Role of Helicobacters in Neuropsychiatric Disease: A Systematic Review in Idiopathic Parkinsonism
| Autor: | Ingvar Bjarnason, Andre Charlett, Bu Hayee, Sylvia M. Dobbs, Aisha D Augustin, Clive Weller, Rosalind M Tucker, David Taylor, R. John Dobbs |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Parkinson's disease lcsh:Medicine Review macromolecular substances Immune tolerance 03 medical and health sciences 0302 clinical medicine Hypokinesia Internal medicine eradication medicine aetiopathogenesis Helicobacter brady/hypokinesia biology Helicobacter pylori business.industry Parkinsonism lcsh:R virulence markers General Medicine biology.organism_classification medicine.disease non-Helicobacter pylori Helicobacters Natural history Systematic review rigidity Parkinson’s disease 030211 gastroenterology & hepatology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Medicine, Vol 9, Iss 2159, p 2159 (2020) Journal of Clinical Medicine |
| ISSN: | 2077-0383 |
| Popis: | Interest in an aetiopathogenic role for Helicobacter in neuropsychiatric diseases started with idiopathic parkinsonism (IP), where the cardinal signs can be assessed objectively. This systematic review, using an EMBASE database search, addresses Oxford Centre for Evidence-Based Medicine based questions on the inter-relationship of Helicobacter and IP, the benefits of eradicating Helicobacter in IP and the outcome of not treating. The search strategy was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines: 21 of 204 articles met the inclusion criteria. The results show that the assumption that any benefit of Helicobacter eradication results from improved levodopa bioavailability is unjustified. The inter-relationship between Helicobacter and IP is well-established. H. pylori virulence markers (associated with autoimmunity and immune tolerance) influence the risk, severity and progression of IP. The birth cohort effect for virulence marker antibodies, seen in controls, is obliterated in IP, suggesting causality. Successful H. pylori eradication in IP is disease-modifying (even in anti-parkinsonian treatment-naïve patients) but not preventive. Hypokinesia regresses with eradication and overall motor severity lessens. Eradication may influence gastrointestinal microbiota adversely, unlocking the next stage in the natural history, the development of rigidity. Failed eradication worsens hypokinesia, as does the presence/persistence of H. pylori at molecular level only. Adequate prognostic assessment of the consequences of not treating Helicobacter, for IP, is prevented by a short follow-up. We conclude that Helicobacter is a pathophysiological driver of IP. |
| Databáze: | OpenAIRE |
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