Parkinson’s Disease and the Gut Microbiota: Mechanistic Insights and Emerging Therapeutic Approaches

Parkinson's Disease (PD) is a neurodegenerative disorder that affects around 14 per 100,000 people each year, making it the second most frequent disease among the elderly behind Alzheimer's. It primarily affects males aged 55 to 65 and is projected to double in prevalence by 2050. The disease causes the loss of dopaminergic neurons in the substantia nigra and the formation of α-synuclein aggregates, including Lewy bodies, in the central and enteric nervous systems. It causes both motor and non-motor symptoms, including rigidity, bradykinesia, and tremors. Environmental pollutants, genetic predispositions, and dietary factors all play a role in the disease's onset and course. Emerging studies focus on the role of gut microbiota imbalances and dysbiosis in Parkinson's disease progression, with data suggesting that changes in gut-brain axis communication may worsen disease symptoms. This review analyses the relationship between gut microbiota, gastrointestinal dysfunction, and Parkinson's disease, with a focus on the effects of reduced short-chain fatty acids and increased intestinal permeability on disease pathology. It also explores the possibilities of dietary therapies, such as ketogenic diets, in controlling Parkinson’s symptoms. Recent therapeutic innovations, such as omega-3 fatty acids, vitamins, fecal microbiota transplantation, gene therapy, and probiotics, present intriguing treatment options. This review emphasizes the significance of a comprehensive approach to management, which includes innovative medications, lifestyle intervention, and nutritional measures to enhance prognosis and perhaps alter disease progression. Key words: Parkinson’s Disease, gut microbiota, gut microbiome therapy, alpha-synuclein, treatment, fecal microbiota transplantation