Progress of pathophysiological mechanism and treatment of constipation in patients with Parkinson disease
MA Xue1,2,3,4 WANG Qiang2,3,4 WANG Yuan2,3,4 YUAN Wei2,3,4 LIU Zhibin2,3,4
1.College of Acupuncture and Moxibustion and Massage, Shaanxi University of Traditional Chinese Medicine, Shaanxi Province, Xianyang 712046, China; 2.the Third Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang Province, Hangzhou 310051, China;
3.Shaanxi Key Laboratory of Acupuncture and Herbal Medicine, Shaanxi Province, Xianyang 712046, China;
4.Key Laboratory of Neurobiology (Acupuncture) of Xianyang, Shaanxi Province, Xianyang 712046, China
Abstract：Constipation is one of the most common precursor non-motor symptoms of Parkinson disease, and the severity of constipation is associated with the risk of Parkinson disease in the future. Constipation not only causes clinical symptoms of Parkinson disease, but also affects the pathophysiological changes of movement fluctuations in patients with advanced Parkinson disease through its negative effects on the absorption of Levodopa. The high socio-economic burden of constipation and other constipation-related intestinal complications in patients with Parkinson disease call for an accurate and effective treatment strategy, which requires an in-depth understanding of the complex pathophysiological factors that affect constipation in patients with Parkinson disease. Therefore, it is very important to study the mechanism of constipation in Parkinson disease. This article will focus on the pathophysiological mechanism and treatment status of constipation in Parkinson disease.
马雪1,2,3,4 王强2,3,4 王渊2,3,4 袁伟2,3,4 刘智斌2,3,4. 帕金森病便秘的病理生理机制及治疗进展[J]. 中国医药导报, 2021, 18(23): 33-37.
MA Xue1,2,3,4 WANG Qiang2,3,4 WANG Yuan2,3,4 YUAN Wei2,3,4 LIU Zhibin2,3,4. Progress of pathophysiological mechanism and treatment of constipation in patients with Parkinson disease. 中国医药导报, 2021, 18(23): 33-37.
[1] Cersosimo MG，Raina GB，Pecci C，et al. Gastrointestinal manifestations in Parkinson’s disease：prevalence and occurrence before motor symptoms [J]. Neurol，2013，260（5）：1332-1338.
[2] Pfeiffer RF. Gastrointestinal Dysfunction in Parkinson’s Disease [J]. Curr Treat Options Neurol，2018，20（12）：54.
[3] Postuma RB，Gagnon JF，Pelletier A. Prodromal autonomic symptoms and signs of Parkinson’s disease and dementia with Lewy bodies [J]. Mov Disord，2013，28（5）：597-604.
[4] Goldman JG，Postuma R. Premotor and nonmotor features of Parkinson’s disease [J]. Curr Opin Neurol，2014，27（4）：434-441.
[5] Sharma A，Kurek J，Morgan JC，et al. Constipation in Parkinson’s Disease：a Nuisance or Nuanced Answer to the Pathophysiological Puzzle？ [J]. Curr Gastroenterol Rep，2018，20（1）：1-9.
[6] Visanji N，Marras C. The relevance of pre-motor symptoms in Parkinson’s disease [J]. Expert Rev Neurother，2015，15（10）：1205.
[7] Adams-Carr K，Schrag A，Shribman S，et al. Constipation preceding Parkinson’s disease：a systematic review and meta-analysis [J]. J Neurol Neurosurg Psychiatry，2016，87（11）：710-716.
[8] Song EM，Lee HJ，Jung KW，et al. Long-term Risks of Parkinson’s Disease, Surgery, and Colorectal Cancer in Patients with Slow-transit Constipation [J]. Clin Gastroenterol Hepatol，2020，S1542-3565（21）：312180.
[9] Lin CH，Lin JW，Liu YC，et al. Risk of Parkinson’s disease following severe constipation：A nationwide population-based cohort study [J]. Parkinsonism Relat Disord，2015，22（9）：1280-1287.
[10] Gao X，Chen H，Schwarzschild MA，et al. A Prospective Study of Bowel Movement Frequency and Risk of Parkinson’s Disease [J]. Am J Epidemiol，2011，174（5）：546-551.
[11] Martinez-Martin P. The importance of non-motor disturbances to quality of life in Parkinson’s disease [J]. J Neurol Sci，2011，310（1/2）：12-16.
[12] Knudsen K，Krogh K，?覫stergaard K，et al. Constipation in parkinson’s disease：Subjective symptoms，objective markers，and new perspectives [J]. Mov Disord，2017，32（1）：94-105.
[13] Stocchi F, Torti M. Constipation in Parkinson’s disease [J]. Int Rev Neurobiol，2017，134：811-826.
[14] Kuo YM，Li Z，Jiao Y，et al. Extensive enteric nervous system abnormalities in mice transgenic for artificial chromosomes containing Parkinson disease-associated alpha-synuclein gene mutations precede central nervous system changes [J]. Hum Mol Genet，2010，4（19）：1633-1650.
[15] Cersosimo MG，Benarroch EE. Pathological correlates of gastrointestinal dysfunction in Parkinson’s disease [J]. Neurobiol Dis，2012，46（3）：559-564.
[16] Hinkle JT，Perepezko K，Mills KA，et al. Dopamine transporter availability reflects gastrointestinal dysautonomia in early Parkinson disease [J]. Parkinsonism Relat Disord，2018，55：8-14.
[17] Fornai M，Pellegrini C，Antonioli L，et al. Enteric dysfunctions in experimental Parkinson’s disease：alterations of excitatory choliner-gic neurotransmission regulating colonic motility in rats [J]. J Pharmacol Exp Ther，2016， 356（2）：434-444.
[18] Gjerloff T，Fedorova T，Knudsen K，et al. Imaging acetylcholinester-ase density in peripheral organs in Parkinson’s disease with 11C-donepezil PETs [J]. Brain，2015， 138：653-663.
[19] Anderson G，Noorian AR，Taylor G，et al. Loss of enteric dopaminergic neurons and associated changes in colon motility in an MPTP mouse model of Parkinson’s disease [J]. Exp Neurol，2007，207：4-12.
[20] Unger MM，Spiegel J，Dillmann KU，et al. Short chain fatty acids and gut microbiota differ between patients with Parkinson’s disease and age-matched controls [J]. Parkinsonism Relat Disord，2016，32：66-72.
[21] Scheperjans F，Aho V，Pereira PAB，et al. Gut microbiota are related to Parkinson’s disease and clinical phenotype [J]. Mov Disord，2015，30（3）：350-358.
[22] Yang NJ，Chiu IM. Bacterial Signaling to the Nervous System through Toxins and Metabolites [J]. J Mol Biol，2017，429（5）：587-605.
[23] Pituch A，Walkowiak J，Banaszkiewicz A. Butyric acid in functional constipation [J]. Prz Gastroenterol，2013，8（5）：295-298.
[24] Fitzgerald E，Murphy S，Martinson HA. Alpha-Synuclein Pathology and the Role of the Microbiota in Parkinson’s Disease [J]. Front Neurosci，2019，13：369.
[25] Hilton D，Stephens M，Kirk L，et al. Accumulation of α-synuclein in the bowel of patients in the pre-clinical phase of Parkinson’s disease [J]. Acta Neuropathologica，2014，127（2）：235-241.
[26] Liddle RA. Parkinson’s disease from the gut [J]. Brain Res，2018，1693（Pt B）：201-206.
[27] Shannon KM，Keshavarzian A，Dodiya HB，et al. Is alpha-synuclein in the colon a biomarker for premotor Parkinson’s disease？Evidence from 3 cases [J]. Mov Disord，2012，27（6）：716-719.
[28] Corbillé AG，Letournel F，Kordower JH，et al. Evaluation of alpha-synuclein immunohistochemical methods for the detection of Lewy-type synucleinopathy in gastrointestinal biopsies [J]. Acta Neuropathol Commun，2016，4：35.
[29] Lebouvier T，Neunlist M，Bruley des Varannes S，et al. Colonic Biopsies to Assess the Neuropathology of Parkinson’s Disease and Its Relationship with Symptoms [J]. PLoS One，2010，5：e12728.
[30] Bhattacharyya D，Mohite GM，Krishnamoorthy J，et al. Lipopolysaccharide from Gut Microbiota Modulates α-Synuclein Aggregation and Alters its Biological Function [J]. Neurosci，2019，10：2229-2236.
[31] Devos D，Lebouvier T，Lardeux B，et al. Colonic inflammation in Parkinson’s disease [J]. Neurobiol Dis，2013， 50：42-48.
[32] 刘晓林，余美玲，谢静，等.便秘、结肠黏膜炎症及肠源性内毒素与帕金森病相关性研究[J].药物治疗学杂志，2017，22（4）：456-460.
[33] Clairembault T，Leclair-Visonneau L，Neunlist M，et al. Enteric glial cells: new players in Parkinson’s disease？[J]. Mov Disord，2015，30（4）：494-498.
[34] Chen QQ，Haikal C，Li W，et al. Gut Inflammation in Association With Pathogenesis of Parkinson’s Disease [J]. Front Mol Neurosci，2019，12：218.
[35] Dutta SK，Verma S，Jain V，et al. Parkinson’s Disease：The Emerging Role of Gut Dysbiosis, Antibiotics，Probiotics，and Fecal Microbiota Transplantation [J]. Neurogastroenterol Motil，2019，25（3）：363-376.
[36] Yu QJ，Yu SY，Zuo LJ，et al. Parkinson disease with constipation: clinical features and relevant factors [J]. Sci Rep，2018，8（1）：567.
[37] Pagano G，Tan EE，Haider JM，et al. Constipation is reduced by beta-blockers and increased by dopaminergic medications in Parkinson’s disease [J]. Parkinsonism Relat Disord，2015，21：120-125.
[38] 刘凤春，高利，常红，等.自制中药穴位贴在帕金森便秘病人中的应用效果[J].中西医结合心脑血管病杂志，2018， 16（22）：3358-3361.
[39] 杨俊秀，张本恕，国树超，等.帕金森病与特发性震颤患者非运动症状的临床分析[J].中国综合临床，2018，34（1）：38-41.
[40] Pedrosa Carrasco AJ，Timmermann L，Pedrosa DJ. Management of Constipation in Patients With Parkinson Disease [J]. NPJ Parkinsons Dis，2018，15（7）：388-389.
[41] Palma JA，Kaufmann H. Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies[J]，Mov Disord，2018，33：372-390.
[42] Pfeiffer RF. Management of Autonomic Dysfunction in Parkinson’s Disease [J]. Semin Neurol，2017，37（2）：176-185.
[43] Freitas ME，Alqaraawi A，Lang AE，et al. Linaclotide and Prucalopride for Management of Constipation in Patients with Parkinsonism [J]. Mov Disord Clin Pract，2018，5（2）：218-220.
[44] Tateno F，Sakakibara R，Yokoi Y，et al. Levadopa ameliorated anorectal constipation in de novo Parkinson’s disease：the QL-GAT study [J]. Parkinsonism Relat Disord，2011，17（9）：662-666.
[45] Edwards LL，Quigley EM，Harned RK，et al. Defecatory response to apomorphine [J]. Ann Neurol，1993，33（5）：490-493.
[46] Mozaffari S，Nikfar S，Daniali M，et al. The pharmacological management of constipation in patients with Parkinson’s disease：a much-needed relief [J]. Expert Opin Pharmacother，2020，21（6）：701-707.
[47] Pedrosa Carrasco AJ，Timmermann L，Pedrosa DJ. Management of constipation in patients with Parkinson’s disease [J]. NPJ Parkinsons Dis，2018（16）：4-6.
[48] 沈利荣，王厹东，沈丽萍，等.针灸治疗中晚期帕金森病便秘的临床疗效及对患者用药依从性的影响[J].上海中医药杂志，2019，53（3）：62-66.
[49] 陈敏，王祎晟，张晓菁.益气健脾汤联合针刺治疗气虚型帕金森病病人便秘的临床疗效[J].中西医结合心脑血管病杂志，2018，16（2）：143-146.
[50] 蔡丽，刘毅，曹燕.止颤汤结合针刺治疗帕金森病病人便秘症状的临床研究[J].中西医结合心脑血管病杂志，2019，17（13）：2034-2037.
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