The role of gut microbiota in the pathogenesis of Parkinson’s disease: mechanisms of influence and therapeutic perspectives (review)

Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide and carries a significant social and medical burden, particularly due to the rapid increase in prevalence associated with global population aging. Recent research highlights the crucial role of gut–brain axis dysfunction, particularly microbiota imbalance, in the pathogenesis of PD. It is increasingly supported that the pathological process may originate in the enteric nervous system under the influence of external factors, with subsequent propagation of aggregated α-synuclein to the central nervous system via the vagus nerve.Intestinal dysbiosis is considered an early trigger of the disease, contributing to systemic and neuroinflammation. Alterations in microbial composition increase intestinal permeability, activate immune responses, and promote excessive production of proinflammatory cytokines (IL-6, TNF-α, IL-1β). These mechanisms initiate neurodegenerative processes, notably the loss of dopaminergic neurons in the substantia nigra, clinically manifesting with both motor and non-motor symptoms of PD. Moreover, the gut microbiota influences the synthesis of short-chain fatty acids and neurotransmitters directly involved in brain regulation.A deeper understanding of the role of microbiota in PD pathogenesis opens new therapeutic perspectives. Current strategies under investigation include probiotics, prebiotics, fecal microbiota transplantation, and pharmacological approaches targeting the gut-brain axis. Despite encouraging findings from experimental and clinical studies, the efficacy of these interventions remains insufficiently proven, emphasizing the need for large-scale randomized controlled trials.Thus, the gut and its microbiota are viewed not only as additional pathogenetic factors but also as potential therapeutic targets capable of modifying the course of Parkinson’s disease and offering new opportunities for personalized medicine.