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Li B, Dettmer U. Interactions of alpha-synuclein with membranes in Parkinson's disease: Mechanisms and therapeutic strategies. Neurobiol Dis 2024:106646. [PMID: 39181187 DOI: 10.1016/j.nbd.2024.106646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/30/2024] [Accepted: 08/19/2024] [Indexed: 08/27/2024] Open
Abstract
Parkinson's disease (PD), the second most common neurodegenerative disease worldwide, is marked by the presence of Lewy bodies and Lewy neurites, neuronal lesions containing large amounts of the synaptic protein alpha-synuclein (αS). While the underlying mechanisms of disease progression in PD remain unclear, increasing evidence supports the importance of interactions between αS and cellular membranes in PD pathology. Therefore, understanding the αS-membrane interplay in health and disease is crucial for the development of therapeutic strategies. In this review, we (1) discuss key scenarios of pathological αS-membrane interactions; (2) present in detail therapeutic strategies explicitly reported to modify αS-membrane interactions; and (3) introduce additional therapeutic strategies that may involve aspects of interfering with αS-membrane interaction. This way, we aim to provide a holistic perspective on this important aspect of disease-modifying strategies for PD and other α-synucleinopathies.
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Affiliation(s)
- Baoyi Li
- Wycombe Abbey, Buckinghamshire HP11 1PE, UK
| | - Ulf Dettmer
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
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di Biase L, Pecoraro PM, Carbone SP, Alessi F, Di Lazzaro V. Smoking exposure and Parkinson's disease: A UK Brain Bank pathology-validated case-control study. Parkinsonism Relat Disord 2024; 125:107022. [PMID: 38865837 DOI: 10.1016/j.parkreldis.2024.107022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Epidemiological studies have consistently shown an inverse association between cigarette smoking and Parkinson's disease. Literature indicates that both current and former smokers have a reduced risk of developing PD compared to non-smokers. If smoking protects against Parkinson's disease risk or, conversely, smoking habit is abated due to the disease itself, according to the reverse causation, is still an unsolved question. METHODS 118 patients from the UK Brain Bank with an alive clinical diagnosis of Parkinson's disease were enrolled. Post-mortem validation served as the gold standard for diagnosis to divide the population into true positive and false positive groups. Patient charts were reviewed to extract smoking exposure information and statistical analyses were conducted to determine the odds associated with smoking in the two diagnostic groups. RESULTS Among alive clinically diagnosed patients with Parkinson's disease, 53 % had no smoking exposure. In the True Positive group, 58 % had no smoking exposure, while this proportion was lower in the False Positive group at 46 %. The Odds Ratio for the association between smoking exposure and the two groups was 0.63 (95 % CI: 0.32-1.37). The Chi-square test yielded a p-value of 0.2804. CONCLUSIONS Our findings emphasize the role of smoking exposure in Parkinson's diagnosis. The results indicate that the observed association is not specific to idiopathic Parkinson's disease but rather a broader phenomenon encompassing various parkinsonian disorders. This suggests a potential common neuroprotective effect of smoking, shared risk factors, or supports the reverse causation hypothesis where parkinsonian symptoms reduce smoking exposure.
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Affiliation(s)
- Lazzaro di Biase
- Operative Research Unit of Neurology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy; Brain Innovations Lab, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128, Rome, Italy.
| | - Pasquale Maria Pecoraro
- Operative Research Unit of Neurology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy; Research Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy
| | - Simona Paola Carbone
- Operative Research Unit of Neurology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy; Research Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy
| | - Francesca Alessi
- Research Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy
| | - Vincenzo Di Lazzaro
- Operative Research Unit of Neurology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy; Research Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy
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Grotewold N, Albin RL. Update: Protective and risk factors for Parkinson disease. Parkinsonism Relat Disord 2024; 125:107026. [PMID: 38879999 DOI: 10.1016/j.parkreldis.2024.107026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 06/18/2024]
Abstract
We review the epidemiologic literature on potential protective and risk factors in Parkinson's Disease (PD). Prior research identified numerous possible protective and risk factors. Potential protective factors include tobacco abuse, physical activity, urate levels, NSAID use, calcium channel blocker use, statin use, and use of some α1-adrenergic antagonists. Some potential protective factors could be products of reverse causation, including increased serum urate, tobacco abuse, and coffee-tea-caffeine consumption. Potential risk factors include traumatic brain injury, pesticide exposure, organic solvent exposure, lead exposure, air pollution, Type 2 Diabetes, some dairy products, cardiovascular disease, and some infections including Hepatitis C, H. pylori, and COVID-19. Potential non-environmental risk factors include bipolar disorder, essential tremor, bullous pemphigoid, and inflammatory bowel disease. There is an inverse relationship with PD and risk of most cancers. Though many potential protective and risk factors for PD were identified, research has not yet led to unique, rigorous prevention trials or successful disease-modifying interventions. While efforts to reduce exposure to some industrial toxicants are well justified, PD incidence might be most effectively reduced by mitigation of risks, such as Type 2 Diabetes, air pollution, traumatic brain injury, or physical inactivity, that are general public health intervention targets.
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Affiliation(s)
- Nikolas Grotewold
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Roger L Albin
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA; GRECC & Neurology Service, VAAAHS, Ann Arbor, MI, 48105, USA; University of Michigan Morris K. Udall Center of Excellence for Parkinson's Disease Research, Ann Arbor, MI, 48109, USA; University of Michigan Parkinson's Foundation Research Center of Excellence, USA.
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Yang Y, Zhou ZD, Yi L, Tan BJW, Tan EK. Interaction between caffeine consumption & genetic susceptibility in Parkinson's disease: A systematic review. Ageing Res Rev 2024; 99:102381. [PMID: 38914264 DOI: 10.1016/j.arr.2024.102381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Caffeine is one of the most consumed psychoactive substances globally. Caffeine-gene interactions in Parkinson's disease (PD) has not been systematically examined. OBJECTIVES To conduct a systematic review on the interaction between caffeine consumption and genetic susceptibility to PD. METHODOLOGY We conducted PubMed and Embase search using terms "Genetic association studies", "Caffeine", "polymorphism" and "Parkinson's disease", from inception till 2023. Of the initial 2391 studies, 21 case-control studies were included. The demographic, genetic and clinical data were extracted and analyzed. RESULTS We identified 21 studies which involved a total of 607,074 study subjects and 17 gene loci (SNCA, MAPT, HLA-DRA, NOS1, NOS3, GBA, ApoE, BST1, ESR2, NAT2, SLC2A13, LRRK2, NOS2A, GRIN2A, CYP1A2, ESR1, ADORA2A) have been investigated for the effect of gene-caffeine interaction and PD risk. The genes were identified through PD GWAS or involved in caffeine or related metabolism pathways. Based on the genetic association and interaction studies, only MAPT, SLC2A13, LRRK2, ApoE, NOS2A, GRIN2A, CYP1A2, and ADORA2A have been shown by at least one study to have a positive caffeine-gene interaction influencing the risk of PD. CONCLUSION Studies have shown an interaction between caffeine with genetic variants of MAPT, SLC2A13, LRRK2, ApoE, NOS2A, GRIN2A, CYP1A2, and ADORA2A in modulating the risk of PD. Due to the potential limitations of these discovery/pilot studies, further independent replication studies are needed. Better designed genetic association studies in multi-ancestry and admixed cohorts to identify potential shared or unique multivariate gene-environmental interactions, as well as functional studies of gene-caffeine interactions will be useful.
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Affiliation(s)
- Yujuan Yang
- Department of Neurology, National Neuroscience Institute, Singapore; Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore.
| | - Zhi Dong Zhou
- Department of Neurology, National Neuroscience Institute, Singapore; Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore.
| | - Lingxiao Yi
- Department of Neurology, National Neuroscience Institute, Singapore.
| | | | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore; Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore.
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Zeng S, Yusufujiang A, Zhang C, Yang C, Li H. Correlation between dietary factors and Parkinson's disease revealed by the analysis of Mendelian randomization. Front Nutr 2024; 11:1273874. [PMID: 38840699 PMCID: PMC11151297 DOI: 10.3389/fnut.2024.1273874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Background The intricate interplay between dietary habits and the development of Parkinson's Disease (PD) has long been a subject of scientific inquiry. Mendelian Randomization (MR) emerges as a potent tool, harnessing genetic variants to infer causality in observational data. While evidence links diet to Parkinson's Disease (PD) etiology, a thorough MR exploration of dietary impacts on PD, particularly involving gut microbiota, is still emerging. Methods This research leverages the IEU Open GWAS project's vast GWAS database to address the knowledge gap in understanding diet's influence on PD, employing a diverse range of dietary variables. Our holistic dataset includes various foods like processed fava beans, bap, red wine, to cheese, reflecting a commitment to untangling dietary complexities in PD etiology. Advancing from initial dietary-PD associations, we innovatively explore the gut microbiota, focusing on Parabacteroides goldsteinii, in relation to bap intake and PD, employing MR. Utilizing weighted median, MR-Egger, and inverse variance weighting methods, we ensure rigorous causality assessments, meticulously mitigating pleiotropy and heterogeneity biases to uphold finding validity. Results Our findings indicate red wine (OR: 1.031; 95% CI 1.001-1.062; p = 0.044) and dried fruit consumption (OR: 2.019; 95% CI 1.052-3.875; p = 0.035) correlate with increased PD risk, whereas broad beans (OR: 0.967; 95% CI 0.939-0.996; p = 0.024) and bap intake (OR: 0.922; 95% CI 0.860-0.989; p = 0.023) show protective effects against PD. Employing MR, specifically the IVW method, revealed a significant inverse association between bap intake and gut microbiota, marked by an 8.010-fold decrease in Parabacteroides goldsteinii per standard deviation increase in bap intake (95% CI 1.005-63.818, p = 0.049). Furthermore, a connection between PD and Parabacteroides goldsteinii was observed (OR: 0.810; 95% CI 0.768-0.999; p = 0.049), suggesting a potential microbiota-mediated pathway in PD etiology. Conclusion Our study links dietary habits to PD risk, showing higher PD risk with red wine and dried fruit consumption, and a protective effect from broad beans and bap. Using MR, we found bap intake inversely correlates with Parabacteroides goldsteinii in the gut, suggesting bap influences microbiota. Further, higher Parabacteroides goldsteinii levels correlate with lower PD risk, highlighting a complex interplay of diet, gut microbiome, and neurological health. These insights shed light on potential dietary interventions for PD.
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Affiliation(s)
- Shan Zeng
- Department of Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, China
| | | | - Chunli Zhang
- Department of Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chen Yang
- Department of Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hongyan Li
- Department of Neurology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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Zhao Y, Lai Y, Konijnenberg H, Huerta JM, Vinagre-Aragon A, Sabin JA, Hansen J, Petrova D, Sacerdote C, Zamora-Ros R, Pala V, Heath AK, Panico S, Guevara M, Masala G, Lill CM, Miller GW, Peters S, Vermeulen R. Association of Coffee Consumption and Prediagnostic Caffeine Metabolites With Incident Parkinson Disease in a Population-Based Cohort. Neurology 2024; 102:e209201. [PMID: 38513162 PMCID: PMC11175631 DOI: 10.1212/wnl.0000000000209201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/14/2023] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Inverse associations between caffeine intake and Parkinson disease (PD) have been frequently implicated in human studies. However, no studies have quantified biomarkers of caffeine intake years before PD onset and investigated whether and which caffeine metabolites are related to PD. METHODS Associations between self-reported total coffee consumption and future PD risk were examined in the EPIC4PD study, a prospective population-based cohort including 6 European countries. Cases with PD were identified through medical records and reviewed by expert neurologists. Hazard ratios (HRs) and 95% CIs for coffee consumption and PD incidence were estimated using Cox proportional hazards models. A case-control study nested within the EPIC4PD was conducted, recruiting cases with incident PD and matching each case with a control by age, sex, study center, and fasting status at blood collection. Caffeine metabolites were quantified by high-resolution mass spectrometry in baseline collected plasma samples. Using conditional logistic regression models, odds ratios (ORs) and 95% CIs were estimated for caffeine metabolites and PD risk. RESULTS In the EPIC4PD cohort (comprising 184,024 individuals), the multivariable-adjusted HR comparing the highest coffee intake with nonconsumers was 0.63 (95% CI 0.46-0.88, p = 0.006). In the nested case-control study, which included 351 cases with incident PD and 351 matched controls, prediagnostic caffeine and its primary metabolites, paraxanthine and theophylline, were inversely associated with PD risk. The ORs were 0.80 (95% CI 0.67-0.95, p = 0.009), 0.82 (95% CI 0.69-0.96, p = 0.015), and 0.78 (95% CI 0.65-0.93, p = 0.005), respectively. Adjusting for smoking and alcohol consumption did not substantially change these results. DISCUSSION This study demonstrates that the neuroprotection of coffee on PD is attributed to caffeine and its metabolites by detailed quantification of plasma caffeine and its metabolites years before diagnosis.
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Affiliation(s)
- Yujia Zhao
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Yunjia Lai
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Hilde Konijnenberg
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - José María Huerta
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Ana Vinagre-Aragon
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Jara Anna Sabin
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Johnni Hansen
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Dafina Petrova
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Carlotta Sacerdote
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Raul Zamora-Ros
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Valeria Pala
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Alicia K Heath
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Salvatore Panico
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Marcela Guevara
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Giovanna Masala
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Christina M Lill
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Gary W Miller
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Susan Peters
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
| | - Roel Vermeulen
- From the Institute for Risk Assessment Sciences (Y.Z., H.K., S. Peters, R.V.), Utrecht University, the Netherlands; Department of Environmental Health Sciences (Y.L., G.W.M.), Mailman School of Public Health, Columbia University, New York, NY; Department of Epidemiology (J.M.H.), Murcia Regional Health Council-IMIB, Murcia; CIBER Epidemiología y Salud Pública (CIBERESP) (J.M.H., M.G.), Madrid; Movement Disorders Unit (A.V.-A.), Department of Neurology, University Hospital Donostia; BioDonostia Health Research Institute (A.V.-A.), Neurodegenerative Diseases Area, San Sebastián, Spain; Division of Cancer Epidemiology (J.A.S.), German Cancer Research Center (DKFZ), Heidelberg, Germany; Danish Cancer Institute (J.H.), Danish Cancer Society, Copenhagen, Denmark; Escuela Andaluza de Salud Pública (EASP) (D.P.); Instituto de Investigación Biosanitaria-ibs.GRANADA (D.P.), Granada; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP) (D.P.), Madrid, Spain; Unit of Cancer Epidemiology (C.S.), Città della Salute e della Scienza University-Hospital, Turin, Italy; Unit of Nutrition and Cancer (R.Z.-R.), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Epidemiology and Prevention Unit (V.P.), Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy; Department of Epidemiology and Biostatistics (A.K.H., M.G.), School of Public Health, Imperial College London, United Kingdom; School of Medicine (S. Panico), Federico II University, Naples, Italy; de Salud Pública y Laboral de Navarra (M.G.), Pamplona; Navarra Institute for Health Research (IdiSNA) (M.G.), Pamplona, Spain; Institute for Cancer Research (G.M.), Prevention and Clinical Network (ISPRO), Florence, Italy; Institute of Epidemiology and Social Medicine (C.M.L.), University of Münster, Germany; Ageing Epidemiology Research Unit (AGE) (C.M.L.), School of Public Health, Imperial College London, United Kingdom; and University Medical Centre Utrecht (R.V.), the Netherlands
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7
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Niu F, Xie W, Zhang W, Kawuki J, Yu X. Vitamin C, vitamin E, β-carotene and risk of Parkinson's disease: a systematic review and dose-response meta-analysis of observational studies. Nutr Neurosci 2024; 27:329-341. [PMID: 36961747 DOI: 10.1080/1028415x.2023.2192561] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
OBJECTIVE This study aimed to explore the relationship between the intake of vitamin C, vitamin E and β-carotene, and the risk of Parkinson's disease (PD). METHODS Web of Science, Embase, PubMed, Cochrane library, CNKI, and WanFang databases were searched from inception to 29 August 2022 for observational studies reporting the odds ratios (ORs) or relative risks (RRs) or hazard ratios (HRs) and 95% confidence intervals (CIs) of PD by Vitamin C/Vitamin E/β-carotene intake. Random-effects models, publication bias assessment, subgroup, sensitivity and dose-response analyses were performed, using.Stata version 12.0. RESULTS A total of 13 studies were included. There was no significant association between high-dose vitamin C intake and the risk of PD compared with low-dose vitamin C intake (RR = 0.98, 95%CI:0.89,1.08). Compared with low-dose intake, high-dose intake of vitamin E can prevent the risk of PD (RR = 0.87, 95%CI:0.77,0.99). Compared with lower β-carotene intake, there was a borderline non-significant correlation between higher intake and PD risk (RR = 0.91, 95%CI:0.82,1.01), and high dose β-carotene intake was found to be associated with a lower risk of PD in women (RR = 0.78, 95%CI:0.64,0.96). CONCLUSION This study shows that vitamin E intake can reduce the risk of PD and play a preventive role.
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Affiliation(s)
- Fang Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, People's Republic of China
| | - Weihua Xie
- Department of Quality Management, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Weili Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, People's Republic of China
| | - Joseph Kawuki
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Xiaojin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, People's Republic of China
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8
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Huang W, Xiao Y, Zhang L, Liu H. Association between a body shape index and Parkinson's disease: A large cross-sectional study from NHANES. Heliyon 2024; 10:e26557. [PMID: 38420444 PMCID: PMC10900994 DOI: 10.1016/j.heliyon.2024.e26557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Objective To further evaluate the connection between obesity and Parkinson's disease, we utilized A body shape index which normalizes waist circumference for Body mass index. Derived from the National Health and Nutrition Examination Survey. Methods Based on National Health and Nutrition Examination Survey data from 2005 to 2018, this study included 31,933 adult participants in total. First, all the participants were divided into the Parkinson's disease group and non-Parkinson's disease group, respectively. Next, according to their quartiles of A body shape index levels, they were further classified into Q1 group (0.058-0.077), Q2 group (0.078-0.081), Q3 group (0.082-0.084), and Q4 group (0.085-0.117). A body shape index was the primary exposure, while Parkinson's disease was the primary outcome. A body shape index is defined by waist circumference divided by Body mass index2/3 × height1/2, and the expected value of waist circumference based on height and weight derived empirically from National Health and Nutrition Examination Survey. Consequently, A body shape index and Parkinson's disease were analyzed through multifactor logistic regression. Results According to the unadjusted multivariate logistic analysis, the Q4 group had a greater likelihood of acquiring Parkinson's disease than the Q1 group [OR = 4.519, 95% CI: 3.094-6.600; P < 0.001]. After adjusting the demographic variables such as age, sex, and race, Q4 group was at a higher risk of Parkinson's disease acquisition than Q1 [OR (95% CI): 2.677 (1.774-4.038); P < 0.001]. Compared with Q1 group, the male participants were in a greater chance of getting Parkinson's disease than female participants in Q4 group, as shown by subgroup analysis by gender [male vs. female: OR = 6.563 (3.289-13.098) vs. OR = 3.827 (2.398-6.108); Interaction P-value<0.001]. Conclusions There is a non-linear positive correlation between the adult A body shape index and the risk of Parkinson's disease. Adults are at a greater risk of getting Parkinson's disease as A body shape index rises, and the link is particularly strong among men aged 20 to 59.
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Affiliation(s)
- Wei Huang
- Department of Orthopaedics, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
| | - Yingqi Xiao
- Department of Pulmonary and Critical Care Medicine, Dongguan Tungwah Hospital, Dongguan, China
| | - Li Zhang
- Department of Pulmonary and Critical Care Medicine, Dongguan Tungwah Hospital, Dongguan, China
| | - Hu Liu
- Department of Orthopaedics, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
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9
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Huang Y, Chen Q, Wang Z, Wang Y, Lian A, Zhou Q, Zhao G, Xia K, Tang B, Li B, Li J. Risk factors associated with age at onset of Parkinson's disease in the UK Biobank. NPJ Parkinsons Dis 2024; 10:3. [PMID: 38167894 PMCID: PMC10762149 DOI: 10.1038/s41531-023-00623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
Substantial evidence shown that the age at onset (AAO) of Parkinson's disease (PD) is a major determinant of clinical heterogeneity. However, the mechanisms underlying heterogeneity in the AAO remain unclear. To investigate the risk factors with the AAO of PD, a total of 3156 patients with PD from the UK Biobank were included in this study. We evaluated the effects of polygenic risk scores (PRS), nongenetic risk factors, and their interaction on the AAO using Mann-Whitney U tests and regression analyses. We further identified the genes interacting with nongenetic risk factors for the AAO using genome-wide environment interaction studies. We newly found physical activity (P < 0.0001) was positively associated with AAO and excessive daytime sleepiness (P < 0.0001) was negatively associated with AAO, and reproduced the positive associations of smoking and non-steroidal anti-inflammatory drug intake and the negative association of family history with AAO. In the dose-dependent analyses, smoking duration (P = 1.95 × 10-6), coffee consumption (P = 0.0150), and tea consumption (P = 0.0008) were positively associated with AAO. Individuals with higher PRS had younger AAO (P = 3.91 × 10-5). In addition, we observed a significant interaction between the PRS and smoking for AAO (P = 0.0316). Specifically, several genes, including ANGPT1 (P = 7.17 × 10-7) and PLEKHA6 (P = 4.87 × 10-6), may influence the positive relationship between smoking and AAO. Our data suggests that genetic and nongenetic risk factors are associated with the AAO of PD and that there is an interaction between the two.
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Affiliation(s)
- Yuanfeng Huang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
| | - Qian Chen
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Zheng Wang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Yijing Wang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
| | - Aojie Lian
- National Health Commission Key Laboratory of Birth Defect Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, Hunan, China
| | - Qiao Zhou
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
| | - Guihu Zhao
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Kun Xia
- Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410008, Hunan, China
| | - Beisha Tang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410008, Hunan, China
| | - Bin Li
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China.
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
| | - Jinchen Li
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China.
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
- Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410008, Hunan, China.
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10
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Ng MG, Chan BJL, Koh RY, Ng KY, Chye SM. Prevention of Parkinson's Disease: From Risk Factors to Early Interventions. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:746-760. [PMID: 37326115 DOI: 10.2174/1871527322666230616092054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/17/2023]
Abstract
Parkinson's disease (PD) is a debilitating neurological disorder characterized by progressively worsening motor dysfunction. Currently, available therapies merely alleviate symptoms, and there are no cures. Consequently, some researchers have now shifted their attention to identifying the modifiable risk factors of PD, with the intention of possibly implementing early interventions to prevent the development of PD. Four primary risk factors for PD are discussed including environmental factors (pesticides and heavy metals), lifestyle (physical activity and dietary intake), drug abuse, and individual comorbidities. Additionally, clinical biomarkers, neuroimaging, biochemical biomarkers, and genetic biomarkers could also help to detect prodromal PD. This review compiled available evidence that illustrates the relationship between modifiable risk factors, biomarkers, and PD. In summary, we raise the distinct possibility of preventing PD via early interventions of the modifiable risk factors and early diagnosis.
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Affiliation(s)
- Ming Guan Ng
- School of Health Science, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Brendan Jun Lam Chan
- School of Health Science, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Rhun Yian Koh
- Division of Applied Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| | - Khuen Yen Ng
- School of Pharmacy, Monash University, 47500 Selangor, Malaysia
| | - Soi Moi Chye
- Division of Applied Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
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11
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Prajjwal P, Flores Sanga HS, Acharya K, Tango T, John J, Rodriguez RS, Dheyaa Marsool Marsool M, Sulaimanov M, Ahmed A, Hussin OA. Parkinson's disease updates: Addressing the pathophysiology, risk factors, genetics, diagnosis, along with the medical and surgical treatment. Ann Med Surg (Lond) 2023; 85:4887-4902. [PMID: 37811009 PMCID: PMC10553032 DOI: 10.1097/ms9.0000000000001142] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/31/2023] [Indexed: 10/10/2023] Open
Abstract
After only Alzheimer's disease (AD), Parkinson's disease (PD) is the second most prevalent neurodegenerative disease. The incidence of this disease increases with age, especially for those above 70 years old. There are many risk factors that are well-established in the contribution to the development of PD, such as age, gender, ethnicity, rapid eye movement sleep disorder, high consumption of dairy products, traumatic brain injury, genetics, and pesticides/herbicides. Interestingly, smoking, consumption of caffeine, and physical activities are the protective factors of PD. A deficiency of dopamine in the substantia nigra of the brainstem is the main pathology. This, subsequently, alters the neurotransmitter, causing an imbalance between excitatory and inhibitory signals. In addition, genetics is also involved in the pathogenesis of the disease. As a result, patients exhibit characteristic motor symptoms such as tremors, stiffness, bradykinesia, and postural instability, along with non-motor symptoms, including dementia, urinary incontinence, sleeping disturbances, and orthostatic hypotension. PD may resemble other diseases; therefore, it is important to pay attention to the diagnosis criteria. Parkinson's disease dementia can share common features with AD; this can include behavioral as well as psychiatric symptoms, in addition to the pathology being protein aggregate accumulation in the brain. For PD management, the administration of pharmacological treatment depends on the motor symptoms experienced by the patients. Non-pharmacological treatment plays a role as adjuvant therapy, while surgical management is indicated in chronic cases. This paper aims to review the etiology, risk factors, protective factors, pathophysiology, signs and symptoms, associated conditions, and management of PD.
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Affiliation(s)
| | - Herson S Flores Sanga
- Department of Telemedicine, Hospital Nacional Carlos Alberto Seguin Escobedo, Arequipa, Peru
| | - Kirtish Acharya
- Maharaja Krishna Chandra Gajapati Medical College and Hospital, Brahmapur, Odisha
| | - Tamara Tango
- Faculty of Medicine Universitas, Jakarta, Indonesia
| | - Jobby John
- Dr. Somervell Memorial CSI Medical College and Hospital, Neyyāttinkara, Kerala, India
| | | | | | | | - Aneeqa Ahmed
- Shadan Hospital and Institute of Medical Sciences, Hyderabad, Telangana
| | - Omniat A. Hussin
- Department of Medicine, Sudan Academy of Sciences, Khartoum, Sudan
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12
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Chin WS, Chien LC, Kao HC, Chuang YN, Liao KW. Monitoring and evaluating the dietary risk of trace elements content in bottled and hand-shaken tea in Taiwan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:55716-55729. [PMID: 36897450 DOI: 10.1007/s11356-023-26130-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Tea is the most frequently consumed beverage worldwide and is obtained from the leaves Camellia sinensis. The traditional way of tea consumption through brewing is gradually being replaced by the consumption of bottled and hand-shaken tea. Despite the different ways of tea consumption, trace elements accumulation and contamination of tea leaves have caused concerns. However, limited studies have reported trace element concentrations in different types of tea in bottled or hand-shaken tea and their health risks. This study aimed to determine the level of trace elements (V, Cr, Co, As, Cd, Pb, Mn, and Zn) in green tea, black tea, and Oolong tea in two varieties of products (bottled and hand-shaken tea). The health risks associated with tea consumption in various age subgroups among Taiwan's general population were also estimated. A Monte Carlo simulation was applied to estimate the distribution of daily trace elements intake through bottled and hand-shaken tea consumption. As to the non-carcinogenic risks, the Monte Carlo simulation showed that hand-shaken green tea had a higher percentage of hazard index (HI) >1 (1.08%~6.05%) among all age groups. As to carcinogenic risks, the Monte Carlo simulation showed that the risks of As exposure from bottled Oolong tea and hand-shaken black, green, and Oolong teas in the 90th percentile in >18 to ≤65 and >65-year-old groups were higher than 10-6. The current study findings provided some information about trace elements of both bottled and hand-shaken tea and human health risks in the general population of Taiwan.
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Affiliation(s)
- Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ho-Ching Kao
- Master Program in Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yung-Ning Chuang
- Master Program in Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Kai-Wei Liao
- School of Food Safety, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei, 11031, Taiwan.
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13
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Rahnemayan S, Ahari SG, Rikhtegar R, Riyahifar S, Sanaie S. An umbrella review of systematic reviews with meta-analysis on the role of vitamins in Parkinson's disease. Acta Neurol Belg 2023; 123:69-83. [PMID: 35920987 DOI: 10.1007/s13760-022-02055-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/20/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This umbrella review aimed to systematically review the available literature and assess the association of dietary intake or serum levels of different vitamins and the risk of PD, to help find out more efficient treatments for PD patients by replenishing the deficiency of vitamins. METHODS Pubmed/Medline, Scopus, Google Scholar and hand searching bibliographies of retrieved articles in duplicate, were used to detect all relevant meta-analyses investigating the relationship between vitamins and PD. After study selection, data were extracted from previously published meta-analyses and pooled by Review Manager version 5.4 and CMA software version 2.2.064 to achieve effect sizes. Level of statistical significance was set at P ≤ 0.05. RESULTS 14 meta-analyses were included in the meta-review. Serum vitamin D and B12 levels were significantly lower in PD (SMD = -0.67 and SMD = -0.40 respectively). Homocysteine (Hcy) levels were significantly higher in PD patients (SMD = 1.26). Also the odds ratio for highest vs. lowest vitamin E intake was 0.73 which was significant. However, there was no significant difference between vitamin A, C and B6 intake or serum levels in PD vs. control groups. CONCLUSION Serum vitamin D and B12 levels were significantly lower in PD in comparison to healthy individuals, while Hcy level was significantly higher in PD patients. Also higher vitamin E intake was associated with significantly lower risk of development of PD in comparison to lower vitamin E intake. However, there was no significant difference between risk of PD and higher vitamin A, C and B6 intake or serum levels of folate.
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Affiliation(s)
- Sama Rahnemayan
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Reza Rikhtegar
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, Faculty of Medicine, University Duisburg-Essen, Duisburg, Germany
| | - Sevda Riyahifar
- Department of Biostatics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sarvin Sanaie
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Golgasht Street, Tabriz, Iran.
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Jiang Z, Gu XJ, Su WM, Duan QQ, Ren YL, Li JR, Chi LY, Wang Y, Cao B, Chen YP. Protective effect of antihypertensive drugs on the risk of Parkinson's disease lacks causal evidence from mendelian randomization. Front Pharmacol 2023; 14:1107248. [PMID: 36909159 PMCID: PMC9995445 DOI: 10.3389/fphar.2023.1107248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
Background: Evidence from observational studies concerning the causal role of blood pressure (BP) and antihypertensive medications (AHM) on Parkinson's disease (PD) remains inconclusive. A two-sample Mendelian randomization (MR) study was performed to evaluate the unconfounded association of genetic proxies for BP and first-line AHMs with PD. Methods: Instrumental variables (IV) from the genome-wide association study (GWAS) for BP traits were used to proxy systolic BP (SBP), diastolic BP, and pulse pressure. SBP-associated variants either located within encoding regions or associated with the expression of AHM targets were selected and then scaled to proxy therapeutic inhibition of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, calcium channel blockers, and thiazides. Positive control analyses on coronary heart disease (CHD) and stroke were conducted to validate the IV selection. Summary data from GWAS for PD risk and PD age at onset (AAO) were used as outcomes. Results: In positive control analyses, genetically determined BP traits and AHMs closely mimicked the observed causal effect on CHD and stroke, confirming the validity of IV selection methodology. In primary analyses, although genetic proxies identified by "encoding region-based method" for β-blockers were suggestively associated with a delayed PD AAO (Beta: 0.115; 95% CI: 0.021, 0.208; p = 1.63E-2; per 10-mmHg lower), sensitivity analyses failed to support this association. Additionally, MR analyses found little evidence that genetically predicted BP traits, overall AHM, or other AHMs affected PD risk or AAO. Conclusion: Our data suggest that BP and commonly prescribed AHMs may not have a prominent role in PD etiology.
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Affiliation(s)
- Zheng Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiao-Jing Gu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Ming Su
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qing-Qing Duan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan-Lin Ren
- Department of Pathophysiology, West China College of Basic medical sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Ju-Rong Li
- Department of Geriatrics, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Li-Yi Chi
- Department of Neurology, Xijing Hospital, Air Force Military Medical University, Xi'an, Shanxi, China
| | - Yi Wang
- Department of Pathophysiology, West China College of Basic medical sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Bei Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yong-Ping Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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15
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Mitchell E, Chohan H, Bestwick JP, Noyce AJ. Alcohol and Parkinson's Disease: A Systematic Review and Meta-Analysis. JOURNAL OF PARKINSON'S DISEASE 2022; 12:2369-2381. [PMID: 36442208 DOI: 10.3233/jpd-223522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A substantial body of research has examined the relationship between alcohol consumption and risk of Parkinson's disease (PD). OBJECTIVE To provide an updated systematic review and meta-analysis of observational studies examining the relationship between alcohol consumption and risk of PD. METHODS Eligible studies comparing PD risk in ever vs. never alcohol drinkers were sourced from six databases. Outcomes were pooled using standard meta-analysis techniques. Separate female and male estimates were generated from studies reporting sex-specific data. Additionally, cohort studies stratifying participants by quantity of alcohol intake were integrated in a dose-response analysis. RESULTS 52 studies were included, totaling 63,707 PD patients and 9,817,924 controls. Our meta-analysis supported a statistically significant overrepresentation of never drinkers among PD subjects; odds ratio (OR) for ever drinking alcohol 0.84 (95% confidence interval (CI) 0.76 - 0.92). A subgroup analysis revealed similar effect estimates in females and males. A further synthesis of seven cohort studies suggested a negative, dose-dependent association between alcohol and risk of PD. CONCLUSION In the absence of a known neuroprotective pathway, there may be reason to doubt a true biological effect. The role of survivor bias, selection and recall bias, misclassification, and residual confounding requires consideration. Alternatively, observations might be attributable to reverse causation if those predestined for PD alter their alcohol habits during the preclinical phase. Major limitations of our study include high between-study heterogeneity (I2 = 93.2%) and lack of adjustment for key confounders, namely smoking status.
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Affiliation(s)
- Eleanor Mitchell
- Preventive Neurology Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Harneek Chohan
- Preventive Neurology Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Jonathan P Bestwick
- Preventive Neurology Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Alastair J Noyce
- Preventive Neurology Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
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16
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Zhang X, Xu J, Liu Y, Chen S, Wu S, Gao X. Diet Quality is Associated with Prodromal Parkinson's Disease Features in Chinese Adults. Mov Disord 2022; 37:2367-2375. [PMID: 36069990 DOI: 10.1002/mds.29208] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The prodromal phase of Parkinson's disease (PD) is a critical window for prevention by modifying lifestyle factors. However, there is limited knowledge on how diet quality is associated with prodromal PD symptoms in Asian populations. OBJECTIVE To examine the association between overall diet quality and prodromal PD features. METHODS A total of 71,640 Chinese participants who were free of PD were included in this cross-sectional study. Diet quality was assessed using the modified Alternative Healthy Eating Index (mAHEI) and alternate Mediterranean Diet (aMED). Five prodromal features including probable rapid eye movement sleep behavior disorder (pRBD), hyposmia, excessive daytime sleepiness, constipation, and depressive symptom were measured using validated questionnaires. Logistic regression was used to calculate the odds ratio (OR) for having a combination of prodromal PD symptoms (1 and 2+ symptoms vs. 0 symptoms), adjusting for age, sex, lifestyle factors, total energy intake, and other potential confounders. RESULTS In the multivariable-adjusted model, the OR for having 2+ versus 0 prodromal PD features was 0.64 (95% confidence interval [CI]: 0.49, 0.85) comparing the highest versus the lowest mAHEI diet quality quartiles with a significant inverse trend (P-trend = 0.003). For individual prodromal PD features, better diet quality, as assessed by the mAHEI, was associated with lower odds of having excessive daytime sleepiness and constipation (P-trend < 0.05 for both). We observed a marginally significant association between aMED and prodromal PD features (adjusted OR comparing the extreme quartiles = 0.74; 95% CI: 0.55, 0.98; P-trend = 0.09). CONCLUSION Better diet quality, as assessed by the mAHEI and the aMED, was associated with lower probability of having prodromal PD features in Chinese adults. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Xinyuan Zhang
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jipo Xu
- Department of Cardiology, Tangjizhuang Hospital Affiliated to Kailuan General Hospital, Tangshan, China
| | - Yesong Liu
- Department of Neurology, Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA.,Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety of Ministry of Education, Institute of Nutrition, Fudan University, Shanghai, China
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17
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Priya M, Zochedh A, Arumugam K, Sultan AB. Quantum Chemical Investigation, Drug-Likeness and Molecular Docking Studies on Galangin as Alpha-Synuclein Regulator for the Treatment of Parkinson’s Disease. CHEMISTRY AFRICA 2022. [DOI: 10.1007/s42250-022-00508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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18
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Abstract
The global burden of Parkinson's disease (PD) has increased from 2.5 to 6.1 million since the 1990s. This is expected to rise as the world population ages and lives longer. With the current consensus on the existence of a prediagnostic phase of PD, which can be divided into a preclinical stage and a prodromal stage, we can better define the risk markers and prodromal markers of PD in the broader context of PD pathogenesis. Here, we review this pathogenetic process, and discuss the evidence behind various heritability factors, exposure to pesticides and farming, high dairy consumption, and traumatic brain injuries that have been known to raise PD risk. Physical activity, early active lifestyle, high serum uric acid, caffeine consumption, exposure to tobacco, nonsteroidal anti-inflammatory drugs, and calcium channel blockers, as well as the Mediterranean and the MIND diets are observed to lower PD risk. This knowledge, when combined with ways to identify at-risk populations and early prodromal PD patients, can help the clinician make practical recommendations. Most importantly, it helps us set the parameters for epidemiological studies and create the paradigms for clinical trials.
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Affiliation(s)
- Suraj Rajan
- Division of Movement Disorders, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bonnie Kaas
- Division of Movement Disorders, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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19
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Onaolapo AY, Ojo FO, Olofinnade AT, Falade J, Lawal IA, Onaolapo OJ. Microbiome-Based Therapies in Parkinson's Disease: Can Tuning the Microbiota Become a Viable Therapeutic Strategy? CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2022; 22:CNSNDDT-EPUB-126136. [PMID: 36056826 DOI: 10.2174/1871527321666220903114559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/20/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
Progressive neurodegenerative disorders such as Parkinson's disease (PD) have continued to baffle medical science, despite strides in the understanding of their pathology. The inability of currently available therapies to halt disease progression is a testament to an incomplete understanding of pathways crucial to disease initiation, progression and management. Science has continued to link the activities and equilibrium of the gut microbiome to the health and proper functioning of brain neurons. They also continue to stir interest in the potential applications of technologies that may shift the balance of the gut microbiome towards achieving a favourable outcome in PD management. There have been suggestions that an improved understanding of the roles of the gut microbiota is likely to lead to the emergence of an era where their manipulation becomes a recognized strategy for PD management. This review examines the current state of our journey in the quest to understand how the gut microbiota can influence several aspects of PD. We highlight the relationship between the gut microbiome/microbiota and PD pathogenesis, as well as preclinical and clinical evidence evaluating the effect of postbiotics, probiotics and prebiotics in PD management. This is with a view to ascertaining if we are at the threshold of discovering the application of a usable tool in our quest for disease modifying therapies in PD.
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Affiliation(s)
- Adejoke Y Onaolapo
- Behavioural Neuroscience/Neurobiology Unit, Department of Anatomy, Faculty of Basic Medical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Folusho O Ojo
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Anthony T Olofinnade
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Clinical Sciences, College of Medicine, Lagos State University, Lagos State
| | - Joshua Falade
- Department of Mental Health, Afe-Babalola University Ado-Ekiti Ekiti State Nigeria
| | - Ismail A Lawal
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
- Department of Anatomy, Faculty of Health Sciences. Alhikmah University Ilorin, Kwara State, Nigeria
| | - Olakunle J Onaolapo
- Behavioural Neuroscience/Neuropharmacology Unit, Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
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20
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Bianchi VE, Rizzi L, Somaa F. The role of nutrition on Parkinson's disease: a systematic review. Nutr Neurosci 2022; 26:605-628. [PMID: 35730414 DOI: 10.1080/1028415x.2022.2073107] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Parkinson's disease (PD) in elderly patients is the second most prevalent neurodegenerative disease. The pathogenesis of PD is associated with dopaminergic neuron degeneration of the substantia nigra in the basal ganglia, causing classic motor symptoms. Oxidative stress, mitochondrial dysfunction, and neuroinflammation have been identified as possible pathways in laboratory investigations. Nutrition, a potentially versatile factor from all environmental factors affecting PD, has received intense research scrutiny. METHODS A systematic search was conducted in the MEDLINE, EMBASE, and WEB OF SCIENCE databases from 2000 until the present. Only randomized clinical trials (RCTs), observational case-control studies, and follow-up studies were included. RESULTS We retrieved fifty-two studies that met the inclusion criteria. Most selected studies investigated the effects of malnutrition and the Mediterranean diet (MeDiet) on PD incidence and progression. Other investigations contributed evidence on the critical role of microbiota, vitamins, polyphenols, dairy products, coffee, and alcohol intake. CONCLUSIONS There are still many concerns regarding the association between PD and nutrition, possibly due to underlying genetic and environmental factors. However, there is a body of evidence revealing that correcting malnutrition, gut microbiota, and following the MeDiet reduced the onset of PD and reduced clinical progression. Other factors, such as polyphenols, polyunsaturated fatty acids, and coffee intake, can have a potential protective effect. Conversely, milk and its accessory products can increase PD risk. Nutritional intervention is essential for neurologists to improve clinical outcomes and reduce the disease progression of PD.
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Affiliation(s)
| | - Laura Rizzi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Fahad Somaa
- King Abdulaziz University, Department of occupational therapy. Jeddah, Makkah, Saudi Arabia
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21
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Reducing neuroinflammation via therapeutic compounds and lifestyle to prevent or delay progression of Parkinson's disease. Ageing Res Rev 2022; 78:101618. [PMID: 35395416 DOI: 10.1016/j.arr.2022.101618] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/08/2022] [Accepted: 04/01/2022] [Indexed: 02/06/2023]
Abstract
Parkinson's disease (PD) is the second most common age-associated neurodegenerative disorder and is characterised by progressive loss of dopamine neurons in the substantia nigra. Peripheral immune cell infiltration and activation of microglia and astrocytes are observed in PD, a process called neuroinflammation. Neuroinflammation is a fundamental response to protect the brain but, when chronic, it triggers neuronal damage. In the last decade, central and peripheral inflammation were suggested to occur at the prodromal stage of PD, sustained throughout disease progression, and may play a significant role in the pathology. Understanding the pathological mechanisms of PD has been a high priority in research, primarily to find effective treatments once symptoms are present. Evidence indicates that early life exposure to neuroinflammation as a consequence of life events, environmental or behaviour factors such as exposure to infections, pollution or a high fat diet increase the risk of developing PD. Many studies show healthy habits and products that decrease neuroinflammation also reduce the risk of PD. Here, we aim to stimulate discussion about the role of neuroinflammation in PD onset and progression. We highlight that reducing neuroinflammation throughout the lifespan is critical for preventing idiopathic PD, and present epidemiological studies that detail risk and protective factors. It is possible that introducing lifestyle changes that reduce neuroinflammation at the time of PD diagnosis may slow symptom progression. Finally, we discuss compounds and therapeutics to treat the neuroinflammation associated with PD.
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22
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Reichmann H. [Caffeine, Chocolate and Adenosine A2A Receptor Antagonists in the Treatment of Parkinson's Disease]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022. [PMID: 35584767 DOI: 10.1055/a-1785-3632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Patients with Parkinson's disease can apparently benefit from caffeine consumption, as a number of experimental and clinical studies have already shown. METHODS The review examined the available literature on caffeine and Parkinson's disease. RESULTS Caffeine can penetrate the blood-brain barrier and exerts its biological effects mainly by antagonizing adenosine receptors. Numerous studies indicate that caffeine and its derivatives theobromine and theophylline are associated with a reduced risk of Parkinson's disease. Caffeine and adenosine antagonists reduce the excitotoxicity caused by glutamate. Evidence from animal models supports the potential of A2A receptor antagonism as an innovative disease-modifying target in Parkinson's disease CONCLUSION: The present review shows that the investigation and synthesis of xanthine derivatives as well as their analysis in clinical studies could be a promising approach in the therapy of neurodegenerative diseases.
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23
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Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and affects about 1% of the population over the age of 60 years in industrialised countries. The aim of this review is to examine nutrition in PD across three domains: dietary intake and the development of PD; whole body metabolism in PD and the effects of PD symptoms and treatment on nutritional status. In most cases, PD is believed to be caused by a combination of genetic and environmental factors and although there has been much research in the area, evidence suggests that poor dietary intake is not a risk factor for the development of PD. The evidence about body weight changes in both the prodromal and symptomatic phases of PD is inconclusive and is confounded by many factors. Malnutrition in PD has been documented as has sarcopaenia, although the prevalence of the latter remains uncertain due to a lack of consensus in the definition of sarcopaenia. PD symptoms, including those which are gastrointestinal and non-gastrointestinal, are known to adversely affect nutritional status. Similarly, PD treatments can cause nausea, vomiting and constipation, all of which can adversely affect nutritional status. Given that the prevalence of PD will increase as the population ages, it is important to understand the interplay between PD, comorbidities and nutritional status. Further research may contribute to the development of interventional strategies to improve symptoms, augment care and importantly, enhance the quality of life for patients living with this complex neurodegenerative disease.
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24
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Nie J, Liu C, Yu C, Guo Y, Pei P, Yang L, Chen Y, Du H, Zhu K, Schmidt D, Avery D, Chen J, Chen Z, Lv J, Li L. Independent and Joint Associations of Tea Consumption and Smoking with Parkinson's Disease Risk in Chinese Adults. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1693-1702. [PMID: 35527564 PMCID: PMC9398092 DOI: 10.3233/jpd-223148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Existing limited evidence suggests that smoking and tea consumption may be associated with a lower risk of Parkinson's disease (PD). However, less is known about the independent and joint roles of these two habits, which are often clustered among Chinese, on PD risk. OBJECTIVE To prospectively examine the independent and joint association of tea consumption and smoking with the risk of PD. METHODS The China Kadoorie Biobank (CKB) study recruited 512,725 participants aged 30 to 79 years from ten areas across China since 2004. Information on smoking and tea consumption was collected at baseline, and PD cases were ascertained by linkage to the national health insurance system and death registry. Cox proportional hazards models were used to estimate the multivariable-adjusted hazard ratios (HRs) and corresponding 95%confidence intervals (CIs). RESULTS During a median of 10.8 years of follow-up, 922 PD cases were recorded. Compared with participants who never consumed tea, the HR (95%CI) for daily consumers was 0.68 (0.55, 0.84). Compared with participants who never or occasionally smoked, the HR (95%CI) for current smokers was 0.66 (0.53, 0.82). Those who had a clustering habit of smoking and tea consumption had a 38%(HR = 0.62; 95%CI: 0.49, 0.79) lower PD risk than those who consumed none. However, there were no statistically significant multiplicative or additive interaction for tea consumption and smoking on PD risk. CONCLUSION We found that smoking and daily tea consumption were independently inversely associated with the risk of PD.
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Affiliation(s)
- Jia Nie
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Chunyu Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Yu Guo
- Fuwai hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom
- Clinical Trial ServiceUnit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom
- Clinical Trial ServiceUnit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom
- Clinical Trial ServiceUnit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Kaifei Zhu
- NCDs Prevention and Control Department, Wuzhong Center for Disease Control and Prevention, China
| | - Danile Schmidt
- Clinical Trial ServiceUnit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Daniel Avery
- Clinical Trial ServiceUnit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial ServiceUnit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Jun Lv
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Liming Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
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25
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Shao C, Wang X, Wang P, Tang H, He J, Wu N. Parkinson's Disease Risk and Alcohol Intake: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Front Nutr 2021; 8:709846. [PMID: 34722604 PMCID: PMC8551485 DOI: 10.3389/fnut.2021.709846] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/15/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The association between Parkinson's disease (PD) risk and alcohol intake is a controversial topic. Objectives: To systematically assess the association between PD risk and alcohol intake. Methods: PubMed and Embase databases were searched for eligible studies with prospective design on PD risk and alcohol intake. A meta-analysis with a random-effects model and dose-response analysis was performed. Relative risk ratios (RRs) with 95% CIs were calculated. Results: Eleven prospective studies were included. Overall, a higher intake of alcohol was inversely associated with PD risk (RR: 0.81, 95% CI: 0.70–0.95, I2 = 73.7%). Significant differences existed between the specific types of alcoholic beverages and geographic area. Specifically, a significant association existed for beer (RR: 0.78, 95% CI: 0.65–0.94, I2 = 0.0%) and studies conducted in Asia (RR: 0.66, 95% CI: 0.55–0.80, I2 = 37.3%). Dose-response analysis indicated a nonlinear relationship between PD risk and alcohol exposure. No evidence for publication bias was detected. Conclusions: In summary, our meta-analysis suggests that alcohol consumption was associated with a decreased risk of PD, with a nearly U-shaped association. Future studies are warranted to clarify the question of a specific type of alcoholic beverage-dependent association, geographic area effect, and possible threshold effects regarding both the adverse and beneficial effects of alcohol.
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Affiliation(s)
- Chuan Shao
- Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China.,Department of Neurosurgery, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China.,Chongqing Medical University, Chongqing, China
| | - Xiaoya Wang
- Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Pan Wang
- Department of Neurosurgery, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China.,Chongqing Medical University, Chongqing, China
| | - Hui Tang
- Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Jiaquan He
- Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Nan Wu
- Department of Neurosurgery, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China.,Chongqing Medical University, Chongqing, China
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26
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Yahalom G, Rigbi A, Israeli-Korn S, Krohn L, Rudakou U, Ruskey JA, Benshimol L, Tsafnat T, Gan-Or Z, Hassin-Baer S, Greenbaum L. Age at Onset of Parkinson's Disease Among Ashkenazi Jewish Patients: Contribution of Environmental Factors, LRRK2 p.G2019S and GBA p.N370S Mutations. JOURNAL OF PARKINSONS DISEASE 2021; 10:1123-1132. [PMID: 32310186 DOI: 10.3233/jpd-191829] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Both genetic and environmental factors contribute to Parkinson's disease (PD) risk. OBJECTIVE We investigated the potential association of several relevant variables with PD age at onset (AAO), focusing on LRRK2 p.G2019S and GBA p.N370S mutations. METHODS Ashkenazi Jewish (AJ) PD patients, screened for LRRK2 and GBA mutations, underwent an interview regarding exposure to the following environmental and lifestyle factors: cigarette smoking, consumption of coffee, tea and alcohol, head injury and rural living. Multivariate linear regression (adjusted for sex) was used to examine the association with AAO, and models included LRRK2 p.G2019S and GBA p.N370S mutation status (carrier/non-carriers), single environmental variable and their interactions terms, as independent variables. RESULTS 225 Israeli AJ PD patients were enrolled: 65 LRRK2 p.G2019S mutation carriers, 60 GBA p.N370S carriers and 100 non-carries of these mutations. In the dichotomized exposure/non-exposure analyses, positive LRRK2 p.G2019S status was associated with younger AAO in all models, at nominal or near significant levels (p = 0.033-0.082). Smoking was associated with older AAO (p = 0.032), and the interaction between GBA p.N370S and history of head injury was associated with younger AAO (p = 0.049), both at nominal significance. There was no indication of a consistent main effect for GBA p.N370S status or significant LRRK2 p.G2019S-environmental factor interaction. In the dose-dependent analyses, increased coffee and tea consumption levels were associated with older AAO (p = 0.001 and p = 0.002, respectively). CONCLUSIONS Our results suggest that genetic and environmental factors may affect AAO in PD patients, but validation in additional samples is required.
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Affiliation(s)
- Gilad Yahalom
- Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Israel.,Department of Neurology, Sheba Medical Center, Tel Hashomer, Israel.,Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel.,Movement Disorders Clinic and Department of Neurology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Amihai Rigbi
- Faculty of Education, Beit Berl College, Kfar Saba, Israel
| | - Simon Israeli-Korn
- Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Israel.,Department of Neurology, Sheba Medical Center, Tel Hashomer, Israel.,Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lynne Krohn
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - Uladzislau Rudakou
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - Jennifer A Ruskey
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Lior Benshimol
- Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Tal Tsafnat
- Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Ziv Gan-Or
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Human Genetics, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Sharon Hassin-Baer
- Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Israel.,Department of Neurology, Sheba Medical Center, Tel Hashomer, Israel.,Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Greenbaum
- Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
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27
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Sia MW, Foo JN, Saffari SE, Wong ASY, Khor CC, Yuan JM, Tan EK, Koh WP, Tan LCS. Polygenic Risk Scores in a Prospective Parkinson's Disease Cohort. Mov Disord 2021; 36:2936-2940. [PMID: 34402545 DOI: 10.1002/mds.28761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/07/2021] [Accepted: 07/26/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Ethnic-specific genetic risk assessment framework for Parkinson's disease (PD) is lacking for the Asian population. OBJECTIVE We investigated the association of a polygenic risk score (PRS) with PD incidence in a population-based Asian prospective cohort. METHODS Genetic, dietary, and lifestyle information were prospectively collected from 25,646 participants within the Singapore Chinese Health Study cohort. PRS was constructed with Asian-specific and top genome-wide association study variants. The association between PRS and PD incidence was evaluated with multivariable Cox proportional hazard models, Kaplan-Meier survival analysis, and concordance statistics. RESULTS A total of 333 incident cases were identified after a follow-up period of more than 20 years. Participants with PRS in the top tertile (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.37-2.39) and middle tertile (HR, 1.35; 95% CI, 1.00-1.83) are at higher risk of developing PD after adjusting for dietary and lifestyle risk factors, with a shorter time to PD event in a Kaplan-Meier survival analysis (P < 0.001). CONCLUSION We identified a PRS that was significantly associated with PD incidence in a prospective Chinese cohort after adjusting for dietary and lifestyle factors. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Jia-Nee Foo
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Department of Human Genetics, Genome Institute of Singapore, Singapore
| | - Seyed-Ehsan Saffari
- Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Department of Neurology, National Neuroscience Institute, Singapore
| | | | - Chiea-Chuen Khor
- Duke-NUS Medical School, Singapore.,Department of Human Genetics, Genome Institute of Singapore, Singapore
| | - Jian-Min Yuan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Louis Chew-Seng Tan
- Duke-NUS Medical School, Singapore.,Department of Neurology, National Neuroscience Institute, Singapore
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Chang MC, Kwak SG, Kwak S. Effect of dietary vitamins C and E on the risk of Parkinson's disease: A meta-analysis. Clin Nutr 2021; 40:3922-3930. [PMID: 34139465 DOI: 10.1016/j.clnu.2021.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/08/2021] [Accepted: 05/12/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND & AIMS A neuroprotective effect of dietary vitamins C and E on Parkinson's disease (PD) has been suggested, however, several human studies have reported controversial results. Therefore, we conducted a meta-analysis on the effect of vitamins C and E on the risk of Parkinson's disease. METHODS A comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, and SCOPUS databases for studies published up to January 23, 2021. We included studies that reported (1) intake of vitamins C and E using validated methods; (2) assessment of odds ratio (OR), relative risk (RR), or hazard ratio (HR); and (3) patients with PD identified by a neurologist, hospital records, or death certificates. The Comprehensive Meta-Analysis Software 2 program was used for statistical analyses of the pooled data. RESULTS A total of 12 studies (four prospective cohort and eight case-control studies) were included in our meta-analysis. No significant risk reduction was observed in the high vitamin C intake group compared to low intake group. On the other hand, the high vitamin E intake group showed a significantly lower risk of development of PD than the low intake group (pooled OR = 0.799. 95% CI = 0.721 to 0.885). CONCLUSIONS We conclude that vitamin E might have a protective effect against PD, while vitamin C does not seem to have such an effect. However, the exact mechanism of the transport and regulation of vitamin E in the CNS remains elusive, and further studies would be necessary in this field.
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Affiliation(s)
- Min Cheol Chang
- Department of Physical Medicine & Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
| | - Soyoung Kwak
- Department of Physical Medicine & Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
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Singla RK, Agarwal T, He X, Shen B. Herbal Resources to Combat a Progressive & Degenerative Nervous System Disorder- Parkinson's Disease. Curr Drug Targets 2021; 22:609-630. [PMID: 33050857 DOI: 10.2174/1389450121999201013155202] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/06/2020] [Accepted: 06/12/2020] [Indexed: 02/08/2023]
Abstract
Parkinson's disease is one of the most common adult-onset, a chronic disorder involving neurodegeneration, which progressively leads to deprivation of dopaminergic neurons in substantia nigra, causing a subsequent reduction of dopamine levels in the striatum resulting in tremor, myotonia, and dyskinesia. Genetics and environmental factors are believed to be responsible for the onset of Parkinson's disease. The exact pathogenesis of Parkinson's disease is quite complicated and the present anti-Parkinson's disease treatments appear to be clinically insufficient. Comprehensive researches have demonstrated the use of natural products such as ginseng, curcumin, ashwagandha, baicalein, etc. for the symptomatic treatment of this disease. The neuroprotective effects exhibited by these natural products are mainly due to their ability to increase dopamine levels in the striatum, manage oxidative stress, mitochondrial dysfunction, glutathione levels, clear the aggregation of α- synuclein, induce autophagy and decrease the pro-inflammatory cytokines and lipid peroxidation. This paper reviews various natural product studies conducted by scientists to establish the role of natural products (both metabolite extracts as well as pure metabolites) as adjunctive neuroprotective agents.
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Affiliation(s)
- Rajeev K Singla
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Xinchuan Road 2222, Chengdu, Sichuan, China
| | - Tanya Agarwal
- School of Medical and Allied Sciences, K.R. Mangalam University, Sohna Road, Gurugram-122103, India
| | - Xuefei He
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Xinchuan Road 2222, Chengdu, Sichuan, China
| | - Bairong Shen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Xinchuan Road 2222, Chengdu, Sichuan, China
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30
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Luo M, Gan RY, Li BY, Mao QQ, Shang A, Xu XY, Li HY, Li HB. Effects and Mechanisms of Tea on Parkinson’s Disease, Alzheimer’s Disease and Depression. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1904413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Min Luo
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou
| | - Ren-You Gan
- Research Center for Plants and Human Health, Institute of Urban Agriculture, Chinese Academy of Agricultural Sciences (CAAS), Chengdu, China
- Key Laboratory of Coarse Cereal Processing (Ministry of Agriculture and Rural Affairs), Sichuan Engineering & Technology Research Center of Coarse Cereal Industralization, Chengdu University, Chengdu, China
| | - Bang-Yan Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou
| | - Qian-Qian Mao
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou
| | - Ao Shang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou
| | - Xiao-Yu Xu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou
| | - Hang-Yu Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou
| | - Hua-Bin Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou
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Medeiros MS, Schumacher-Schuh AF, Altmann V, Rieder CRDM. A Case-Control Study of the Effects of Chimarrão ( Ilex paraguariensis) and Coffee on Parkinson's Disease. Front Neurol 2021; 12:619535. [PMID: 33776884 PMCID: PMC7988202 DOI: 10.3389/fneur.2021.619535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/25/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Coffee has been inversely associated with Parkinson's disease (PD) in many studies, and caffeine is the leading candidate to mediate this effect. Mate (Ilex paraguariensis, IP), a caffeinated beverage rich in antioxidants consumed in South America, was also inversely associated with PD in one study from Argentina. Other varieties of IP infusion, such as chimarrão, were never studied in PD. Chimarrão is a common caffeinated beverage consumed in Brazil made with the leaves and stems of IP. Methods: A case–control study was conducted to evaluate the relationship between chimarrão ingestion and PD in southern Brazil. All subjects answered a questionnaire about the frequency of chimarrão and coffee intake. A multiple regression analysis adjusted for age and sex was performed to assess the association between PD and chimarrão consumption. Results: We included 200 PD patients and 200 healthy controls. High consumption of chimarrão was inversely associated with PD (OR = 0.44, 95% CI = 0.24–0.81, P = 0.008). High consumption of coffee was also inversely associated with PD, as expected. Chimarrão remained associated when adjusted for coffee consumption, smoking history, and age (OR 0.46, 95% CI = 0.25–0.86, P = 0.014). These two exposures showed an additive effect. Conclusion:Chimarrão consumption was inversely associated with PD, even after adjusting for coffee intake, suggesting a possible protective role. IP's effect can be mediated by caffeine and through its antioxidant components. Chimarrão has a lower concentration of caffeine compared with coffee and has numerous substances with antioxidative effects that may be important to PD protection. Further studies are needed to test this hypothesis.
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Affiliation(s)
| | - Artur Francisco Schumacher-Schuh
- Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Departamento de Farmacologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vivian Altmann
- Departamento de Neurologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Fukutomi R, Ohishi T, Koyama Y, Pervin M, Nakamura Y, Isemura M. Beneficial Effects of Epigallocatechin-3- O-Gallate, Chlorogenic Acid, Resveratrol, and Curcumin on Neurodegenerative Diseases. Molecules 2021; 26:E415. [PMID: 33466849 PMCID: PMC7829779 DOI: 10.3390/molecules26020415] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 02/07/2023] Open
Abstract
Many observational and clinical studies have shown that consumption of diets rich in plant polyphenols have beneficial effects on various diseases such as cancer, obesity, diabetes, cardiovascular diseases, and neurodegenerative diseases (NDDs). Animal and cellular studies have indicated that these polyphenolic compounds contribute to such effects. The representative polyphenols are epigallocatechin-3-O-gallate in tea, chlorogenic acids in coffee, resveratrol in wine, and curcumin in curry. The results of human studies have suggested the beneficial effects of consumption of these foods on NDDs including Alzheimer's and Parkinson's diseases, and cellular animal experiments have provided molecular basis to indicate contribution of these representative polyphenols to these effects. This article provides updated information on the effects of these foods and their polyphenols on NDDs with discussions on mechanistic aspects of their actions mainly based on the findings derived from basic experiments.
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Affiliation(s)
- Ryuuta Fukutomi
- Quality Management Division, Higuchi Inc. Minato-ku, Tokyo 108-0075, Japan
| | - Tomokazu Ohishi
- Institute of Microbial Chemistry (BIKAKEN), Microbial Chemistry Research Foundation, Numazu, Shizuoka 410-0301, Japan;
| | - Yu Koyama
- Shizuoka Eiwa Gakuin University Junior College, Suruga-ku, Shizuoka 422-8545, Japan;
| | - Monira Pervin
- Tea Science Research Center, University of Shizuoka, Suruga-ku, Shizuoka 422-8526, Japan; (M.P.); (Y.N.)
| | - Yoriyuki Nakamura
- Tea Science Research Center, University of Shizuoka, Suruga-ku, Shizuoka 422-8526, Japan; (M.P.); (Y.N.)
| | - Mamoru Isemura
- Tea Science Research Center, University of Shizuoka, Suruga-ku, Shizuoka 422-8526, Japan; (M.P.); (Y.N.)
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Manalo RVM, Medina PMB. Caffeine reduces deficits in mechanosensation and locomotion induced by L-DOPA and protects dopaminergic neurons in a transgenic Caenorhabditis elegans model of Parkinson's disease. PHARMACEUTICAL BIOLOGY 2020; 58:721-731. [PMID: 32715838 PMCID: PMC7470077 DOI: 10.1080/13880209.2020.1791192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/02/2020] [Accepted: 06/30/2020] [Indexed: 05/08/2023]
Abstract
CONTEXT L-DOPA is the first-line drug for Parkinson's disease (PD). However, chronic use can lead to dyskinesia. Caffeine, which is a known neuroprotectant, can potentially act as an adjunct to minimise adverse effects of L-DOPA. OBJECTIVES This study determined changes in terms of neurodegeneration, locomotion and mechanosensation in Caenorhabditis elegans (Rhabditidae) strain UA57 overexpressing tyrosine hydroxylase (CAT-2) when treated with caffeine, L-DOPA or their combinations. MATERIALS AND METHODS Neurodegeneration was monitored via fluorescence microscopy of GFP-tagged dopaminergic neurons in the head and tail regions of C. elegans (n = 20). Meanwhile, mechanosensation and locomotion under vehicle (0.1% DMSO), L-DOPA (60 mM), caffeine (10 mM) or 60 mM L-DOPA + 10 or 20 mM caffeine (60LC10 and 60LC20) treatments were scored for 3 days. RESULTS L-DOPA (60 mM) reduced CEP and ADE neurons by 4.3% on day 3, with a concomitant decrease in fluorescence by 44.6%. This correlated with reductions in gentle head (-35%) and nose touch (-40%) responses, but improved locomotion (20-75%) compared with vehicle alone. CEP and ADE neuron counts were preserved with caffeine (10 mM) or 60LC10 (98-100%), which correlated with improved mechanosensation (10-23%) and locomotion (18-76%). However, none of the treatments was able to preserve PDE neuron count, reducing the basal slowing response. Discussion and conclusions: Taken together, we show that caffeine can protect DAergic neurons and can reduce aberrant locomotion and loss of sensation when co-administered with L-DOPA, which can potentially impact PD treatment and warrants further investigation.
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Affiliation(s)
- Rafael Vincent M. Manalo
- Biological Models Laboratory, Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Paul Mark B. Medina
- Biological Models Laboratory, Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines Manila, Manila, Philippines
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Gentile F, Doneddu PE, Riva N, Nobile-Orazio E, Quattrini A. Diet, Microbiota and Brain Health: Unraveling the Network Intersecting Metabolism and Neurodegeneration. Int J Mol Sci 2020; 21:E7471. [PMID: 33050475 PMCID: PMC7590163 DOI: 10.3390/ijms21207471] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023] Open
Abstract
Increasing evidence gives support for the idea that extra-neuronal factors may affect brain physiology and its predisposition to neurodegenerative diseases. Epidemiological and experimental studies show that nutrition and metabolic disorders such as obesity and type 2 diabetes increase the risk of Alzheimer's and Parkinson's diseases after midlife, while the relationship with amyotrophic lateral sclerosis is uncertain, but suggests a protective effect of features of metabolic syndrome. The microbiota has recently emerged as a novel factor engaging strong interactions with neurons and glia, deeply affecting their function and behavior in these diseases. In particular, recent evidence suggested that gut microbes are involved in the seeding of prion-like proteins and their spreading to the central nervous system. Here, we present a comprehensive review of the impact of metabolism, diet and microbiota in neurodegeneration, by affecting simultaneously several aspects of health regarding energy metabolism, immune system and neuronal function. Advancing technologies may allow researchers in the future to improve investigations in these fields, allowing the buildup of population-based preventive interventions and development of targeted therapeutics to halt progressive neurologic disability.
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Affiliation(s)
- Francesco Gentile
- Experimental Neuropathology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy; (F.G.); (N.R.)
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute IRCCS, 20089 Milan, Italy; (P.E.D.); (E.N.-O.)
| | - Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute IRCCS, 20089 Milan, Italy; (P.E.D.); (E.N.-O.)
| | - Nilo Riva
- Experimental Neuropathology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy; (F.G.); (N.R.)
- Department of Neurology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute IRCCS, 20089 Milan, Italy; (P.E.D.); (E.N.-O.)
- Department of Medical Biotechnology and Translational Medicine, University of Milan, 20122 Milan, Italy
| | - Angelo Quattrini
- Experimental Neuropathology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy; (F.G.); (N.R.)
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Ying AF, Khan S, Wu Y, Jin A, Wong AS, Tan E, Yuan J, Koh W, Tan LC. Dietary Antioxidants and Risk of Parkinson's Disease in the Singapore Chinese Health Study. Mov Disord 2020; 35:1765-1773. [PMID: 32643256 PMCID: PMC7754435 DOI: 10.1002/mds.28173] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/24/2020] [Accepted: 05/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite experimental evidence implicating oxidative stress in the pathogenesis of PD, epidemiological studies have provided inconsistent associations between dietary antioxidants and risk of developing PD. Furthermore, no study has been done in any Asian population. OBJECTIVES We examined the associations for intake levels of dietary carotenoids (α-carotene, β-carotene, lycopene, β-cryptoxanthin, and lutein) and vitamins (vitamin A, C and E) and the risk of developing PD. METHODS We used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63,257 men and women aged 45 to 74 years during enrollment in 1993-1998. Antioxidant intake was derived from a validated semiquantitative food frequency questionnaire. Incident cases were identified through follow-up interviews, hospital records, or PD registries through 31 July 2018. Hazard ratios and corresponding 95% confidence intervals were derived from multivariable Cox proportional hazard regression models with adjustment for other lifestyle and dietary factors. RESULTS During an average 19.4 years of follow-up, 544 incident PD cases were identified. No association was found for dietary carotenoids, individually or summed. Hazard ratio comparing highest to lowest quartile for total carotenoids was 0.98 (95% confidence interval: 0.76-1.28; Ptrend = 0.83). There were also no clear dose-dependent associations of dietary vitamins A, C, and E with risk of developing PD (all Ptrend ≥ 0.10). Sensitive analyses with lag time and excluding supplement use did not materially alter results. CONCLUSIONS Intake of dietary antioxidants, such as carotenoids and vitamins, was not associated with the risk of developing PD in Singaporean Chinese. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Shazma Khan
- Department of NeurologyNational Neuroscience InstituteSingapore
| | - Ying Wu
- Department of NeurologyNational Neuroscience InstituteSingapore
| | - Aizhen Jin
- Health Services and Systems Research, Duke‐NUS Medical SchoolSingapore
| | - Aidan S.Y. Wong
- Department of NeurologyNational Neuroscience InstituteSingapore
| | - Eng‐King Tan
- Health Services and Systems Research, Duke‐NUS Medical SchoolSingapore
- Department of NeurologyNational Neuroscience InstituteSingapore
| | - Jian‐Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, and Department of EpidemiologyGraduate School of Public Health, University of PittsburghPittsburghPennsylvaniaUSA
| | - Woon‐Puay Koh
- Health Services and Systems Research, Duke‐NUS Medical SchoolSingapore
- Saw Swee Hock School of Public HealthNational University of Singapore
| | - Louis C.S. Tan
- Health Services and Systems Research, Duke‐NUS Medical SchoolSingapore
- Department of NeurologyNational Neuroscience InstituteSingapore
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Schepici G, Silvestro S, Bramanti P, Mazzon E. Caffeine: An Overview of Its Beneficial Effects in Experimental Models and Clinical Trials of Parkinson's Disease. Int J Mol Sci 2020; 21:ijms21134766. [PMID: 32635541 PMCID: PMC7369844 DOI: 10.3390/ijms21134766] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 12/20/2022] Open
Abstract
Parkinson’s Disease (PD) is a neurological disease characterized by the progressive degeneration of the nigrostriatal dopaminergic pathway with consequent loss of neurons in the substantia nigra pars compacta and dopamine depletion. The cytoplasmic inclusions of α-synuclein (α-Syn), known as Lewy bodies, are the cytologic hallmark of PD. The presence of α-Syn aggregates causes mitochondrial degeneration, responsible for the increase in oxidative stress and consequent neurodegeneration. PD is a progressive disease that shows a complicated pathogenesis. The current therapies are used to alleviate the symptoms of the disease without changing its clinical course. Recently, phytocompounds with neuroprotective effects and antioxidant properties such as caffeine have aroused the interest of researchers. The purpose of this review is to summarize the preclinical studies present in the literature and clinical trials recorded in ClinicalTrial.gov, aimed at illustrating the effects of caffeine used as a nutraceutical compound combined with the current PD therapies. Therefore, the preventive effects of caffeine in the neurodegeneration of dopaminergic neurons encourage the use of this alkaloid as a supplement to reduce the progress of the PD.
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The Effect of Caffeine on the Risk and Progression of Parkinson's Disease: A Meta-Analysis. Nutrients 2020; 12:nu12061860. [PMID: 32580456 PMCID: PMC7353179 DOI: 10.3390/nu12061860] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 12/21/2022] Open
Abstract
Coffee and caffeine are speculated to be associated with the reduced risk of Parkinson's disease (PD). The present study aimed to investigate the disease-modifying potential of caffeine on PD, either for healthy people or patients, through a meta-analysis. The electronic databases were searched using terms related to PD and coffee and caffeinated food products. Articles were included only upon fulfillment of clear diagnostic criteria for PD and details regarding their caffeine content. Reference lists of relevant articles were reviewed to identify eligible studies not shortlisted using these terms. In total, the present study enrolled 13 studies, nine were categorized into a healthy cohort and the rest into a PD cohort. The individuals in the healthy cohort with regular caffeine consumption had a significantly lower risk of PD during follow-up evaluation (hazard ratio (HR) = 0.797, 95% CI = 0.748-0.849, p < 0.001). The outcomes of disease progression in PD cohorts included dyskinesia, motor fluctuation, symptom onset, and levodopa initiation. Individuals consuming caffeine presented a significantly lower rate of PD progression (HR = 0.834, 95% CI = 0.707-0.984, p = 0.03). In conclusion, caffeine modified disease risk and progression in PD, among both healthy individuals or those with PD. Potential biological benefits, such as those obtained from adenosine 2A receptor antagonism, may require further investigation for designing new drugs.
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Nutraceuticals Targeting Generation and Oxidant Activity of Peroxynitrite May Aid Prevention and Control of Parkinson's Disease. Int J Mol Sci 2020; 21:ijms21103624. [PMID: 32455532 PMCID: PMC7279222 DOI: 10.3390/ijms21103624] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/29/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease (PD) is a chronic low-grade inflammatory process in which activated microglia generate cytotoxic factors-most prominently peroxynitrite-which induce the death and dysfunction of neighboring dopaminergic neurons. Dying neurons then release damage-associated molecular pattern proteins such as high mobility group box 1 which act on microglia via a range of receptors to amplify microglial activation. Since peroxynitrite is a key mediator in this process, it is proposed that nutraceutical measures which either suppress microglial production of peroxynitrite, or which promote the scavenging of peroxynitrite-derived oxidants, should have value for the prevention and control of PD. Peroxynitrite production can be quelled by suppressing activation of microglial NADPH oxidase-the source of its precursor superoxide-or by down-regulating the signaling pathways that promote microglial expression of inducible nitric oxide synthase (iNOS). Phycocyanobilin of spirulina, ferulic acid, long-chain omega-3 fatty acids, good vitamin D status, promotion of hydrogen sulfide production with taurine and N-acetylcysteine, caffeine, epigallocatechin-gallate, butyrogenic dietary fiber, and probiotics may have potential for blunting microglial iNOS induction. Scavenging of peroxynitrite-derived radicals may be amplified with supplemental zinc or inosine. Astaxanthin has potential for protecting the mitochondrial respiratory chain from peroxynitrite and environmental mitochondrial toxins. Healthful programs of nutraceutical supplementation may prove to be useful and feasible in the primary prevention or slow progression of pre-existing PD. Since damage to the mitochondria in dopaminergic neurons by environmental toxins is suspected to play a role in triggering the self-sustaining inflammation that drives PD pathogenesis, there is also reason to suspect that plant-based diets of modest protein content, and possibly a corn-rich diet high in spermidine, might provide protection from PD by boosting protective mitophagy and thereby aiding efficient mitochondrial function. Low-protein diets can also promote a more even response to levodopa therapy.
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Maladie de Parkinson, nutrition et micronutrition. ACTUALITES PHARMACEUTIQUES 2020. [DOI: 10.1016/j.actpha.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Peng B, Yang Q, B Joshi R, Liu Y, Akbar M, Song BJ, Zhou S, Wang X. Role of Alcohol Drinking in Alzheimer's Disease, Parkinson's Disease, and Amyotrophic Lateral Sclerosis. Int J Mol Sci 2020; 21:ijms21072316. [PMID: 32230811 PMCID: PMC7177420 DOI: 10.3390/ijms21072316] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 02/08/2023] Open
Abstract
Neurodegenerative diseases, including Alzheimer’s disease (AD), Parkinson’s disease (PD) and amyotrophic lateral sclerosis (ALS), increase as the population ages around the world. Environmental factors also play an important role in most cases. Alcohol consumption exists extensively and it acts as one of the environmental factors that promotes these neurodegenerative diseases. The brain is a major target for the actions of alcohol, and heavy alcohol consumption has long been associated with brain damage. Chronic alcohol intake leads to elevated glutamate-induced excitotoxicity, oxidative stress and permanent neuronal damage associated with malnutrition. The relationship and contributing mechanisms of alcohol with these three diseases are different. Epidemiological studies have reported a reduction in the prevalence of Alzheimer’s disease in individuals who drink low amounts of alcohol; low or moderate concentrations of ethanol protect against β-amyloid (Aβ) toxicity in hippocampal neurons; and excessive amounts of ethanol increase accumulation of Aβ and Tau phosphorylation. Alcohol has been suggested to be either protective of, or not associated with, PD. However, experimental animal studies indicate that chronic heavy alcohol consumption may have dopamine neurotoxic effects through the induction of Cytochrome P450 2E1 (CYP2E1) and an increase in the amount of α-Synuclein (αSYN) relevant to PD. The findings on the association between alcohol consumption and ALS are inconsistent; a recent population-based study suggests that alcohol drinking seems to not influence the risk of developing ALS. Additional research is needed to clarify the potential etiological involvement of alcohol intake in causing or resulting in major neurodegenerative diseases, which will eventually lead to potential therapeutics against these alcoholic neurodegenerative diseases.
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Affiliation(s)
- Bin Peng
- Departments of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Qiang Yang
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye 435100, China
| | - Rachna B Joshi
- Departments of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Internal Medicine, Stafford Medical, PA. 1364 NJ-72, Manahawkin, NJ 08050, USA
| | - Yuancai Liu
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye 435100, China
| | - Mohammed Akbar
- Division of Neuroscience & Behavior, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20852, USA;
| | - Byoung-Joon Song
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA;
| | - Shuanhu Zhou
- Departments of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Correspondence: (S.Z.); (X.W.); Tel.: 1-617-732-5398 (S.Z.); 1-617-732-4186 (X.W.)
| | - Xin Wang
- Departments of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Correspondence: (S.Z.); (X.W.); Tel.: 1-617-732-5398 (S.Z.); 1-617-732-4186 (X.W.)
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Modifiable risk and protective factors in disease development, progression and clinical subtypes of Parkinson's disease: What do prospective studies suggest? Neurobiol Dis 2019; 134:104671. [PMID: 31706021 DOI: 10.1016/j.nbd.2019.104671] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 12/20/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder whose pathogenesis depends on a combination of genetic and environmental factors. The aim of the present review was to provide an updated description of the findings emerging from prospective longitudinal cohort studies on the possible risk/protective factors underlying the development, progression and clinical subtypes of PD. We reviewed all the environmental, lifestyle, dietary, comorbid and pharmacological factors that have been investigated as possible modifiable protective/risk factors for PD by longitudinal studies. Only a few factors have the epidemiological evidence and the biological plausibility to be considered risk (pesticides, dairy products, β2-adrenoreceptor antagonists) or protective (smoking, caffeine and tea intake, physical activity, gout, vitamin E intake, non-steroidal anti-inflammatory drugs and β2-adrenoreceptor agonists) factors for PD. Caffeine intake and physical activity also seem to slow down the progression of the disease, thus representing good candidates for primary prevention and disease modifying strategies in PD. Possible modifiable risk factors of PD subtypes is almost unknown and this might depend on the uncertain biological and neuropathological reliability of clinical subtypes. The results of the present review suggest that only eleven risk/protective factors may be associated with the risk of PD. It may be possible to target some of these factors for preventive interventions aimed at reducing the risk of developing and the rate of progression of PD.
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Abstract
Despite recent successes in understanding the genetics of Parkinson’s disease (PD), the causes of late-onset sporadic PD remain elusive. Many of the epidemiologic findings on PD etiology have been challenged by alternative explanations such as reverse causation. This is mainly because PD often takes decades to develop before it can be diagnosed late in life. Convincing evidence shows that this prodromal stage of PD is characterized by various prodromal symptoms such as olfactory impairment and rapid-eye-movement sleep behavior disorder (RBD). As they likely reflect PD pathogenesis years, if not decades, before nigrostriatal involvement, research on these symptoms may represent an unprecedented opportunity to dissect the etiology of PD. Using PD prodromal symptoms as intermediate phenotypes, we may be able to identify factors that contribute to the development of these symptoms and factors that modify their progression to clinical PD. Further, this line of research will also enable examinations of novel etiological hypotheses of PD development such as the microbiome and prion hypotheses. In this article, the author used olfactory impairment and RBD as examples to illustrate the promises and challenges of epidemiologic research on prodromal symptoms to understand PD etiology.
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Affiliation(s)
- Honglei Chen
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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Kalampokini S, Becker A, Fassbender K, Lyros E, Unger MM. Nonpharmacological Modulation of Chronic Inflammation in Parkinson's Disease: Role of Diet Interventions. PARKINSON'S DISEASE 2019; 2019:7535472. [PMID: 31534664 PMCID: PMC6732577 DOI: 10.1155/2019/7535472] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/22/2019] [Accepted: 08/12/2019] [Indexed: 12/30/2022]
Abstract
Neuroinflammation is increasingly recognized as an important pathophysiological feature of neurodegenerative diseases such as Parkinson's disease (PD). Recent evidence suggests that neuroinflammation in PD might originate in the intestine and the bidirectional communication between the central and enteric nervous system, the so-called "gut-brain axis," has received growing attention due to its contribution to the pathogenesis of neurological disorders. Diet targets mediators of inflammation with various mechanisms and combined with dopaminergic treatment can exert various beneficial effects in PD. Food-based therapies may favorably modulate gut microbiota composition and enhance the intestinal epithelial integrity or decrease the proinflammatory response by direct effects on immune cells. Diets rich in pre- and probiotics, polyunsaturated fatty acids, phenols including flavonoids, and vitamins, such as the Mediterranean diet or a plant-based diet, may attenuate chronic inflammation and positively influence PD symptoms and even progression of the disease. Dietary strategies should be encouraged in the context of a healthy lifestyle with physical activity, which also has neuroimmune-modifying properties. Thus, diet adaptation appears to be an effective additive, nonpharmacological therapeutic strategy that can attenuate the chronic inflammation implicated in PD, potentially slow down degeneration, and thereby modify the course of the disease. PD patients should be highly encouraged to adopt corresponding lifestyle modifications, in order to improve not only PD symptoms, but also general quality of life. Future research should focus on planning larger clinical trials with dietary interventions in PD in order to obtain hard evidence for the hypothesized beneficial effects.
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Affiliation(s)
- Stefania Kalampokini
- Department of Neurology, University Hospital of Saarland, Kirrberger Straße, 66421 Homburg, Germany
| | - Anouck Becker
- Department of Neurology, University Hospital of Saarland, Kirrberger Straße, 66421 Homburg, Germany
| | - Klaus Fassbender
- Department of Neurology, University Hospital of Saarland, Kirrberger Straße, 66421 Homburg, Germany
| | - Epameinondas Lyros
- Department of Neurology, University Hospital of Saarland, Kirrberger Straße, 66421 Homburg, Germany
| | - Marcus M. Unger
- Department of Neurology, University Hospital of Saarland, Kirrberger Straße, 66421 Homburg, Germany
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Nutritional Risk Factors, Microbiota and Parkinson's Disease: What Is the Current Evidence? Nutrients 2019; 11:nu11081896. [PMID: 31416163 PMCID: PMC6722832 DOI: 10.3390/nu11081896] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 02/06/2023] Open
Abstract
Parkinson’s disease (PD) is a frequent neurodegenerative disease among elderly people. Genetic and underlying environmental factors seem to be involved in the pathogenesis of PD related to degeneration of dopaminergic neurons in the striatum. In previous experimental researches oxidative stress, mitochondrial dysfunction, homocysteine, and neuroinflammation have been reported as potential mechanisms. Among environmental factors, nutrition is one of the most investigated areas as it is a potentially modifiable factor. The purpose of this review is to provide current knowledge regarding the relation between diet and PD risk. We performed a comprehensive review including the most relevant studies from the year 2000 onwards including prospective studies, nested case-control studies, and meta-analysis. Among dietary factors we focused on specific nutrients and food groups, alcoholic beverages, uric acid, and dietary patterns. Furthermore, we included studies on microbiota as recent findings have shown a possible impact on neurodegeneration. As a conclusion, there are still many controversies regarding the relationship between PD and diet which, beside methodological differences among studies, may be due to underlying genetic and gender-specific factors. However, some evidence exists regarding a potential protective effect of uric acid, poly-unsaturated fatty acids, coffee, and tea but mainly in men, whereas dairy products, particularly milk, might increase PD risk through contaminant mediated effect.
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Meade RM, Fairlie DP, Mason JM. Alpha-synuclein structure and Parkinson's disease - lessons and emerging principles. Mol Neurodegener 2019; 14:29. [PMID: 31331359 PMCID: PMC6647174 DOI: 10.1186/s13024-019-0329-1] [Citation(s) in RCA: 247] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/01/2019] [Indexed: 12/22/2022] Open
Abstract
Alpha-synuclein (αS) is the major constituent of Lewy bodies and a pathogenic hallmark of all synucleinopathathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). All diseases are determined by αS aggregate deposition but can be separated into distinct pathological phenotypes and diagnostic criteria. Here we attempt to reinterpret the literature, particularly in terms of how αS structure may relate to pathology. We do so in the context of a rapidly evolving field, taking into account newly revealed structural information on both native and pathogenic forms of the αS protein, including recent solid state NMR and cryoEM fibril structures. We discuss how these new findings impact on current understanding of αS and PD, and where this information may direct the field.
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Affiliation(s)
- Richard M. Meade
- Department of Biology & Biochemistry, University of Bath, Claverton Down, Bath, BA2 7AY UK
| | - David P. Fairlie
- Division of Chemistry and Structural Biology, Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4072 Australia
| | - Jody M. Mason
- Department of Biology & Biochemistry, University of Bath, Claverton Down, Bath, BA2 7AY UK
- Division of Chemistry and Structural Biology, Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4072 Australia
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Lange KW, Nakamura Y, Chen N, Guo J, Kanaya S, Lange KM, Li S. Diet and medical foods in Parkinson’s disease. FOOD SCIENCE AND HUMAN WELLNESS 2019. [DOI: 10.1016/j.fshw.2019.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Kizza J, Lewington S, Mappin‐Kasirer B, Turnbull I, Guo Y, Bian Z, Chen Y, Yang L, Chen Z, Clarke R. Cardiovascular risk factors and Parkinson's disease in 500,000 Chinese adults. Ann Clin Transl Neurol 2019; 6:624-632. [PMID: 31019987 PMCID: PMC6469341 DOI: 10.1002/acn3.732] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 01/08/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE The objectives of this study were to compare the risks of Parkinson's disease among those with versus those without prior stroke or heart disease at baseline in a prospective study of 0.5 million adults in China, and to examine associations of cardiovascular disease risk factors (cigarette smoking, hypertension, diabetes, obesity) with risk of Parkinson's disease. METHODS During an average of 11.5 years of follow-up of 503,497 middle-aged participants in the China Kadoorie Biobank study, 603 incident cases were hospitalized with a diagnosis of Parkinson's disease. Cox proportional hazards models were used to assess associations of history of heart disease or stroke with Parkinson's disease in all participants, and of cardiovascular disease risk factors with Parkinson's disease in a subset without prior cardiovascular disease. RESULTS In this population the incidence rate of Parkinson's disease (mean [SD] age of cases, 61 [10] years) was 13.3 (95% confidence interval: 12.3-14.4) per 100,000 person-years. Incidence increased with age, and was higher in men than in women, and in urban than in rural residents. Prior stroke was associated with about twofold higher risk of Parkinson's disease (hazard ratio 1.94; 1.39-2.69). After adjustment for confounders in those without prior cardiovascular disease, a 5 kg/m2 higher body mass index was associated with 17% (1.17; 1.03-1.34: P = 0.019) higher risk of Parkinson's disease, but neither hypertension, diabetes, nor current cigarette smoking was significantly associated with Parkinson's disease. INTERPRETATION Prior stroke and adiposity were each associated with higher risks of Parkinson's disease, but none of the other cardiovascular disease risk factors were significantly associated with Parkinson's disease in this population.
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Affiliation(s)
- Jennifer Kizza
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Benjamin Mappin‐Kasirer
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Iain Turnbull
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Yu Guo
- Chinese Academy of Medical SciencesBeijingChina
| | - Zheng Bian
- Chinese Academy of Medical SciencesBeijingChina
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
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Schommer J, Marwarha G, Nagamoto-Combs K, Ghribi O. Palmitic Acid-Enriched Diet Increases α-Synuclein and Tyrosine Hydroxylase Expression Levels in the Mouse Brain. Front Neurosci 2018; 12:552. [PMID: 30127714 PMCID: PMC6087752 DOI: 10.3389/fnins.2018.00552] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/20/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Accumulation of the α-synuclein (α-syn) protein and depletion of dopaminergic neurons in the substantia nigra are hallmarks of Parkinson's disease (PD). Currently, α-syn is under scrutiny as a potential pathogenic factor that may contribute to dopaminergic neuronal death in PD. However, there is a significant gap in our knowledge on what causes α-syn to accumulate and dopaminergic neurons to die. It is now strongly suggested that the nature of our dietary intake influences both epigenetic changes and disease-related genes and may thus potentially increase or reduce our risk of developing PD. Objective: In this study, we determined the extent to which a 3 month diet enriched in the saturated free fatty acid palmitate (PA) influences levels of α-syn and tyrosine hydroxylase, the rate limiting enzyme in dopamine synthesis in mice brains. Methods: We fed the m-Thy1-αSyn (m-Thy1) mouse model for PD and its matched control, the B6D2F1/J (B6D2) mouse a PA-enriched diet or a normal diet for 3 months. Levels of α-syn, tyrosine hydroxylase, and the biogenic amines dopamine and dopamine metabolites, serotonin and noradrenaline were determined. Results: We found that the PA-enriched diet induces an increase in α-syn and TH protein and mRNA expression levels in m-Thy1 transgenic mice. We also show that, while it didn't affect levels of biogenic amine content in the B6D2 mice, the PA-enriched diet significantly reduces dopamine metabolites and increases the level of serotonin in m-Thy1 mice. Conclusion: Altogether, our results demonstrate that a diet rich in the saturated fatty acid palmitate can modulate levels of α-syn, TH, dopamine, and serotonin which all are proteins and neurochemicals that play key roles in increasing or reducing the risk for many neurodegenerative diseases including PD.
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Affiliation(s)
- Jared Schommer
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Gurdeep Marwarha
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Kumi Nagamoto-Combs
- Department of Pathology, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Othman Ghribi
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
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Kujawska M, Jodynis-Liebert J. Polyphenols in Parkinson's Disease: A Systematic Review of In Vivo Studies. Nutrients 2018; 10:nu10050642. [PMID: 29783725 PMCID: PMC5986521 DOI: 10.3390/nu10050642] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 12/21/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disorder. However, therapeutic options treating only its symptoms are very disappointing. Therefore there is an ongoing search for compounds capable of tackling the multi-dimensional features of PD. Recently natural polyphenols have gained great interest as potential therapeutic agents. Herein, we have attempted to summarize results obtained in different animal models demonstrating their neuroprotective effects. The in vivo findings presented below are supported by human subject data and reports regarding the ability of polyphenols to cross the blood-brain barrier. The beneficial effects of polyphenols are demonstrated by the results of behavioral examinations, mainly related to motor and cognitive capabilities, histopathological and immunohistochemical examination concerning the protection of dopaminergic neurons, analyses of dopamine and the concentration of its metabolites, as well as mechanistic studies regarding the modulation of oxidative stress, neuroinflammation, cellular iron management, proteinopathy, and additionally the regulation of signaling pathways. Importantly, data about brain distribution of the metabolic derivatives of the reviewed polyphenols are crucial for the justification of their nutritional intake in neuroprotective intervention, as well as for the identification of potential targets for a novel therapeutic approach to Parkinson’s disease.
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Affiliation(s)
- Małgorzata Kujawska
- Department of Toxicology, Poznan University of Medical Sciences, 30 Dojazd Str., 60-631 Poznań, Poland.
| | - Jadwiga Jodynis-Liebert
- Department of Toxicology, Poznan University of Medical Sciences, 30 Dojazd Str., 60-631 Poznań, Poland.
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50
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Abbas MM, Koh WP, Tan EK, Tan LCS. Positive predictive value of different methods for identifying Parkinson's disease cases in an epidemiological study. Parkinsonism Relat Disord 2018; 54:119-120. [PMID: 29681505 DOI: 10.1016/j.parkreldis.2018.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/03/2018] [Accepted: 04/09/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Masoom M Abbas
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Louis C S Tan
- Department of Neurology, National Neuroscience Institute, Singapore.
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