Yongtao Zhou, Yusheng Su, Weihua Xu*, Wei Wang and Shukun Yao Pages 241 - 249 ( 9 )
Objective: Recent studies suggest that constipation is not only a clinical marker of premotor phase in Parkinson’s disease (PD), but also is correlated with the duration and severity. Some reports indicated that inflammatory from gut dysbiosis might be involved in the pathogenesis of PD, but the correlation between them remains poorly understood. This study aims to investigate how the presence of constipation affect the dopamine level of nigrostriatal system and whether gastrointestinal (GI) inflammatory is involved in the brain-gut axis.
Methods: Clinical materials, serum inflammatory factors, and datum of dopamine level included 84 cases and 83 controls, were collected consecutively and randomly from November 1, 2017 to October 31, 2018. Dopamine levels of nigrostriatal system were detected by [18F]-DTBZ radiotracer (18F-AV-133). Data analysis was conducted by variance, covariance analysis, bicorrelation, partial correlation, chi-square analysis and logistic regression.
Results: The mean age of cases was older than that of controls, and male prodominance was also observed (P<0.05). The mean scores of Hoehn-Yahr and unified Parkinson disease rating scale Ⅲ (UPDRS-Ⅲ) were significant different of duration between two groups (P<0.05). The total dose of levodopa was no difference between two groups (P>0.05). The dopamine levels of putamen and caudate nucleus, especially in the dorsal part of putamen, were significantly decreased in cases than that in controls (P<0.05). There were significant differences of complement 3 (C3) and complement 4 (C4) between cases and controls (P<0.05). Dopamine levels in putamen and caudate nucleus were negative correlated with serum concentrations of immunoglobulin A (IgA), immunoglobulin G (IgG) and C3 in cases (P<0.05). But we did not observed similar negative correlations in controls (P>0.05).
Conclusion: The presence of constipation may increases the severity of motor symptoms and decrease dopamine levels of nigrostriatal system in PD. Inflammatory factors may be involved in the brain-gut axis of PD.
Constipation, parkinson disease, inflammation, dopamine, immunoglobulin.
The Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, The Nuclear Medicine Department, Xuanwu Hospital of Capital Medical University, Beijing, Gastroenterology Department of Traditional Chinese Medicine, China-Japan Friendship Hospital, Beijing 100053, Gastroenterology Department of Traditional Chinese Medicine, China-Japan Friendship Hospital, Beijing 100053, Gastroenterology Department of Traditional Chinese Medicine, China-Japan Friendship Hospital, Beijing 100053