Hegelmaier T, Lebbing M, Duscha A, Tomaske L, Tönges L, Holm JB, Bjørn Nielsen H, Gatermann SG, Przuntek H, Haghikia A. Interventional Influence of the Intestinal Microbiome Through Dietary Intervention and Bowel Cleansing Might Improve Motor Symptoms in Parkinson's Disease. Cells. 2020 Feb 6;9(2):376.PMID: 32041265; PMCID: PMC7072275.
The impact of the gut microbiome is gaining increasing importance in healthcare and various chronic diseases, including neurodegenerative diseases such as Parkinson's. In the pathogenesis of Parkinson's disease, the role of the gut has been previously established. In conjunction with a better understanding of the gut microbiome, a link to the misfolding and spread of alpha-synuclein via inflammatory processes in the gut has been discussed. In a case-control study, we examined the gut microbiome of 54 PD patients and 32 healthy controls (HC). In addition, in this proof-of-concept study, we tested whether dietary intervention alone or additional physical colon cleansing could lead to changes in the gut microbiome in PD.
16 PD patients underwent a well-controlled, balanced, ovo-lacto-vegetarian dietary intervention with short fatty acids for 14 days. 10 of these patients received an additional treatment of daily stool enema for 8 days. Stool samples were collected before and after 14 days of the intervention. Compared to HC, we confirmed previously reported PD-associated microbiome changes. The UDPRS III (disease score in PD patients) improved significantly, and the levodopa-equivalent daily dose decreased after vegetarian diet and fecal enema at one-year follow-up. In addition, we observed a significant association between gut microbiome diversity and UPDRS III and the frequency of Ruminococcus. Additionally, the frequency of Clostridiaceae was significantly reduced after an enema. Dietary intervention and bowel cleansing could provide an additional non-pharmacological therapeutic option for PD patients.
