The gastrointestinal microbiome is altered in Parkinson’s disease and likely plays a key role in its pathophysiology, affecting symptoms and response to therapy and perhaps modifying progression or even disease initiation. Gut dysbiosis therefore has a significant potential as a therapeutic target in Parkinson’s disease, a condition elusive to disease-modifying therapy thus far. The gastrointestinal environment hosts a complex ecology, and efforts to modulate the relative abundance or function of established microorganisms are still in their infancy. Still, these techniques are being rapidly developed and have important implications for our understanding of Parkinson’s disease. Currently, modulation of the microbiome can be achieved through non-pharmacologic means such as diet, pharmacologically through probiotic, prebiotic, or antibiotic use and procedurally through fecal transplant. Novel techniques being explored include the use of small molecules or genetically engineered organisms, with vast potential. Here, we review how some of these approaches have been used to date, important areas of ongoing research, and how microbiome modulation may play a role in the clinical management of Parkinson’s disease in the future.

胃肠道微生物组在帕金森病中发生改变，并且可能在其病理生理学中发挥关键作用，影响症状和对治疗的反应，甚至可能改变进展甚至疾病的发生。因此，肠道菌群失调具有作为帕金森病治疗靶点的巨大潜力，帕金森病是一种迄今为止难以通过疾病缓解疗法实现的疾病。胃肠道环境具有复杂的生态系统，调节已建立微生物的相对丰度或功能的努力仍处于起步阶段。尽管如此，这些技术正在迅速发展，对我们了解帕金森病具有重要意义。目前，微生物组的调节可以通过非药物手段（例如饮食）来实现，药理学上可以通过益生菌、益生元或抗生素的使用来实现，程序上可以通过粪便移植来实现。正在探索的新技术包括使用小分子或基因工程生物，具有巨大的潜力。在这里，我们回顾了其中一些方法迄今为止的应用情况、正在进行的研究的重要领域，以及微生物组调节如何在未来帕金森病的临床管理中发挥作用。