Parkinson's disease is a degenerative neurological disorder characterized by tremors, rigidity, and bradykinesia. (Wikimedia Commons) 
Medicine

Microbiome Marvel: Fecal Transplants Offer Hope for Parkinson's Patients

In Parkinson's disease, fecal microbiota transplants show promise in potentially changing the course of the disease by balancing the gut microbiota

Dr. Pallavi Saxena

Highlights

  • A novel study investigates the potential of fecal microbiota transplantation (FMT) in the management of Parkinson's disease (PD).

  • Significant improvements in motor symptoms are seen in PD patients receiving FMT, according to a clinical experiment carried out in Belgium.

  • FMT shows promise in balancing the gut microbiota and reducing symptoms, providing hope for improved quality of life in the treatment of Parkinson's disease.

With its limited treatment choices and complex nature, Parkinson's disease (PD) affects millions of people globally and presents substantial obstacles. Nevertheless, by investigating the therapeutic potential of using Fecal Microbiota Transplantation (FMT) to harness beneficial gut bacteria, this groundbreaking work provides a glimmer of hope.

This study is predicated on the idea that the gut-brain microbiome axis (GBA) may be a viable target for treatment since it plays a critical role in the pathophysiology of PD.

In PD, dysregulation of the microbiome of GBA is a critical mechanism that occurs before motor symptoms. Alterations in the gut microbiota linked to PD indicate major changes in metabolic activities that are important for disease progression. The varied population of bacteria living in the GI tract is known as the gut microbiome, and it has been suggested that this community may have a role in the etiology of several diseases, including neurological conditions like PD.

Exploring the intricate link between the gut and the brain: Unraveling the mysteries of the gut-brain axis in Parkinson's disease. (Wikimedia Commons)

The GBA is a bidirectional communication network between the gut and the central nervous system. Changes in this pathway may impact the development of neurologic illnesses. This raises the question of whether changes in the gut microbiota may have an impact on the development and symptoms of Parkinson's disease.

Could the gut microbiome hold the secret to treating Parkinson's disease? Scientists investigate the complex relationship. (Wikimedia Commons)

To restore a more varied and balanced microbiota composition, FMT entails transferring fecal material from a healthy donor to the recipient.

In this context, a single-center, double-blind, randomized controlled trial has been carried out in Belgium.  The research team started a clinical experiment called GUT-PARFECT under the direction of Professor Patrick Santens of University Hospital Ghent (UZ Gent), in cooperation with Professors Debby Laukens of Ghent University and Roosmarijn Vandenbroucke of the VIB-UGent Center for Inflammation Research. Their goal was to find out if FMT helped balance the gut microbiota and lessen Parkinson's symptoms.

This phase II of the clinical trial stretches from December 2020 to 2021. In this period, the FMT procedure was carried out on 46 patients with early-stage PD between the ages of 50 and 65 who were randomly assigned to receive the “nose-to-intestine” route of FMT. 

Participants in the research with early-stage Parkinson's disease underwent a minimally invasive procedure to obtain stool transplants from healthy donors. Interestingly, compared to the placebo group, the FMT group showed much better motor symptom resolution after a full year of treatment. Notably, between the sixth and twelfth months following transplantation, these gains grew stronger, indicating a possible long-lasting therapeutic effect.

The study's implications extend beyond symptom management, with participants also experiencing relief from constipation, a prevalent and distressing symptom in Parkinson's patients. While further research is necessary to ascertain the treatment's ability to slow disease progression, this study represents a significant stride toward enhancing the therapeutic arsenal against Parkinson's disease.

This ground-breaking study highlights the revolutionary potential of FMT in changing the landscape of Parkinson's disease treatment and is a monument to the strength of collaborative research. This finding brings hope to the millions of people affected by Parkinson's disease and signals a more promising future in the battle against this debilitating neurological disorder as the search for novel medicines continues.

This cutting-edge study, which was just published in eClinicalMedicine, shows that FMT may be effective in reducing symptoms and enhancing the quality of life for those suffering from this crippling neurological illness.

What does the research team say??

Our results are really encouraging! After twelve months, participants who received the healthy donor stool transplant showed a significant improvement in their motor score, the most important measure for Parkinson's symptoms.
Dr. Arnout Bruggeman, First Author of the Study, Department of Neurology, University Hospital Ghent, Ghent, Belgium Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium VIB-UGent Center for Inflammation Research, VIB, Ghent, Belgium Faculty of Sciences, Ghent University, Ghent, Belgium
"Because there were major questions about the feasibility at the start of the study, financing this research was no easy task. This research was only possible thanks to the support of patient organizations, donations to the UGent Parkinson Research Fund, and the willingness of participants to undergo the rather invasive procedures"
Professor Patrick Santens, Department of Neurology, University Hospital Ghent, Ghent, Belgium Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
Our study provides promising hints that FMT can be a valuable new treatment for Parkinson's disease. More research is needed, but it offers a potentially safe, effective, and cost-effective way to improve symptoms and quality of life for millions of people with Parkinson's disease worldwide
Professor Roosmarijn Vandenbroucke, VIB-UGent Center for Inflammation Research, VIB, Ghent, Belgium Faculty of Sciences, Ghent University, Ghent, Belgium
"Our next step is now to obtain funding to try to determine which bacteria have a positive influence. This could lead to the development of a 'bacterial pill' or other targeted therapy that could replace FMT in the future"
Professor Debby Laukens, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

References

Bruggeman, Arnout, Charysse Vandendriessche, Hannelore Hamerlinck, Danny De Looze, David J. Tate, Marnik Vuylsteke, Lindsey De Commer, et al. 2024. “Safety and Efficacy of Faecal Microbiota Transplantation in Patients With Mild to Moderate Parkinson’s Disease (GUT-PARFECT): A Double-blind, Placebo-controlled, Randomised, Phase 2 Trial.” EClinicalMedicine 71 (May): 102563. https://doi.org/10.1016/j.eclinm.2024.102563.

By Dr. Pallavi Saxena

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