J Clin Neurol.  2016 Apr;12(2):147-150. 10.3988/jcn.2016.12.2.147.

Association between Parkinson's Disease and Helicobacter Pylori

• Çamcı G
• OÄŸuz S

• KMID: 2354133
• DOI: http://doi.org/10.3988/jcn.2016.12.2.147

Abstract

Helicobacter pylori (HP) is a common infection of the gastrointestinal system that is usually related to peptic ulcers. However, recent studies have revealed relationships between HP and many other diseases. Although the exact mechanism is unknown, HP can prevent the absorption of certain drugs. A high prevalence of HP has been found in patients with Parkinson's disease, and this bacterium causes motor fluctuations by affecting the absorption of levodopa, which is the main drug used to treat Parkinson's disease. Eradicating HP from patients with Parkinson's disease by applying antibiotic treatment will increase the absorption of levodopa and decrease their motor fluctuations.

Keyword

Parkinson's disease; Helicobacter pylori; levodopa; motor fluctuations

MeSH Terms

Absorption
Helicobacter pylori*
Helicobacter*
Humans
Levodopa
Parkinson Disease*
Peptic Ulcer
Prevalence
Levodopa

Reference

1. Memiş S. Parkinson hastalığı ve bakım. In : Durna Z, editor. Kronik Hastalıklar ve Bakım. İstanbul: Nobel Tıp Kitabevi;2011. p. 277.

2. Barnum CJ, Tansey MG. Neuroinflammation and non-motor symptoms: the dark passenger of Parkinson's disease? Curr Neurol Neurosci Rep. 2012; 12:350–358.

3. Bu XL, Wang X, Xiang Y, Shen LL, Wang QH, Liu YH, et al. The association between infectious burden and Parkinson's disease: a case-control study. Parkinsonism Relat Disord. 2015; 21:877–881.

4. Tan AH, Mahadeva S, Thalha AM, Gibson PR, Kiew CK, Yeat CM, et al. Small intestinal bacterial overgrowth in Parkinson's disease. Parkinsonism Relat Disord. 2014; 20:535–540.

5. Chaudhuri KR, Healy DG, Schapira AH. National Institute for Clinical Excellence. Non-motor symptoms of Parkinson's disease: diagnosis and management. Lancet Neurol. 2006; 5:235–245.

6. Simuni T, Sethi K. Nonmotor manifestations of Parkinson's disease. Ann Neurol. 2008; 64:Suppl 2. S65–S80.

7. Lim SY, Lang AE. The nonmotor symptoms of Parkinson's disease--an overview. Mov Disord. 2010; 25:Suppl 1. S123–S130.

8. McColl KE. Clinical practice. Helicobacter pylori infection. N Engl J Med. 2010; 362:1597–1604.

9. Franceschi F, Gasbarrini A. Helicobacter pylori and extragastric diseases. Best Pract Res Clin Gastroenterol. 2007; 21:325–334.

10. Tan HJ, Goh KL. Extragastrointestinal manifestations of Helicobacter pylori infection: facts or myth? A critical review. J Dig Dis. 2012; 13:342–349.

11. Dobbs RJ, Charlett A, Dobbs SM, Weller C, Peterson DW. Parkinsonism: differential age-trend in Helicobacter pylori antibody. Aliment Pharmacol Ther. 2000; 14:1199–1205.

12. Pierantozzi M, Pietroiusti A, Brusa L, Galati S, Stefani A, Lunardi G, et al. Helicobacter pylori eradication and l-dopa absorption in patients with PD and motor fluctuations. Neurology. 2006; 66:1824–1829.

13. Lee WY, Yoon WT, Shin HY, Jeon SH, Rhee PL. Helicobacter pylori infection and motor fluctuations in patients with Parkinson's disease. Mov Disord. 2008; 23:1696–1700.

14. Dobbs RJ, Charlett A, Dobbs SM, Weller C, A Ibrahim MA, Iguodala O, et al. Leukocyte-subset counts in idiopathic parkinsonism provide clues to a pathogenic pathway involving small intestinal bacterial overgrowth. A surveillance study. Gut Pathog. 2012; 4:12.

15. Tan AH, Mahadeva S, Marras C, Thalha AM, Kiew CK, Yeat CM, et al. Helicobacter pylori infection is associated with worse severity of Parkinson's disease. Parkinsonism Relat Disord. 2015; 21:221–225.

16. Weller C, Charlett A, Oxlade NL, Dobbs SM, Dobbs RJ, Peterson DW, et al. Role of chronic infection and inflammation in the gastrointestinal tract in the etiology and pathogenesis of idiopathic parkinsonism. Part 3: predicted probability and gradients of severity of idiopathic parkinsonism based on H. pylori antibody profile. Helicobacter. 2005; 10:288–297.

17. Charlett A, Dobbs RJ, Dobbs SM, Weller C, Brady P, Peterson DW. Parkinsonism: siblings share Helicobacter pylori seropositivity and facets of syndrome. Acta Neurol Scand. 1999; 99:26–35.

18. Blaecher C, Smet A, Flahou B, Pasmans F, Ducatelle R, Taylor D, et al. Significantly higher frequency of Helicobacter suis in patients with idiopathic parkinsonism than in control patients. Aliment Pharmacol Ther. 2013; 38:1347–1353.

19. Dobbs SM, Dobbs RJ, Weller C, Charlett A. Link between Helicobacter pylori infection and idiopathic parkinsonism. Med Hypotheses. 2000; 55:93–98.

20. Schulz JD, Hawkes EL, Shaw CA. Cycad toxins, Helicobacter pylori and parkinsonism: cholesterol glucosides as the common denomenator. Med Hypotheses. 2006; 66:1222–1226.

21. Dobbs RJ, Dobbs SM, Weller C, Charlett A, Bjarnason IT, Curry A, et al. Helicobacter hypothesis for idiopathic parkinsonism: before and beyond. Helicobacter. 2008; 13:309–322.

22. Kountouras J, Zavos C, Polyzos SA, Deretzi G, Vardaka E, Giartza-Taxidou E, et al. Helicobacter pylori infection and Parkinson's disease: apoptosis as an underlying common contributor. Eur J Neurol. 2012; 19:e56.

23. Fasano A, Bove F, Gabrielli M, Ragazzoni E, Fortuna S, Tortora A, et al. Liquid melevodopa versus standard levodopa in patients with Parkinson disease and small intestinal bacterial overgrowth. Clin Neuropharmacol. 2014; 37:91–95.

24. Pfeiffer R. Beyond here be dragons: SIBO in Parkinson's disease. Mov Disord. 2013; 28:1764–1765.

25. Lahner E, Annibale B, Delle Fave G. Systematic review: Helicobacter pylori infection and impaired drug absorption. Aliment Pharmacol Ther. 2009; 29:379–386.

26. Niehues M, Hensel A. In-vitro interaction of L-dopa with bacterial adhesins of Helicobacter pylori: an explanation for clinicial differences in bioavailability? J Pharm Pharmacol. 2009; 61:1303–1307.

27. Lyte M. Microbial endocrinology as a basis for improved L-DOPA bioavailability in Parkinson's patients treated for Helicobacter pylori. Med Hypotheses. 2010; 74:895–897.

28. Pierantozzi M, Pietroiusti A, Sancesario G, Lunardi G, Fedele E, Giacomini P, et al. Reduced L-dopa absorption and increased clinical fluctuations in Helicobacter pylori-infected Parkinson's disease patients. Neurol Sci. 2001; 22:89–91.

29. Rahne KE, Tagesson C, Nyholm D. Motor fluctuations and Helicobacter pylori in Parkinson's disease. J Neurol. 2013; 260:2974–2980.

30. Dobbs SM, Charlett A, Dobbs RJ, Weller C, Iguodala O, Smee C, et al. Antimicrobial surveillance in idiopathic parkinsonism: indication-specific improvement in hypokinesia following Helicobacter pylori eradication and non-specific effect of antimicrobials for other indications in worsening rigidity. Helicobacter. 2013; 18:187–196.

31. Bjarnason IT, Charlett A, Dobbs RJ, Dobbs SM, Ibrahim MA, Kerwin RW, et al. Role of chronic infection and inflammation in the gastrointestinal tract in the etiology and pathogenesis of idiopathic parkinsonism. Part 2: response of facets of clinical idiopathic parkinsonism to Helicobacter pylori eradication. A randomized, double-blind, placebo-controlled efficacy study. Helicobacter. 2005; 10:276–287.

32. Dobbs SM, Dobbs RJ, Weller C, Charlett A, Bjarnason IT, Lawson AJ, et al. Differential effect of Helicobacter pylori eradication on time-trends in brady/hypokinesia and rigidity in idiopathic parkinsonism. Helicobacter. 2010; 15:279–294.

33. Hashim H, Azmin S, Razlan H, Yahya NW, Tan HJ, Manaf MR, et al. Eradication of Helicobacter pylori infection improves levodopa action, clinical symptoms and quality of life in patients with Parkinson's disease. PLoS One. 2014; 9:e112330.

34. Narożańska E, Białecka M, Adamiak-Giera U, Gawrońska-Szklarz B, Sołtan W, Schinwelski M, et al. Pharmacokinetics of levodopa in patients with Parkinson disease and motor fluctuations depending on the presence of Helicobacter pylori infection. Clin Neuropharmacol. 2014; 37:96–99.

35. ClinicalTrials.gov (US). Helicobacter pylori eradication in Parkinson's disease: a double-blind randomised placebo controlled trial [Internet]. Kuala Lumpur: University of Malaya;2014. cited 2015 Sep 16. Available from: https://clinicaltrials.gov/show/NCT02108704.