Fecal microbiota transplant as a potential treatment for Parkinson's disease – A case series

Segal, Arik; Zlotnik, Yair; Moyal-Atias, Keren; Abuhasira, Ran; Ifergane, Gal

doi:10.1016/j.clineuro.2021.106791

Cited by 74 publications

(70 citation statements)

References 31 publications

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“…One case study reported that FMT can significantly reduce the short-term constipation and tremor of lower limbs in patients with PD in China (180). Another case report showed that FMT via colonoscopy resulted in improvement of PD motor and non-motor symptoms at 6 months, including constipation (181). A large descriptive cohort study of 2010 patients who underwent FMT and received follow-up for more than 3 months found that FMT is a safe and effective method for the treatment of gastrointestinal dysfunction (182), and another study conducted by Li et al reported similar results (183).…”

Section: Fmtmentioning

confidence: 99%

Gut Microbiota: A Novel Therapeutic Target for Parkinson’s Disease

Zhu

Liu

et al. 2022

Front. Immunol.

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Parkinson’s disease (PD) is the second most common neurodegenerative disease characterized by motor dysfunction. Growing evidence has demonstrated that gut dysbiosis is involved in the occurrence, development and progression of PD. Numerous clinical trials have identified the characteristics of the changed gut microbiota profiles, and preclinical studies in PD animal models have indicated that gut dysbiosis can influence the progression and onset of PD via increasing intestinal permeability, aggravating neuroinflammation, aggregating abnormal levels of α-synuclein fibrils, increasing oxidative stress, and decreasing neurotransmitter production. The gut microbiota can be considered promising diagnostic and therapeutic targets for PD, which can be regulated by probiotics, psychobiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, diet modifications, and Chinese medicine. This review summarizes the recent studies in PD-associated gut microbiota profiles and functions, the potential roles, and mechanisms of gut microbiota in PD, and gut microbiota-targeted interventions for PD. Deciphering the underlying roles and mechanisms of the PD-associated gut microbiota will help interpret the pathogenesis of PD from new perspectives and elucidate novel therapeutic strategies for PD.

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Section: Fmtmentioning

confidence: 99%

Gut Microbiota: A Novel Therapeutic Target for Parkinson’s Disease

Zhu

Liu

et al. 2022

Front. Immunol.

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“…[61] No clinical trials have been performed with FMT in PD patients so far. In the available case series (total of 33 patients), one patient reported an SAE (episodes of vasovagal pre-syncope),[46] while mild transient side effects related to the procedure were reported in two series [45, 47]. The incidence and type of FMT- or procedure-related problems and (S)AEs in this group is unknown, and will be the main objective of this pilot study.…”

Section: Methodsmentioning

confidence: 99%

“…A potential beneficial effect of FMT in PD is shown in several mouse studies [41][42][43]. Recently, one case report [44] and three case series (15, 11, and 6 patients) [45][46][47] have been published reporting the results of FMT in PD patients. In general, some improvement of motor and non-motor symptoms, including constipation, was reported in all series.…”

Section: Introductionmentioning

confidence: 94%

Safety and feasibility of fecal microbiota transplantation for Parkinson’s disease patients: a protocol for a self-controlled interventional donor-FMT pilot study

Vendrik

Bekker-Chernova

Kuijper

et al. 2022

Preprint

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Several experimental studies suggest a role of the gut microbiota in the pathophysiology of Parkinson’s disease (PD) via the gut-brain axis. In addition, the gut microbiota can influence the metabolism of levodopa, which is the mainstay of treatment of PD. Therefore, modifying the gut microbiota by fecal microbiota transplantation (FMT) could be a supportive treatment strategy. We developed a study protocol for a single center, prospective, self-controlled, interventional, safety and feasibility donor-FMT pilot study with randomization and double blinded allocation of donor feces. The primary objectives are to assess feasibility and safety of FMT in PD patients. Secondary objectives are to explore whether FMT leads to alterations of motor complications and PD symptoms in the short term, determine alterations in gut microbiota composition and donor-recipient microbiota similarities and their association with PD symptoms and motor complications, assess the ease of the study protocol and examine FMT-related adverse events in PD patients. The study population will consist of 16 idiopathic PD patients that use levodopa and experience motor complications. They will receive FMT with feces from one of two selected healthy human donors. Patients will be pretreated with vancomycin and bowel lavage to increase donor feces engraftment, and domperidone to prevent nausea and regurgitation. The FMT will be performed via direct injection of the fecal suspension into the duodenum via a gastroscope. There will be six follow-up moments during three months. Blood will be drawn on three occasions. Physical examination, filling in of questionnaires and a diary, and collection of stool samples are performed at baseline and each in-person follow-up visit (except for the FMT visit). This study was approved by the Medical Ethical Committee Leiden Den Haag Delft (ref. P20.087) and is registered in the Netherlands Trial Register (NL9438). Study results will be disseminated through publication in peer-reviewed journals and international conferences.

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“…56 A systematic review of 16 microbiome-based treatments (including probiotics) for autism did not report convincing evidence of benefit, although overall data was lacking. 57 Small case series of patients with Parkinson's disease have demonstrated improvement in constipation, 58,59 and, in some, motor symptoms, 60 with a preference for colonoscopic over nasojejunal administration suggested by one study. 61 Positive results with varying proposed mechanisms have been demonstrated in mouse models of Parkinsons.…”

Section: The Gut-brain Axis: Neurological and Psychiatric Conditionsmentioning

confidence: 99%

An update on fecal microbiota transplantation for the treatment of gastrointestinal diseases

Waller

Leong

Paramsothy

2021

J of Gastro and Hepatol

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Our understanding of the microbiome and its implications for human health and disease continues to develop. Fecal microbiota transplantation (FMT) is now an established treatment for recurrent Clostridioides difficile infection. There is also increasing evidence for the efficacy of FMT in inducing remission for mild-moderate ulcerative colitis. However, for other indications, data for FMT are limited, with randomized controlled trials rare, typically small and often conflicting. Studies are continuing to explore the role of FMT for many other conditions, including Crohn's disease, functional gut disorders, metabolic syndrome, modulating responses to chemotherapy, eradication of multidrug resistant organisms, and the gut-brain axis. In light of safety, logistical, and regulatory challenges, there is a move to standardized products including narrow spectrum consortia. However, the mechanisms underpinning FMT remain incompletely understood, including the role of non-bacterial components, which may limit success of novel microbial approaches.

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Fecal microbiota transplant as a potential treatment for Parkinson's disease – A case series

Cited by 74 publications

References 31 publications

Gut Microbiota: A Novel Therapeutic Target for Parkinson’s Disease

Gut Microbiota: A Novel Therapeutic Target for Parkinson’s Disease

Safety and feasibility of fecal microbiota transplantation for Parkinson’s disease patients: a protocol for a self-controlled interventional donor-FMT pilot study

An update on fecal microbiota transplantation for the treatment of gastrointestinal diseases

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