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Consultant Per Borghammer is showing some scannings from his research project in Parkinson's disease (photo: Tonny Foghmar, Aarhus University Hospital). |
Dec. 11, 2015
Lundbeck Foundation grants DKK 10
million for a research project to investigate whether Parkinson’s disease
starts in the gut many years before it affects the brain.
As early as ten to twenty years
before patients are diagnosed with Parkinson’s disease, many have problems with
digestion, for example constipation. This may be a very early sign that the
nerve pathways that regulate gut function have been damaged. New research
indicates that Parkinson’s disease may start in the gut and, from there, spread
to the brain via the nerve fibres that connect the gut to the brain.
Per Borghammer, consultant at the
Department of Nuclear Medicine and PET Centre at Aarhus University Hospital,
has recently received a five-year fellowship of DKK 10 million from Lundbeck
Foundation to test this hypothesis thoroughly.
“We’ve developed the world’s first
method to take pictures of the nerve pathways which control, among other
things, gut function. Consequently, we’re now able to see whether the nerve
pathways were already damaged several years before patients develop symptoms of
Parkinson’s disease,” says Per Borghammer.
Healthy bright nerves or pale small
intestine
The method uses a radioactive
tracer which binds to a particular enzyme in the parasympathetic nervous
system. This is the part of the nervous system that connects the body’s organs
to the brain and spinal cord and is responsible for, among other things,
stimulating digestion. The enzyme is found in healthy nerve tissue but is not
present when the tissue has been damaged.
When Per Borghammer injects the
tracer into patients, he uses a specific type of scan (PET) to take pictures of
the nerve connections. If there is a strong signal, the nerves are healthy.
However, a weak signal indicates that there is a loss of nerve connection.
“We’ve scanned over 30 Parkinson’s
patients and the PET scans of almost all of them show the same ‘pale small
intestine’ compared to healthy controls,” says the newly-appointed Lundbeck
Foundation Fellow. “We expect to see indications of this nerve damage in the
gut many years before the patient is diagnosed.”
The Lundbeck Foundation grant will
ensure that he is able to concentrate on his project for the next five years.
He will now use this scanning method to examine a larger number of patients who
have not yet been diagnosed with Parkinson’s but who most likely will develop
the disease. We know that the majority of patients with a particular REM sleep
behaviour disorder (whereby patients, during REM sleep, behave like they do in
their dreams) later develop Parkinson’s disease. By scanning these patients,
Per Borghammer can investigate whether the hypothesis holds up; whether the
earliest indications of Parkinson’s disease can be detected by scanning the
gut.
Early diagnosis results in better
treatment options
If it is proven that the earliest
signs of Parkinson’s disease can be seen in the gut, his method can be used to
make a diagnosis much earlier than we can at present.
“Drugs have not yet been developed
that can halt Parkinson’s disease, but it’s important that, as soon as a
treatment comes on to the market, patients can be diagnosed as early as
possible so that they can be treated before they develop serious symptoms,”
stresses Per Borghammer.
Lundbeck Foundation has chosen to
support Per Borghammer with a Fellowship, since his research project has great
potential to provide a better understanding of Parkinson’s disease:
“Per Borghammer is a highly
qualified clinical researcher with a well though-out project to test an elegant
hypothesis. There’s a high probability that his research will generate
fundamental new knowledge of Parkinson’s disease and that the project will pave
the way for research into potential, new treatment methods,” says Anne-Marie
Engel, director of research at Lundbeck Foundation.
About the Lundbeck Foundation
Fellowship Programme
With its Fellowship Programme,
Lundbeck Foundation aims to provide talented scientists with a unique
opportunity to conduct concentrated and dedicated research for a period of five
years. Each Fellow receives a research grant for DKK 10 million. Grants go to
young scientists who have gained a PhD within the past five to seven years and
are qualified to establish or develop their own research teams in biomedical
sciences.
Facts about Parkinson’s disease
Parkinson’s disease is one of the
most common neurological diseases. In Denmark, 7000 people suffer from the
disease and it is estimated that seven to ten million people have Parkinson’s
disease worldwide. The disease is chronic and gradually worsens as we lose from
the brain increasing numbers of neurons that produce important
neurotransmitters, including dopamine. Dopamine is a neurotransmitter that
transfers messages from one neuron to another. A lack of dopamine is what
causes the main physical symptoms such as shaking, muscular stiffness and slow,
sluggish movement.
For additional information:
Regitze Reeh, head of
communications, tel.: +45 3054 6608, email: rr@lundbeckfonden.com
Per Borghammer MD, PhD, DMSc,
research consultant, tel.: +45 2381 8581, email: perborgh@rm.dk
http://www.en.auh.dk/press-room/news-archive/dkk-10-million-to-investigate-whether-parkinsons-begins-in-the-gut
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Parkinson’s disease and the Microbiome
Have you ever had an “Aha!” moment? In science, these moments happen all the time. Old ideas are refreshed, and new perspectives pave the road to medical discovery. In fact, research concerning the prevention and treatment of Parkinson’s disease (PD) is moving in the wake of such an “Aha!” moment. The human microbiome, identified as a driving force behind health, is now considered a key player in the pathology of PD. The microbiome is comprised of all of the bacteria that live in your gut. By taking a closer look at the interconnectedness of PD and the microbiome, we see a hopeful future that explores the use of probiotic therapy to manage and heal a common neurodegenerative disorder.
Take a moment and think about your experience with PD. What comes to mind? Has your gait turned into a shuffle? Do you have a tremor? Maybe you simply feel a bit stiff and off-balance. While motor symptoms are hallmarks of advanced PD, a slue of non-motor symptoms may appear 10 years prior to shaky, slow, and stiff movements. Among the early symptoms of PD are gastrointestinal disturbances that tend to worsen as the disease progresses. Although the percentage of PD patients who experience constipation varies, researchers Jost and Schimrigk at Saarland University in Germany found that constipation may affect up to 80% of PD patients.
While gastrointestinal disturbances may seem marginally important, the gut’s involvement in PD demands attention. The human gut is a complex system that influences the body’s ability to absorb nutrients, fight pathogens, and impact brain function. With over 100 trillion microorganisms living in your gut, it’s no surprise that your microbiome has a big impact on health. The microbiota, which vary in composition and function as determined by genetics and the environment, may influence the motor symptoms and even non-motor symptoms you’re experiencing. Research shows that the enteric nervous system, known as the little brain of the gut, communicates the inner workings of the microbiome to the central nervous system via the vagus nerve. The gut microbiome may even influence the secretion of α-synuclein, a protein capable of causing mitochondrial dysfunction and the loss of dopaminergic neurons.
It is difficult to know if an altered microbiome is a cause or consequence of PD; however, research does confirm a unique bacteria composition in PD patients. When examining the bacteria in PD patients compared to healthy individuals, Scheperjans et al. discovered a positive association between Enterobacteriaceae abundance and postural instability and gait difficulty. Additionally, PD patients tend to have a reduced abundance of the bacterial family Prevotellaceae. Fasano and colleagues have shown that SIBO, or small intestinal bacterial overgrowth, has also been associated with more severe motor symptoms.
What is the bottom line? PD and the gut microbiome are interconnected, and although there is much to learn about their relationship, it is safe to say that the future of PD diagnosis and treatment is bright with respect to the gut. At present, the growing awareness of gut health has prompted the use of probiotics to maintain a diverse gut flora full of “good” bacteria. By consuming PD-friendly foods that promote a healthy microbiome, you can do your part to ensure gut health. Try incorporating raw garlic, onions, and leeks into your diet. When consumed they act as food for “good” bacteria. If you are feeling more adventurous, drink kombucha, a fermented tea, or Korean kimchi, an assortment fermented vegetables.
Dysbiosis, a microbiome that contains too many of one species and not enough of others, may become relevant in the diagnosis and treatment of PD in the future. Perhaps your symptoms of Parkinson’s disease will one day be treated, in part, with specific strains of bacteria or through a diet rich in gut-healthy foods.
http://www.briangrant.org/a-new-perspective-parkinsons-disease-and-the-microbiome/
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