading of aggregated α-synuclein from neuron to neuron leading to a sustained neuroinflammation. This is supported by age-dependent defects of protein uptake in microglia and monocytes, so-called "inflammaging", including α-synuclein oligomers, as the key pathological protein in PD. Genetic risk markers and inherited forms of PD are also associated with inflammation, which is highly relevant for potential therapeutical targets. The documented associations of inflammatory markers and clinical phenotypes indicate a pro-inflammatory concept of specific PD pathophysiology here. An in-depth understanding of inflammatory mechanisms in PD from bottom (gut) to top (CNS) and vice versa is needed to design novel immunomodulatory approaches to delay or even stop PD. Future studies focusing on structured protocols in large patient cohorts with appropriate control groups and comparative analysis among studies will aid the discovery of novel candidate biomarkers.
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Bacteroides abundance correlates with an increase in plasma TNF-alpha and interferon-gamma levels in patients with Parkinson's disease.
“The abundance of Bacteroides also increased significantly in PD mice and is known to correlate with an increase in plasma TNF-α and interferon-γ levels in patients with PD [49].”
From Neuroprotective Effects of Sodium Butyrate by Restoring Gut Microbiota and Inhibiting TLR4 Signaling in Mice with MPTP-Induced Parkinson’s Disease (2023) · cites this paper as [49]
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Guo, T.-T., Zhang, Z., Sun, Y., Zhu, R.-Y., Wang, F.-X., Ma, L.-J., Jiang, L., & Liu, H.-D. (2023) · Nutrients · doi:10.3390/nu15040930 · Cited by 82 · see citing works
- Authors
- Bartl, M., Xylaki, M., Bähr, M., Weber, S., Trenkwalder, C., & Mollenhauer, B.
- Affiliations
- Universitätsmedizin Göttingen (DE)
- Corresponding author
- Bartl, Michael
- Venue
- Neurobiology of Disease
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 170
- Pages
- 105744
- ISSN
- 0969-9961 (ISSN-L)
- OpenAlex
- W4225262656
- Cited by
- 33
- References
- 108
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 5 · 2023: 12 · 2022: 3
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neurobiology of Disease (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- Funders
- Michael J. Fox Foundation for Parkinson's Research
- Biogen
- International Parkinson and Movement Disorder Society
- Parkinson's Foundation
- Deutsche Forschungsgemeinschaft (413501650)
- Sun Pharma
- Deutsche Parkinson Vereinigung
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Nuclear Receptors and Signaling
- Keywords
- Parkinson's disease, neuroinflammation, gut microbiota, Bacteroides, leaky gut, cytokines, alpha-synuclein, microglial activation, T cell activation, inflammaging, prodromal Parkinson's disease, neurodegeneration, biomarkers, immunomodulatory therapy
- MeSH terms
- Humans, Inflammation, Monocytes, Parkinson Disease, Biomarkers, Microglia, alpha-Synuclein
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