Acupuncture modulates the microbiota-gut-brain axis: a new strategy for Parkinson's disease treatment

Abstract

Parkinson's disease is a relatively common neurodegenerative disorder in clinical practice, and its prevalence is increasing worldwide. It not only causes patients to have movement disorders such as tremors and delayed initiation but also makes them suffer from olfactory disorders, gastrointestinal disorders, insomnia and other symptoms, which imposes a heavy burden on both patients and their families. In recent years, some scholars believe that the gut-brain axis may be the key to revealing the pathogenesis of Parkinson's disease. The changes in intestinal flora, or bacterial infections and oxidative stress, lead to abnormal aggregation of alpha-synuclein and formation of neurotoxic Lewy bodies, which are transmitted to the central nervous system via the vagus nerve, thus causing Parkinson's disease. A large number of evidence-based studies have shown that acupuncture is effective in treating motor disorders and non-motor symptoms such as constipation, neuropsychiatric symptoms, and dysphagia symptoms in Parkinson's disease, also this treatment is safe. However, its mechanism remains unclear. Acupuncture may affect the gut-brain axis and treat PD by improving intestinal flora imbalance, interfering with the expression of alpha-synuclein protecting neurological function, reducing imflammation, and influencing glial cells, etc. Therefore, the aim of this review is to elucidate the pathogenesis of PD from the perspective of neural, immune, and metabolic signaling pathways of the microbiota-gut-brain axis. In addition, this paper integrates the mechanism of acupuncture treatment with the pathogenesis of PD for the first time and to provide potential new strategies for its treatment.

Keywords: Parkinson’s disease; acupuncture; microbiota-gut-brain axis; pathogenesis; strategy.

Figure 1

Acupuncture regulates Parkinson’s disease through the gut-brain axis. Due to changes in the intestinal microbiota, and bacterial infections, leading to the aggregated α-syn. Then they are transmitted to the CNS via the vagus nerve and form neurotoxic LBs in the brain, which lead to PD. EGCs activation impairs the gut barrier and increases peripheral proinflammatory factors, activates microglia, opens the BBB, and then allows aggregated α-syn to enter the brain. Changes in the gut microbiota may also lead to a reduction in SCFAs. Acupuncture mainly affects the gut-brain axis by improving intestinal flora dysbiosis, interfering with α-syn expression, protecting neurological function, anti-inflammation, and affecting glial cells. This figure was created by BioRender (www.biorender.com).