Colonic Biopsies to Assess the Neuropathology of Parkinson’s Disease and Its Relationship with Symptoms – Source: PLoS One, Sep 14, 2010

[Note: to read the full text of this article free, click HERE.  Lewy bodies/neurites are abnormal protein clumps that develop inside the nerve cells of Parkinson’s patients – both in the brain and, as this study of colon biopsies demonstrates, in the enteric nervous system (which directly controls the gastrointestinal system).]

Background: The presence of Lewy bodies and Lewy neurites (LN) has been demonstrated in the enteric nervous system (ENS) of Parkinson's disease (PD) patients.
The aims of the present research were to use routine colonoscopy biopsies:

1. To analyze, in depth, enteric pathology throughout the colonic submucosal plexus (SMP) [tissue containing nerves, blood and lymphatic vessels supplying the mucous lining], and

2. To correlate the pathological burden with neurological and gastrointestinal (GI) symptoms.

Methodology/Principal Findings: A total of 10 control and 29 PD patients divided into 3 groups according to disease duration were included. PD and GI symptoms were assessed using the Unified Parkinson's Disease Rating Scale part III and the Rome III questionnaire, respectively. Four biopsies were taken from the ascending and descending colon during the course of a total colonoscopy.

Immunohistochemical analysis was performed using antibodies against phosphorylated alpha-synuclein, neurofilaments NF 220 kDa (NF) and tyrosine hydroxylase (TH).

The density of LN, labeled by anti-phosphorylated alpha-synuclein antibodies, was evaluated using a quantitative rating score.

Lewy pathology was apparent in the colonic biopsies from 21 patients and in none of the controls.

A decreased number of NF-immunoreactive neurons per ganglion was observed in the SMP of PD patients compared to controls.

The amount of LN in the ENS was inversely correlated with neuronal count and positively correlated with levodopa-unresponsive features and constipation.

Conclusion/Significance: Analysis of the ENS by routine colonoscopy biopsies:

• Is a useful tool for pre-mortem neuropathological diagnosis of PD,

• And also provides insight into the progression of motor and non-motor symptoms.

Source: PLoS One, Sep 14, 2010;5(9): e12728. DOI:10.1371/journal.pone.0012728, by Lebouvier T, Neunlist M, de varannes SB, Coron E, Brouard A, N’guyen JM, Chaumette T, Tasselli M, Paillusson S, flamand M, Galmiche JP, Damier P, Derkinderen P. Inserm, Nantes; Universite de Nantes; CHU Nantes, France. [Email:]

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