Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T22:15:06.106Z Has data issue: false hasContentIssue false

Increased Intestinal Permeability and Parkinson Disease Patients: Chicken or Egg?

Published online by Cambridge University Press:  02 December 2014

D. Salat-Foix*
Affiliation:
Movement Disorders Program, Department of Clinical Neurosciences, University of Calgary, Calgary
K. Tran
Affiliation:
Division of Gastroenterology, Department of Internal Medicine, University of Calgary, Calgary
R. Ranawaya
Affiliation:
Movement Disorders Program, Department of Clinical Neurosciences, University of Calgary, Calgary
J. Meddings
Affiliation:
Division of Gastroenterology, Department of Internal Medicine, University of Calgary, Calgary
O. Suchowersky
Affiliation:
Department of Medicine (Neurology) and Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
*
Movement Disorders Program. Department of Clinical Neurosciences, Area 3, UCMC, 3350 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Gastrointestinal involvement is a frequent and early event in the course of Parkinson Disease (PD), and may have a prominent role in the early pathophysiology of the disease. On the other hand, derangement in intestinal permeability could also result from the involvement of the gastrointestinal tract over the course of the disease.

Patients and methods:

The intestinal permeability of 12 non-selected PD patients was studied using a validated, non-invasive test; these results were compared to predefined age-adjusted reference values.

Results:

4/12 PD patients had abnormal gastrointestinal permeability; two had both an abnormal lactulose/mannitol ratio and an abnormal sucrose concentration, and two an isolated abnormal result. An increased lactulose/mannitol ratio is consistent with defect of either the enterocytes or the tight junctions between them.

Conclusion:

Intestinal permeability is increased in a significant proportion of unselected PD patients with minimal gastrointestinal symptoms. The significance of this finding needs to be further evaluated.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2012

References

1Abbott, RD, Ross, GW, White, LR, et al.Environmental, life-style, and physical precursors of clinical Parkinson’s disease: recent findings from the Honolulu-Asia Aging Study. J Neurol. 2003 Oct;250 Suppl 3:III309.CrossRefGoogle ScholarPubMed
2Kaye, J, Gage, H, Kimber, A, et al.Excess burden of constipation in Parkinson’s disease: a pilot study. Mov Disord. 2006 Aug;21(8): 12703.CrossRefGoogle ScholarPubMed
3Savica, R, Carlin, JM, Grossardt, BR, et al.Medical records documentation of constipation preceding Parkinson disease: A case-control study. Neurology. 2009 Nov 24;73(21):17528.Google Scholar
4Abbott, RD, Ross, GW, Petrovitch, H, et al.Bowel movement frequency in late-life and incidental Lewy bodies. Mov Disord. 2007 Aug 15;22(11): 15816.Google Scholar
5Petrovitch, H, Abbott, RD, Ross, GW, et al.at>Bowel movement frequency in late-life and substantia nigra neuron density at death. Mov Disord. 2009 Feb 15;24(3): 3716.Google Scholar
6Hawkes, CH, Del Tredici, K, Braak, H.Parkinson’s disease: a dualhit hypothesis. Neuropathol Appl Neurobiol. 2007 Dec;33(6): 599614.Google Scholar
7Lebouvier, T, Chaumette, T, Paillusson, S, et al.The second brain and Parkinson’s disease. Eur J Neurosci. 2009 Sep;30(5):73541.Google Scholar
8Jost, WH.Gastrointestinal dysfunction in Parkinson’s Disease. J Neurol Sci. 2010 Feb 15;289(1-2):6973.Google Scholar
9Teshima, CW, Meddings, JB.The measurement and clinical significance of intestinal permeability. Curr Gastroenterol Rep. 2008 Oct;10(5):4439.Google Scholar
10Hughes, AJ, Daniel, SE, Kilford, L, Lees, AJ.Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):1814.Google Scholar
11Tomlinson, CL, Stowe, R, Patel, S, et al, Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord. 2010 Nov 15;25(15): 264953.Google Scholar
12Chaudhuri, KR, Martinez-Martin, P, Schapira, AH, et al.International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson’s disease: the NMSQuest study. Mov Disord. 2006 Jul;21(7):91623.Google Scholar
13Goetz, CG, Tilley, BC, Shaftman, SR, et alon behalf of the Movement Disorder Society UPDRS Revision Task Force. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008 Nov 15;23(15): 212970.Google Scholar
14Bushara, KO.Neurologic presentation of celiac disease. Gastroenterology. 2005 Apr;128(4 Suppl 1):S927.CrossRefGoogle ScholarPubMed
15Vogelsang, H, Schwarzenhofer, M, Oberhuber, G.Changes in gastrointestinal permeability in celiac disease. Dig Dis. 1998 Nov-Dec;16(6):3336.Google Scholar
16Edelblum, KL, Turner, JR.The tight junction in inflammatory disease: communication breakdown. Curr Opin Pharmacol. 2009 Dec;9(6):71520.Google Scholar
17Ohman, L, Simrén, M.Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions. Nat Rev Gastroenterol Hepatol. 2010 Mar;7(3):16373.Google Scholar
18De Keyser, F, Elewaut, D, De Vos, M, et al.Bowel inflammation and the spondyloarthropathies. Rheum Dis Clin North Am. 1998 Nov;24(4):785813, ix-x.Google Scholar
19Feld, JJ, Meddings, J, Heathcote, EJ.Abnormal intestinal permeability in primary biliary cirrhosis. Dig Dis Sci. 2006 Sep; 51(9):160713.CrossRefGoogle ScholarPubMed
20Pirlich, M, Norman, K, Lochs, H, Bauditz, J.Role of intestinal function in cachexia. Curr Opin Clin Nutr Metab Care. 2006 Sep;9(5):6036.Google Scholar
21Douek, D.HIV disease progression: immune activation, microbes, and a leaky gut. Top HIV Med. 2007 Aug-Sep;15(4):1147.Google Scholar
22Liu, H, Li, W, Wang, X, Li, J, Yu, W.Early gut mucosal dysfunction in patients with acute pancreatitis. Pancreas. 2008 Mar;36(2):1926.Google Scholar
23Sandek, A, Rauchhaus, M, Anker, SD, von Haehling, S.The emerging role of the gut in chronic heart failure. Curr Opin Clin Nutr Metab Care. 2008 Sep;11(5):6329.Google Scholar
24Vaarala, O.Leaking gut in type 1 diabetes. Curr Opin Gastroenterol. 2008 Nov;24(6):7016.Google Scholar
25Miele, L, Valenza, V, La Torre, G, et al.Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease. Hepatology. 2009 Jun;49(6):187787.Google Scholar
26Davies, KN, King, D, Billington, D, et al.Intestinal permeability and orocaecal transit time in elderly patients with Parkinson’s disease. Postgrad Med J. 1996 Mar;72(845):1647.Google Scholar
27Goddard, AF.Review article: factors influencing antibiotic transfer across the gastric mucosa. Aliment Pharmacol Ther. 1998 Dec; 12(12):117584.Google Scholar
28Höglinger, GUOertel, WHHirsch, EC.The rotenone model of parkinsonism-the five years inspection. J Neural Transm Suppl. 2006;(70):26972.Google Scholar
29Pan-Montojo, F, Anichtchik, O, Dening, Y, et al.Progression of Parkinson’s disease pathology is reproduced by intragastric administration of rotenone in mice. PLoS One. 2010 Jan 19;5(1): e8762.Google Scholar