1
|
Vaia Y, Bruschi F, Tagi VM, Tosi M, Montanari C, Zuccotti G, Tonduti D, Verduci E. Microbiota gut-brain axis: implications for pediatric-onset leukodystrophies. Front Nutr 2024; 11:1417981. [PMID: 39070252 PMCID: PMC11272617 DOI: 10.3389/fnut.2024.1417981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024] Open
Abstract
Neurodegenerative disorders are a group of diseases characterized by progressive degeneration of the nervous system, leading to a gradual loss of previously acquired motor, sensory and/or cognitive functions. Leukodystrophies are amongst the most frequent childhood-onset neurodegenerative diseases and primarily affect the white matter of the brain, often resulting in neuro-motor disability. Notably, gastrointestinal (GI) symptoms and complications, such as gastroesophageal reflux disease (GERD) and dysphagia, significantly impact patients' quality of life, highlighting the need for comprehensive management strategies. Gut dysbiosis, characterized by microbial imbalance, has been implicated in various GI disorders and neurodegenerative diseases. This narrative review explores the intricate relationship between GI symptoms, Gut Microbiota (GM), and neurodegeneration. Emerging evidence underscores the profound influence of GM on neurological functions via the microbiota gut-brain axis. Animal models have demonstrated alterations in GM composition associated with neuroinflammation and neurodegeneration. Our single-centre experience reveals a high prevalence of GI symptoms in leukodystrophy population, emphasizing the importance of gastroenterological assessment and nutritional intervention in affected children. The bidirectional relationship between GI disorders and neurodegeneration suggests a potential role of gut dysbiosis in disease progression. Prospective studies investigating the GM in leukodystrophies are essential to understand the role of gut-brain axis dysfunction in disease progression and identify novel therapeutic targets. In conclusion, elucidating the interplay between GI disorders, GM, and neurodegeneration holds promise for precision treatments aimed at improving patient outcomes and quality of life.
Collapse
Affiliation(s)
- Ylenia Vaia
- C.O.A.L.A. (Center for Diagnosis and Treatment of Leukodystrophies), Unit of Pediatric Neurology, V. Buzzi Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Fabio Bruschi
- C.O.A.L.A. (Center for Diagnosis and Treatment of Leukodystrophies), Unit of Pediatric Neurology, V. Buzzi Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Veronica Maria Tagi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Department of Pediatrics, V. Buzzi Children's Hospital, Milan, Italy
| | - Martina Tosi
- Department of Pediatrics, V. Buzzi Children's Hospital, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Chiara Montanari
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Department of Pediatrics, V. Buzzi Children's Hospital, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Department of Pediatrics, V. Buzzi Children's Hospital, Milan, Italy
| | - Davide Tonduti
- C.O.A.L.A. (Center for Diagnosis and Treatment of Leukodystrophies), Unit of Pediatric Neurology, V. Buzzi Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Elvira Verduci
- Department of Health Sciences, University of Milan, Milan, Italy
- Metabolic Diseases Unit, Department of Pediatrics, V. Buzzi Children’s Hospital, University of Milan, Milan, Italy
| |
Collapse
|
4
|
Amir Yazdani P, St-Jean ML, Matovic S, Spahr A, Tran LT, Boucher RM, Poulin C, Osterman B, Srour M, Rosenblatt B, Chenier S, Soucy JF, Laberge AM, Braverman N, D’Agostino MD, Nguyen CTE, Morsa M, Bernard G. Experience of Parents of Children with Genetically Determined Leukoencephalopathies Regarding the Adapted Health Care Services During the COVID-19 Pandemic. J Child Neurol 2022; 37:237-245. [PMID: 34986037 PMCID: PMC9066235 DOI: 10.1177/08830738211065317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Parents of children with genetically determined leukoencephalopathies play a major role in their children's health care. Because of the COVID-19 pandemic, many health care services were suspended, delayed or delivered remotely with telemedicine. We sought to explore the experience of parents of children with genetically determined leukoencephalopathies during the pandemic given the adapted health care services. We conducted semistructured interviews with 13 parents of 13 affected children. Three main themes were identified using thematic analysis: perceived impact of COVID-19 on health care services, benefits and challenges of telemedicine, and expectations of health care after the pandemic. Parents perceived a loss/delay in health care services while having a positive response to telemedicine. Parents wished telemedicine would remain in their care after the pandemic. This is the first study assessing the impact of COVID-19 on health care services in this population. Our results suggest that parents experience a higher level of stress owing to the shortage of services and the children's vulnerability.
Collapse
Affiliation(s)
- Pouneh Amir Yazdani
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Université Laval, Québec, Québec, Canada,Geneviève Bernard, MD, MSc, FRCPc; Research Institute of the McGill University Health Centre, 1001 boul Décarie, Montréal, QC H4A 3J1, Canada.
| | - Marie-Lou St-Jean
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Université de Montréal, Montréal, Québec, Canada
| | - Sara Matovic
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Aaron Spahr
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Luan T. Tran
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Renée-Myriam Boucher
- Department of Pediatrics, Division of Pediatric Neurology, Centre Hospitalier de l’Université Laval, Québec, Canada
| | - Chantal Poulin
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Bradley Osterman
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Myriam Srour
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Bernard Rosenblatt
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Sébastien Chenier
- Department of Medical Genetics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Francois Soucy
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada,Medical Genetics Division, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Anne-Marie Laberge
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada,Medical Genetics Division, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Nancy Braverman
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Department of Human Genetics, McGill University, Montreal, Québec, Canada,Division of Medical Genetics, Montreal Children's Hospital, Montréal, Québec, Canada,Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montréal, Québec, Canada
| | - Maria Daniela D’Agostino
- Department of Human Genetics, McGill University, Montreal, Québec, Canada,Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montréal, Québec, Canada
| | - Cam-Tu Emilie Nguyen
- Department of Neurosciences and Pediatrics, Division of Pediatric Neurology, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Maxime Morsa
- Université de Montréal, Montréal, Québec, Canada,Sorbonne Paris Nord University, Laboratory of Health Education and Practice, Bobigny, France
| | - Geneviève Bernard
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Department of Human Genetics, McGill University, Montreal, Québec, Canada,Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montréal, Québec, Canada
| |
Collapse
|