Two hallmarks of Parkinson’s disease (PD) are the widespread deposition of misfolded alpha-synuclein (αSyn) protein in the nervous system and loss of substantia nigra dopamine neurons. Recent research has suggested that αSyn aggregates in the enteric nervous system (ENS) lead to prodromal gastrointestinal (GI) symptoms such as constipation in PD, then propagating to the brain stem and eventually triggering neurodegeneration and motor symptoms. Additionally, whether the microbiome changes in PD contribute to the primary pathogenesis or, alternatively, are consequential to either the disease process or medication is still unclear. In this review, we discuss the possible roles of αSyn and microbiome changes in the GI system in PD and consider if and how the changes interact and contribute to the disease process and symptoms.

帕金森病 (PD) 的两个标志是错误折叠的 α-突触核蛋白 (αSyn) 蛋白在神经系统中的广泛沉积和黑质多巴胺神经元的丧失。最近的研究表明，肠神经系统 (ENS) 中的 αSyn 聚集体会导致前驱胃肠道 (GI) 症状，例如 PD 中的便秘，然后传播到脑干并最终引发神经变性和运动症状。此外，PD 中的微生物组变化是否有助于原发性发病机制，或者是否与疾病过程或药物有关，目前尚不清楚。在这篇综述中，我们讨论了 PD 中 GI 系统中αSyn 和微生物组变化的可能作用，并考虑这些变化是否以及如何相互作用并促成疾病过程和症状。