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. 2022 May;15(2):106-114.
doi: 10.14802/jmd.21085. Epub 2021 Dec 24.

Fecal Calprotectin in Parkinson's Disease and Multiple System Atrophy

Jia Wei Hor  1   2 , Shen-Yang Lim  1   2 , Eng Soon Khor  3 , Kah Kian Chong  1 , Sze Looi Song  4 , Norlinah Mohamed Ibrahim  5 , Cindy Shuan Ju Teh  6 , Chun Wie Chong  7 , Ida Normiha Hilmi  8 , Ai Huey Tan  1   2
Affiliations

Fecal Calprotectin in Parkinson's Disease and Multiple System Atrophy

Jia Wei Hor et al. J Mov Disord. 2022 May.

Abstract

Objective: Converging evidence suggests that intestinal inflammation is involved in the pathogenesis of neurodegenerative diseases. Previous studies on fecal calprotectin in Parkinson's disease (PD) were limited by small sample sizes, and literature regarding intestinal inflammation in multiple system atrophy (MSA) is very scarce. We investigated the levels of fecal calprotectin, a marker of intestinal inflammation, in PD and MSA.

Methods: We recruited 169 subjects (71 PD, 38 MSA, and 60 age-similar nonneurological controls). Clinico-demographic data were collected. PD and MSA were subtyped and the severity assessed using the MDS-UPDRS and UMSARS, respectively. Fecal calprotectin and blood immune markers were analyzed.

Results: Compared to controls (median: 35.7 [IQR: 114.2] μg/g), fecal calprotectin was significantly elevated in PD (median: 95.6 [IQR: 162.1] μg/g, p = 0.003) and even higher in MSA (median: 129.5 [IQR: 373.8] μg/g, p = 0.002). A significant interaction effect with age was observed; between-group differences were significant only in older subjects (i.e., ≥ 61 years) and became more apparent with increasing age. A total of 28.9% of MSA and 18.3% of PD patients had highly abnormal fecal calprotectin levels (≥ 250 μg/g); however, this difference was only significant for MSA compared to controls. Fecal calprotectin correlated moderately with selected blood immune markers in PD, but not with clinical features of PD or MSA.

Conclusion: s Elevated fecal calprotectin suggests a role for intestinal inflammation in PD and MSA. A more complete understanding of gut immune alterations could open up new avenues of research and treatment for these debilitating diseases.

Keywords: Fecal calprotectin; Intestinal inflammation; Multiple system atrophy; Parkinson’s disease.

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Conflict of interest statement

Conflicts of Interest

The authors have no financial conflicts of interest.

Figures

Figure 1.
Figure 1.
Fecal calprotectin levels in PD, MSA and controls. A: Between-group comparisons were analyzed using the Mann–Whitney U test. Data are expressed as median [interquartile range]. B: Percentage of subjects with highly abnormal calprotectin levels (> 250 µg/g). Between-group comparisons were analyzed using the chi-square test. *denotes statistical significance. PD, Parkinson’s disease; MSA, multiple system atrophy
Figure 2.
Figure 2.
Fecal calprotectin levels in PD, MSA and controls, according to age. A: Scatterplot of fecal calprotectin levels (µg/g) in PD vs. controls against age. B: Scatterplot of fecal calprotectin levels (µg/g) in MSA vs. controls against age. C and D: Comparison of fecal calprotectin levels (µg/g) between PD, MSA and controls in two age groups, 60 years and below and 61 years and above. Between-group comparisons were analyzed using the Mann–Whitney U test. Data are expressed as median [interquartile range]. *denotes statistical significance. PD, Parkinson’s disease; MSA, multiple system atrophy.
See this image and copyright information in PMC

References

    1. Pouclet H, Lebouvier T, Coron E, Rouaud T, Flamant M, Toulgoat F, et al. Analysis of colonic alpha-synuclein pathology in multiple system atrophy. Parkinsonism Relat Disord. 2012;18:893–895. - PubMed
    1. Tremlett H, Bauer KC, Appel-Cresswell S, Finlay BB, Waubant E. The gut microbiome in human neurological disease: a review. Ann Neurol. 2017;81:369–382. - PubMed
    1. Tan AH, Chong CW, Lim SY, Yap IKS, Teh CSJ, Loke MF, et al. Gut microbial ecosystem in Parkinson disease: new clinicobiological insights from multi-omics. Ann Neurol. 2021;89:546–559. - PubMed
    1. Houser MC, Tansey MG. The gut-brain axis: is intestinal inflammation a silent driver of Parkinson’s disease pathogenesis? NPJ Parkinsons Dis. 2017;3:3. - PMC - PubMed
    1. Tan AH, Chong CW, Song SL, Teh CSJ, Yap IKS, Loke MF, et al. Altered gut microbiome and metabolome in patients with multiple system atrophy. Mov Disord. 2018;33:174–176. - PubMed