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Videlock EJ, Xing T, Yehya AHS, Travagli RA. Experimental models of gut-first Parkinson's disease: A systematic review. Neurogastroenterol Motil 2023; 35:e14604. [PMID: 37125607 PMCID: PMC10524037 DOI: 10.1111/nmo.14604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND There is strong support from studies in humans and in animal models that Parkinson's disease (PD) may begin in the gut. This brings about a unique opportunity for researchers in the field of neurogastroenterology to contribute to advancing the field and making contributions that could lead to the ability to diagnose and treat PD in the premotor stages. Lack of familiarity with some of the aspects of the experimental approaches used in these studies may present a barrier for neurogastroenterology researchers to enter the field. Much remains to be understood about intestinal-specific components of gut-first PD pathogenesis and the field would benefit from contributions of enteric and central nervous system neuroscientists. PURPOSE To address these issues, we have conducted a systematic review of the two most frequently used experimental models of gut-first PD: transneuronal propagation of α-synuclein preformed fibrils and oral exposure to environmental toxins. We have reviewed the details of these studies and present methodological considerations for the use of these models. Our aim is that this review will serve as a framework and useful reference for neuroscientists, gastroenterologists, and neurologists interested in applying their expertise to advancing our understanding of gut-first PD.
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Affiliation(s)
- Elizabeth J. Videlock
- Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Tiaosi Xing
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Ashwaq Hamid Salem Yehya
- Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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Kulcsarova K, Bang C, Berg D, Schaeffer E. Pesticides and the Microbiome-Gut-Brain Axis: Convergent Pathways in the Pathogenesis of Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2023; 13:1079-1106. [PMID: 37927277 PMCID: PMC10657696 DOI: 10.3233/jpd-230206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
The increasing global burden of Parkinson's disease (PD), termed the PD pandemic, is exceeding expectations related purely to population aging and is likely driven in part by lifestyle changes and environmental factors. Pesticides are well recognized risk factors for PD, supported by both epidemiological and experimental evidence, with multiple detrimental effects beyond dopaminergic neuron damage alone. The microbiome-gut-brain axis has gained much attention in recent years and is considered to be a significant contributor and driver of PD pathogenesis. In this narrative review, we first focus on how both pesticides and the microbiome may influence PD initiation and progression independently, describing pesticide-related central and peripheral neurotoxicity and microbiome-related local and systemic effects due to dysbiosis and microbial metabolites. We then depict the bidirectional interplay between pesticides and the microbiome in the context of PD, synthesizing current knowledge about pesticide-induced dysbiosis, microbiome-mediated alterations in pesticide availability, metabolism and toxicity, and complex systemic pesticide-microbiome-host interactions related to inflammatory and metabolic pathways, insulin resistance and other mechanisms. An overview of the unknowns follows, and the role of pesticide-microbiome interactions in the proposed body-/brain-first phenotypes of PD, the complexity of environmental exposures and gene-environment interactions is discussed. The final part deals with possible further steps for translation, consisting of recommendations on future pesticide use and research as well as an outline of promising preventive/therapeutic approaches targeted on strengthening or restoring a healthy gut microbiome, closing with a summary of current gaps and future perspectives in the field.
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Affiliation(s)
- Kristina Kulcsarova
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, L. Pasteur University Hospital, Kosice, Slovak Republic
- Department of Clinical Neurosciences, University Scientific Park MEDIPARK, P. J. Safarik University, Kosice, Slovak Republic
| | - Corinna Bang
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Eva Schaeffer
- Department of Neurology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
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Wang EW, Trojano ML, Lewis MM, Du G, Chen H, Brown GL, Jellen LC, Song I, Neely E, Kong L, Connor JR, Huang X. HFE H63D Limits Nigral Vulnerability to Paraquat in Agricultural Workers. Toxicol Sci 2021; 181:47-57. [PMID: 33739421 DOI: 10.1093/toxsci/kfab020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Paraquat is an herbicide whose use is associated with Parkinson's disease (PD), a neurodegenerative disorder marked by neuron loss in the substantia nigra pars compacta (SNc). We recently observed that the murine homolog to the human H63D variant of the homeostatic iron regulator (HFE) may decrease paraquat-associated nigral neurotoxicity in mice. The present study examined the potential influence of H63D on paraquat-associated neurotoxicity in humans. Twenty-eight paraquat-exposed workers were identified from exposure histories and compared with 41 unexposed controls. HFE genotypes, and serum iron and transferrin were measured from blood samples. MRI was used to assess the SNc transverse relaxation rate (R2*), a marker for iron, and diffusion tensor imaging scalars of fractional anisotropy (FA) and mean diffusivity, markers of microstructural integrity. Twenty-seven subjects (9 exposed and 18 controls) were H63D heterozygous. After adjusting for age and use of other PD-associated pesticides and solvents, serum iron and transferrin were higher in exposed H63D carriers than in unexposed carriers and HFE wildtypes. SNc R2* was lower in exposed H63D carriers than in unexposed carriers, whereas SNc FA was lower in exposed HFE wildtypes than in either unexposed HFE wildtypes or exposed H63D carriers. Serum iron and SNc FA measures correlated positively among exposed, but not unexposed, subjects. These data suggest that H63D heterozygosity is associated with lower neurotoxicity presumptively linked to paraquat. Future studies with larger cohorts are warranted to replicate these findings and examine potential underlying mechanisms, especially given the high prevalence of the H63D allele in humans.
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Affiliation(s)
- Ernest W Wang
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Max L Trojano
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Mechelle M Lewis
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Pharmacology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Hairong Chen
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Gregory L Brown
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Leslie C Jellen
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Insung Song
- Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Elizabeth Neely
- Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Lan Kong
- Department of Public Health Sciences, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - James R Connor
- Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Pharmacology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Neurosurgery, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Radiology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.,Department of Kinesiology, Pennsylvania State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA
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Chiu WH, Kovacheva L, Musgrove RE, Arien-Zakay H, Koprich JB, Brotchie JM, Yaka R, Ben-Zvi D, Hanani M, Roeper J, Goldberg JA. α-Synuclein-induced Kv4 channelopathy in mouse vagal motoneurons drives nonmotor parkinsonian symptoms. SCIENCE ADVANCES 2021; 7:eabd3994. [PMID: 33692101 PMCID: PMC7946367 DOI: 10.1126/sciadv.abd3994] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 01/25/2021] [Indexed: 05/06/2023]
Abstract
No disease-modifying therapy is currently available for Parkinson's disease (PD), the second most common neurodegenerative disease. The long nonmotor prodromal phase of PD is a window of opportunity for early detection and intervention. However, we lack the pathophysiological understanding to develop selective biomarkers and interventions. By using a mutant α-synuclein selective-overexpression mouse model of prodromal PD, we identified a cell-autonomous selective Kv4 channelopathy in dorsal motor nucleus of the vagus (DMV) neurons. This functional remodeling of intact DMV neurons leads to impaired pacemaker function in vitro and in vivo, which, in turn, reduces gastrointestinal motility, a common early symptom of prodromal PD. We identify a chain of events from α-synuclein via a biophysical dysfunction of a specific neuronal population to a clinically relevant prodromal symptom. These findings will facilitate the rational design of clinical biomarkers to identify people at risk for developing PD.
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Affiliation(s)
- Wei-Hua Chiu
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada, The Faculty of Medicine, The Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Lora Kovacheva
- Institute of Neurophysiology, Neuroscience Center, Goethe University, 60590 Frankfurt, Germany
| | - Ruth E Musgrove
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada, The Faculty of Medicine, The Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Hadar Arien-Zakay
- School of Pharmacy, Institute for Drug Research, The Faculty of Medicine, The Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - James B Koprich
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON M5T 2S8, Canada
- Atuka Inc., Toronto, ON M5X 1C9, Canada
| | - Jonathan M Brotchie
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON M5T 2S8, Canada
- Atuka Inc., Toronto, ON M5X 1C9, Canada
| | - Rami Yaka
- School of Pharmacy, Institute for Drug Research, The Faculty of Medicine, The Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Danny Ben-Zvi
- Department of Developmental Biology and Cancer Research, Institute of Medical Research Israel-Canada, The Faculty of Medicine, The Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Menachem Hanani
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada, The Faculty of Medicine, The Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
- Laboratory of Experimental Surgery, Hadassah Medical Center, Mount Scopus, 91240 Jerusalem, Israel
| | - Jochen Roeper
- Institute of Neurophysiology, Neuroscience Center, Goethe University, 60590 Frankfurt, Germany
| | - Joshua A Goldberg
- Department of Medical Neurobiology, Institute of Medical Research Israel-Canada, The Faculty of Medicine, The Hebrew University of Jerusalem, 9112102 Jerusalem, Israel.
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Parkinson disease and the gut: new insights into pathogenesis and clinical relevance. Nat Rev Gastroenterol Hepatol 2020; 17:673-685. [PMID: 32737460 DOI: 10.1038/s41575-020-0339-z] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2020] [Indexed: 12/12/2022]
Abstract
The classic view portrays Parkinson disease (PD) as a motor disorder resulting from loss of substantia nigra pars compacta dopaminergic neurons. Multiple studies, however, describe prodromal, non-motor dysfunctions that affect the quality of life of patients who subsequently develop PD. These prodromal dysfunctions comprise a wide array of gastrointestinal motility disorders including dysphagia, delayed gastric emptying and chronic constipation. The histological hallmark of PD - misfolded α-synuclein aggregates that form Lewy bodies and neurites - is detected in the enteric nervous system prior to clinical diagnosis, suggesting that the gastrointestinal tract and its neural (vagal) connection to the central nervous system could have a major role in disease aetiology. This Review provides novel insights on the pathogenesis of PD, including gut-to-brain trafficking of α-synuclein as well as the newly discovered nigro-vagal pathway, and highlights how vagal connections from the gut could be the conduit by which ingested environmental pathogens enter the central nervous system and ultimately induce, or accelerate, PD progression. The pathogenic potential of various environmental neurotoxicants and the suitability and translational potential of experimental animal models of PD will be highlighted and appraised. Finally, the clinical manifestations of gastrointestinal involvement in PD and medications will be discussed briefly.
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