原发性帕金森病与胃肠道起源假说研究进展

Research Progress on Idiopathic Parkinson's Disease and Gastrointestinal-originated Hypothesis

原发性帕金森病(PD)是一种常见的神经系统退行性疾病,黑质多巴胺能神经元的变性死亡及剩余神经元内α-突触核蛋白组成的路易小体(LB)出现是PD的特征性病理改变。2003至2006年Braak基于PD患者尸检中胃肠道及各易受累脑区α-突触核蛋白和LB的沉积规律提出假设,α-突触核蛋白异常聚集可能首先在胃肠道发生,后经迷走神经传至中枢神经系统。随后的一系列基础、临床和流行病学研究分别给予了支持性和反对性的依据。因研究结果的不一致以及无法动态检测黑质α-突触核蛋白异常聚集的技术性瓶颈,目前研究者们认为下定论为时过早。

Idiopathic Parkinson’s disease( PD) is a common neurodegenerative disease. The pathological hallmarks of PD are degenerative death of dopaminergic neurons in the substantia nigra and accumulation of Lewy bodies( LB) composed of α-synuclein in the remaining surviving neurons. Between2003 and 2006,based on distribution of α-synuclein and LB from the autopsy of gastrointestinal tract and brain region in PD patients, Braak proposed the hypothesis that α-synuclein may originate in gastrointestinal tract,then spread into central nervous system along vagus nerve. The subsequent basic,clinical and epidemiologic researches provided supporting and opposing evidences,respectively. The heterogeneity of research findings and technical restriction to dynamically detect α-synuclein aggregation in substantia nigra make researchers consider that it is too early to draw any definitive conclusion.