More evidence of a link between systemic inflammation and Parkinson's disease

[jeffreyn]

"... the incidence of PD was 78% lower in patients with IBD who received anti-TNF therapy compared with those who did not ..."

"These findings support a role of systemic inflammation in the development of both PD and IBD ..."

Medscape article: Old Drug May Get New Life in Parkinson's Prevention.

medscape.com/viewarticle/89...

EurekAlert article: Parkinson's disease among patients with inflammatory bowel disease.

eurekalert.org/pub_releases...

Research paper (not open access, only "Key Points" and "Abstract" are accessible): Anti-Tumor Necrosis Factor Therapy and Incidence of Parkinson Disease Among Patients With Inflammatory Bowel Disease, Inga Peter et al., JAMA Neurol. Published online April 23, 2018. doi:10.1001/jamaneurol.2018.0605.

jamanetwork.com/journals/ja...

Editorial (not open access, only first page is accessible): Discovering New Benefits From Old Drugs With Big Data - Promise for Parkinson Disease, Abby Olsen et al., JAMA Neurol. Published online April 23, 2018. doi:10.1001/jamaneurol.2018.0345.

jamanetwork.com/journals/ja...

Although the research paper and the editorial are not open access, I found the bits that were accessible to be of interest.

[jeffreyn]

Update: I've just noticed that the SoPD blog has done a substantial post on this topic.

scienceofparkinsons.com/201...

[park_bear]

A while back someone posted a reference to alpha synulcein being released in the GI tract as part of an inflammatory response and elsewhere likewise in the brain. So I agree the evidence is pointing in this direction.

[jeffreyn in reply to park_bear]

Hi park_bear,

This might be the one you were thinking of:

healthunlocked.com/parkinso...

Jeff

[park_bear in reply to jeffreyn]

Those are good additions to the list. Here is another courtesy of aspergerian:

ncbi.nlm.nih.gov/pubmed/288...

"Alpha-synuclein levels increased during norovirus infection in the duodenum of children. In an in vitro paradigm, monomeric and oligomeric alpha-synuclein acted as chemoattractants for neutrophils and monocytes, and promoted the maturation of dendritic cells. This suggests that alpha-synuclein facilitates immune responses to infection."

[jeffreyn in reply to park_bear]

Yes indeed. That link points to the corresponding editorial covering the Stolzenberg et al. paper that I linked to.

Thanks,

Jeff

[jeffreyn]

A few other websites have now written articles covering this research paper. I found the following articles to be of interest, particularly as they include expert commentary from independent researchers.

AlzForum article: Treat IBD, Dodge PD? Epidemiology Ties Parkinson’s to Inflammation.

alzforum.org/news/research-...

MEDPAGE TODAY article: Anti-TNF Cuts PD Risk in IBD

medpagetoday.com/gastroente...

MANAGED HEALTH CARE CONNECT article: IBD Patients Treated With Anti-TNF Drugs Have a Lower Risk of Parkinson’s

managedhealthcareconnect.co...

[Kimbo1962]

Totally agree. My hubbys PD symptoms always become worse when he gets inflammation which affects his joints. He was misdiagnosed for 7 years with gout until eventually diagnosed with PD. Flares up suddenly and then his movements become so slow.

[jeffreyn in reply to Kimbo1962]

Does he also have arthritis?

(just checking)

[Kimbo1962 in reply to jeffreyn]

Yes, he does now, the pain is always bad when the inflammation flares up. The only thing that helps is cortisone and amazingly improves his movement immensely.

[jeffreyn in reply to Kimbo1962]

I'm not a doctor and I don't have arthritis, but it occurs to me that it could be the arthritis which is flaring up and causing the inflammation (i.e. the inflammation is independent of the PD).

[Kimbo1962 in reply to jeffreyn]

Could be.....all we have figured out is that when the inflammation is at its worst the PD symptoms are much worse.

[jeffreyn in reply to Kimbo1962]

I'm sorry for being persistent, but this might be significant.

Movements slowing down when arthritis flares up seems normal to me (i.e. arthritis occurs in the joints). Have you noticed any other PD symptoms getting worse when the inflammation gets worse?

[Kimbo1962 in reply to jeffreyn]

What starts first is the brain fog....when this happens we know there is going to be a flare up. The tremors also worsen. Interestingly he was tested for rheumatoid arthritis but was negative. From what I have read inflammation seems to be part of Parkinson’s.

[jeffreyn in reply to Kimbo1962]

Thanks very much for the extra details.

Regarding inflammation and PD, chronic inflammation in the brain seems to be associated with PD. It is known that (chronic) inflammation in the body will cause (chronic) inflammation in the brain. In my case, I'm not even aware of the inflammation (i.e. my dopamine neurons are dying quietly).

From what you describe, arthritis flares up periodically and this seems to cause (or at least is associated with) a worsening of PD symptoms. Wow! If it was me who had the arthritis (as well as my PD) I would be doing everything I could to stop the arthritis from flaring up (e.g. anti-inflammatory medication, cod liver oil, ...).

[Hidden]

Hi there. This is interesting territory to me as well. I have a relapsing remitting inflammatory arthritis/ RA with Sjögren’s Syndrome and Hashimoto’s thyroid disease - ie very autoimmune. I am also struggling with Parkinsonism - waiting for assessment for PD or cerebral Vasculitis.

I too find that when I’m on steroids my balance and gait improve no end but I do have a very neurological presentation of Sjögren’s with resting tremors and vibrations, Ataxia, small fibre neuropathy, autonomic dysfunction, dyslexia/ dyspraxia and small vessel disease.

One of the hallmarks of active inflammatory arthritis is morning stiffness. So I think it would be very hard to distinguish between the two of you have both.

[jeffreyn in reply to Hidden]

Thanks for the input.

If I've understood you correctly, you are saying that if someone has both active inflammatory arthritis and PD, it would be very difficult to distinguish between the two. The reason is that one of the hallmarks of active inflammatory arthritis is morning stiffness (i.e. just like some forms of PD).

I can't comment on that myself (insufficient depth), but it is certainly something for Kimbo1962 to consider.

[Hidden in reply to jeffreyn]

Well I’m not really saying this actually - I’m asking while relaying info about inflammatory arthritis at the same time. I don’t have a diagnosis of PD but I think it’s a possibility for me so I’ve studied the most classic symptoms and wondered because severe stiffness is a hallmark of both and also many of my Sjögren’s symptoms are very similar eg dry eye, rigid face, stiffness, tremor, altered taste and loss of sense of smell, slow transit digestion etc. And when we have one degenerative condition our doctors are apt to focus on this and may not see potential comorbidities or identify seemingly unrelated conditions.

I’ve just read a post on Vasculitis UK HU from someone who was misdiagnosed with PD and then thought to have MS and now is being told she probably has neither but might have cerebral Vasculitis.

In my experience we can sometimes find ourselves focussing so hard on one condition, which we try to blame all our symptoms on, that we risk not seeing the wood for the trees.