Role of Chronic Infection and Inflammation in the Gastrointestinal Tract in the Etiology and Pathogenesis of Idiopathic Parkinsonism

Abstract

Interim analysis points to a direct or surrogate (not necessarily unique) role of a particular infection in the pathogenesis of parkinsonism. With eradication failure, bolus release of antigen from killed bacteria could aggravate an effect of ongoing infection.

Helicobacter pylori infection is associated with worse severity of Parkinson's disease

“…However, only two studies [19,23] attempted to correlate, in a cross-sectional manner, the presence of HP infection with worse PD severity. These studies were limited by small sample size [18e20, 22,23], open-label design [19,20,22], and/or the use of non-validated assessments of motor function [17,21,23]; several have been reported in abstract form only [20,22,23]. Thus, a recent Cochrane review concluded that further studies are required to address the gaps in knowledge regarding the role of HP infection in PD [24], and screening PD patients for HP status has yet to enter routine clinical practice.…”

High prevalence of Helicobacter pylori infection in Malaysian Parkinson's disease patients

“…3 Cycad is known to cause amyotrophic lateral sclerosis/parkinsonism-dementia complex among populations in Guam 4,5 and Japan's Kii Peninsula. 6 Studies have shown that H. pylori infection leads to poorer motor function, 7,8 and eradication leads to improvement in stride length. 7 Eradication of H. pylori also correlated with a reduction in inflammatory markers, 9,10 leading some authors to hypothesize that H. pylori infection leads to a chronic inflammatory process resulting in the destruction of dopaminergic neurons.…”

Other Forms of Gastroparesis

“…Electrogastrography has also been used to study gastric motor activity in PD, but correlations with symptoms have been poor. 70,71 Parenthetically, it is of interest to note the suggestion that Helicobacter pylori and Helicobacter heilmannii infection are implicated in contributing to, not only gastrointestinal symptoms and weight loss in PD 72 , but also systemic proinflammatory cytokine activation, 73 and even the pathogenesis of PD itself. 74 …”