A new study has shown that people who have a history of upper gastrointestinal damage have a 76 per cent higher risk of developing Parkinson’s disease later in life.
Typically, Parkinson’s disease has been thought to originate in the brain, however, recent research has stipulated the gut-first hypothesis of Parkinson’s disease which suggests that people with a history of gastrointestinal problems are more likely to go on to develop the condition.
In fact, many patients with Parkinson’s disease experience gastrointestinal problems during the condition and for many years before.
Now, a new study led by Beth Israel Deaconess Medical Center has taken a closer look at whether upper gastrointestinal mucosal damage is associated with increased risk of developing Parkinson’s.
The study looked at 9350 patients with no prior history of Parkinson’s, finding that mucosal damage, such as oesophageal damage or ulcers, was associated with a 76 per cent greater risk of developing a clinical Parkinson’s disease diagnosis.
Speaking to the Harvard Gazette, corresponding author of the study, Trisha Pasricha, a neurogastroenterologist and director of Clinical Research at the Institute for Gut-Brain Research at BIDMC, explained: “A growing body of evidence suggests that, at least in a subset of individuals, Parkinson’s disease originates in the gut before affecting the central nervous system.
“People often think about the ways the brain influences the gut, but the gut can exert enormous influence on the brain in ways we are still only beginning to understand.
“Many people who get Parkinson’s disease experience GI symptoms like constipation and nausea for years — even decades — prior to developing motor symptoms like difficulty walking or tremors.
“Our lab has been trying to better illuminate this ‘gut-first’ pathway of Parkinson’s disease because it can open new avenues for early intervention and treatment strategies.”
Gastrointestinal damage can also be caused by the use of nonsteroidal anti-inflammatory drugs (NSAID).
“NSAID use is so widespread — from back pain to headaches — and with peptic ulcers globally affecting upwards of eight million people, understanding the path from mucosal damage to Parkinson’s disease pathology may prove crucial to early recognition of risk as well as potential intervention,” Pasricha told the publication.
The authors wrote: “The findings of our investigation corroborate our hypothesis that upper gastrointestinal mucosal damage would be associated with clinical Parkinson’s disease development, reinforcing the theory of a gut-first progression in Parkinson’s disease in a subset of patients.
“These findings likely suggest one of two possibilities: first, that mucosal damage may serve as an inciting event that could precipitate pathologic alpha-synuclein misfolding in the gut. Second, as dopamine is known to play a key gastroprotective role, it may be that patients with subclinical dopaminergic signalling reduction are at higher risk of mucosal damage and that alpha-synuclein pathology preceded this event.
“Understanding these mechanisms is of great interest in future research endeavours.”
Based on the findings, the researchers have suggested that there should be increased vigilance among patients with upper gastrointestinal mucosal damage for future Parkinson’s disease diagnosis.
