Helicobacter Hypothesis for Idiopathic Parkinsonism: Before and Beyond
Identifieur interne : 000153 ( Psycho/Analysis ); précédent : 000152; suivant : 000154Helicobacter Hypothesis for Idiopathic Parkinsonism: Before and Beyond
Auteurs : R. John Dobbs [Royaume-Uni] ; Sylvia M. Dobbs [Royaume-Uni] ; Clive Weller [Royaume-Uni] ; André Charlett [Royaume-Uni] ; Ingvar T. Bjarnason ; Alan Curry [Royaume-Uni] ; David S. Ellis ; Mohammad A. A. Ibrahim ; Maria V. Mccrossan ; John O'Donohue ; Robert J. Owen [Royaume-Uni] ; Norman L. Oxlade [Royaume-Uni] ; Ashley B. Price [Royaume-Uni] ; Jeremy D. Sanderson [Royaume-Uni] ; Malur Sudhanva [Royaume-Uni] ; John Williams [Royaume-Uni]Source :
- Helicobacter [ 1083-4389 ] ; 2008-10.
Abstract
We challenge the concept of idiopathic parkinsonism (IP) as inevitably progressive neurodegeneration, proposing a natural history of sequential microbial insults with predisposing host response. Proof‐of‐principle that infection can contribute to IP was provided by case studies and a placebo‐controlled efficacy study of Helicobacter eradication. “Malignant” IP appears converted to “benign”, but marked deterioration accompanies failure. Similar benefit on brady/hypokinesia from eradicating “low‐density” infection favors autoimmunity. Although a minority of UK probands are urea breath test positive for Helicobacter, the predicted probability of having the parkinsonian label depends on the serum H. pylori antibody profile, with clinically relevant gradients between this “discriminant index” and disease burden and progression. In IP, H. pylori antibodies discriminate for persistently abnormal bowel function, and specific abnormal duodenal enterocyte mitochondrial morphology is described in relation to H. pylori infection. Slow intestinal transit manifests as constipation from the prodrome. Diarrhea may flag secondary small‐intestinal bacterial overgrowth. This, coupled with genetically determined intense inflammatory response, might explain evolution from brady/hypokinetic to rigidity‐predominant parkinsonism.
Url:
DOI: 10.1111/j.1523-5378.2008.00622.x
Affiliations:
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Owen</name><affiliation wicri:level="3"><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Helicobacter Reference Unit, Health Protection Agency, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Oxlade, Norman L" sort="Oxlade, Norman L" uniqKey="Oxlade N" first="Norman L." last="Oxlade">Norman L. 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Price</name><affiliation wicri:level="3"><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Department of Histopathology, Northwick Park and St. Mark's Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Sanderson, Jeremy D" sort="Sanderson, Jeremy D" uniqKey="Sanderson J" first="Jeremy D." last="Sanderson">Jeremy D. Sanderson</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Gastroenterology, Guy's and St Thomas's Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Sudhanva, Malur" sort="Sudhanva, Malur" uniqKey="Sudhanva M" first="Malur" last="Sudhanva">Malur Sudhanva</name><affiliation wicri:level="3"><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>South London Specialist Virology Centre, Health Protection Agency Regional Laboratory, Kings College Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Williams, John" sort="Williams, John" uniqKey="Williams J" first="John" last="Williams">John Williams</name><affiliation wicri:level="3"><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Diagnostic Parasitology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Helicobacter</title><title level="j" type="alt">HELICOBACTER</title><idno type="ISSN">1083-4389</idno><idno type="eISSN">1523-5378</idno><imprint><biblScope unit="vol">13</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="309">309</biblScope><biblScope unit="page" to="322">322</biblScope><biblScope unit="page-count">14</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2008-10">2008-10</date></imprint><idno type="ISSN">1083-4389</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1083-4389</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We challenge the concept of idiopathic parkinsonism (IP) as inevitably progressive neurodegeneration, proposing a natural history of sequential microbial insults with predisposing host response. Proof‐of‐principle that infection can contribute to IP was provided by case studies and a placebo‐controlled efficacy study of Helicobacter eradication. “Malignant” IP appears converted to “benign”, but marked deterioration accompanies failure. Similar benefit on brady/hypokinesia from eradicating “low‐density” infection favors autoimmunity. Although a minority of UK probands are urea breath test positive for Helicobacter, the predicted probability of having the parkinsonian label depends on the serum H. pylori antibody profile, with clinically relevant gradients between this “discriminant index” and disease burden and progression. In IP, H. pylori antibodies discriminate for persistently abnormal bowel function, and specific abnormal duodenal enterocyte mitochondrial morphology is described in relation to H. pylori infection. Slow intestinal transit manifests as constipation from the prodrome. Diarrhea may flag secondary small‐intestinal bacterial overgrowth. This, coupled with genetically determined intense inflammatory response, might explain evolution from brady/hypokinetic to rigidity‐predominant parkinsonism.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Grand Manchester</li></region><settlement><li>Londres</li><li>Manchester</li></settlement></list><tree><noCountry><name sortKey="Bjarnason, Ingvar T" sort="Bjarnason, Ingvar T" uniqKey="Bjarnason I" first="Ingvar T." last="Bjarnason">Ingvar T. Bjarnason</name><name sortKey="Ellis, David S" sort="Ellis, David S" uniqKey="Ellis D" first="David S." last="Ellis">David S. Ellis</name><name sortKey="Ibrahim, Mohammad A A" sort="Ibrahim, Mohammad A A" uniqKey="Ibrahim M" first="Mohammad A. A." last="Ibrahim">Mohammad A. A. Ibrahim</name><name sortKey="Mccrossan, Maria V" sort="Mccrossan, Maria V" uniqKey="Mccrossan M" first="Maria V." last="Mccrossan">Maria V. Mccrossan</name><name sortKey="O Donohue, John" sort="O Donohue, John" uniqKey="O Donohue J" first="John" last="O'Donohue">John O'Donohue</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Dobbs, R John" sort="Dobbs, R John" uniqKey="Dobbs R" first="R. John" last="Dobbs">R. John Dobbs</name></region><name sortKey="Charlett, Andre" sort="Charlett, Andre" uniqKey="Charlett A" first="André" last="Charlett">André Charlett</name><name sortKey="Curry, Alan" sort="Curry, Alan" uniqKey="Curry A" first="Alan" last="Curry">Alan Curry</name><name sortKey="Dobbs, Sylvia M" sort="Dobbs, Sylvia M" uniqKey="Dobbs S" first="Sylvia M." last="Dobbs">Sylvia M. Dobbs</name><name sortKey="Owen, Robert J" sort="Owen, Robert J" uniqKey="Owen R" first="Robert J." last="Owen">Robert J. Owen</name><name sortKey="Oxlade, Norman L" sort="Oxlade, Norman L" uniqKey="Oxlade N" first="Norman L." last="Oxlade">Norman L. Oxlade</name><name sortKey="Price, Ashley B" sort="Price, Ashley B" uniqKey="Price A" first="Ashley B." last="Price">Ashley B. Price</name><name sortKey="Sanderson, Jeremy D" sort="Sanderson, Jeremy D" uniqKey="Sanderson J" first="Jeremy D." last="Sanderson">Jeremy D. Sanderson</name><name sortKey="Sudhanva, Malur" sort="Sudhanva, Malur" uniqKey="Sudhanva M" first="Malur" last="Sudhanva">Malur Sudhanva</name><name sortKey="Weller, Clive" sort="Weller, Clive" uniqKey="Weller C" first="Clive" last="Weller">Clive Weller</name><name sortKey="Williams, John" sort="Williams, John" uniqKey="Williams J" first="John" last="Williams">John Williams</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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