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Review
. 2021;11(1):31-43.
doi: 10.3233/JPD-202279.

Infection and Risk of Parkinson's Disease

Richard J Smeyne  1 , Alastair J Noyce  2   3 , Matthew Byrne  1 , Rodolfo Savica  4 , Connie Marras  5
Affiliations
Review

Infection and Risk of Parkinson's Disease

Richard J Smeyne et al. J Parkinsons Dis. 2021.

Abstract

Parkinson's disease (PD) is thought to be caused by a combination of genetic and environmental factors. Bacterial or viral infection has been proposed as a potential risk factor, and there is supporting although not entirely consistent epidemiologic and basic science evidence to support its role. Encephalitis caused by influenza has included parkinsonian features. Epidemiological evidence is most compelling for an association between PD and hepatitis C virus. Infection with Helicobacter pylori may be associated not only with PD risk but also response to levodopa. Rapidly evolving knowledge regarding the role of the microbiome also suggests a role of resident bacteria in PD risk. Biological plausibility for the role for infectious agents is supported by the known neurotropic effects of specific viruses, particular vulnerability of the substantia nigra and even the promotion of aggregation of alpha-synuclein. A common feature of implicated viruses appears to be production of high levels of cytokines and chemokines that can cross the blood-brain barrier leading to microglial activation and inflammation and ultimately neuronal cell death. Based on multiple avenues of evidence it appears likely that specific bacterial and particularly viral infections may increase vulnerability to PD. The implications of this for PD prevention requires attention and may be most relevant once preventive treatments for at-risk populations are developed.

Keywords: Parkinson’s disease; bacteria; etiology; infection; viruses.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Dr. Smeyne receives research support from the National Institute of Neurological Disorders and Str-oke and the National Institute of Environmental Health Science.

Dr. Marras Receives research support from the Parkinson’s Foundation (US), Michael J Fox Foundation, Canadian Institutes of Health Research and is a site investigator for a clinical trial supported by Theravance.

Dr. Savica receives research support from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, and the Mayo Clinic Small Grants Program National Center for Advancing Translational Sciences (NCATS) and Acadia Pharmaceuticals Inc.

Dr. Noyce is funded by the Barts Charity. He reports additional grants from Parkinson’s UK, Ali-gning Science Across Parkinson’s (ASAP) and Michael J Fox Foundation (MJFF), the Virginia Kieley Benefaction, grants and non-financial support from GE Healthcare, and personal fees from Bial, Britannia, AbbVie, Profile, F. Hoffmann-La Roche and Biogen.

Figures

Fig. 1
Fig. 1
Based on available evidence, hypothesized process by which infectious agents increase susceptibility to PD.
See this image and copyright information in PMC

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