In this study, a total of 22 participants with early Parkinson’s disease received a transplant from a healthy donor and 24 received their own feces as a placebo as part of the GUT-PARFECT trial conducted at Ghent University Hospital in Belgium. . December 1, 2020 and December 12, 2022.

Fecal transplants for both the treatment and placebo groups were performed through a tube inserted through the nose into the jejunum, which is part of the small intestine.

The researchers followed up with participants at three, six, and 12 months after the transplant. They collected data on gastrointestinal symptoms, non-motor symptoms, depression and anxiety, sleep and fatigue, and cognition.

People who received fecal transplants from healthy donors recorded improvements in motor symptoms but appeared to experience increased fatigue.

The reason for this adverse effect is unknown, said Patrick Santens, MD, lead author of the study and professor of neurology at Ghent University Hospital.

“We don’t have a sufficient explanation. [for this phenomenon], but it is suspected that inflammatory mechanisms may be involved. “Fatigue is prevalent in inflammatory bowel disease,” he said. Today’s medical news.

One of the limitations of this study is that a strong placebo effect was observed because the placebo treatment was likely considered invasive to the participants.

There is evidence to suggest that the more invasive the placebo treatment, the greater the placebo effect.

It’s also possible that some of the effects seen in the placebo group were more than just a placebo effect, Santens suggested.

“The placebo effect was quite large. This may be due, on the one hand, to the nature of the treatment, which comes with high expectations. On the other hand, there is also preliminary evidence that: [fecal transplant] Using your own stool may also have a limited positive effect, at least on intestinal function. Therefore, the next step is to try a placebo treatment using a colored inert solution. ”

Other trials of fecal transplants in Parkinson’s disease patients have shown small improvements.

Herbert DuPont, MD, clinical professor of medical infectious diseases at Baylor College of Medicine in Houston, Texas, was the first author of the paper published in 2006. frontiers of neurology In 2023, it was shown that fecal transplants may have some effect on Parkinson’s symptoms.

He was not involved in this latest study but commented on its results. MNTHe explained that microbiome disturbances in Parkinson’s disease patients have been known for many years, and there are various ways the gut can influence Parkinson’s disease.

“One is through the central nervous system, through the vagus nerve to the enteric nervous system, through the spinal nerves to the brain, and that’s a direct neural connection,” he said.

“Another way is through the immune system. Eighty percent of the body’s immune cells are in the gastrointestinal tract, and our immune response relies on a healthy microbiome,” DuPont added.

“And the last one is hormone production,” he told us. “Chemicals, biochemicals and metabolites produced by microorganisms can reach and affect the brain through the bloodstream or the vagus nerve. All three routes are very important.”

Relevant in the context of this study is Braak’s hypothesis regarding Parkinson’s disease. This hypothesis proposes that Parkinson’s disease begins to develop when pathogens enter the body through the nose, reach the intestines, and begin to accumulate bacteria. alpha-synuclein in the nose and digestive tract.

Some researchers believe this can spread to the nervous system and brain and cause Parkinson’s disease.

DuPont explained:

“We believe that neural connections are very important in the movement of alpha-synuclein, a small protein involved in the production of cell death in the brain. This is the so-called Braak hypothesis. We think this is correct. But I think biochemicals are very important. And I think the immune system is very important.”

“I thought [it] It was critical that one dose demonstrate: [fecal transplant] There may be lasting effects,” DuPont told us in commenting on the study results.

“I felt that if it was a genetic disease or a chronic disease with chronic changes in the body, it would have to be treated. [fecal matter] Over and over again to get results, that’s how we’ve done our research.But this shows that [even] One dose is effective,” he added.

Multiple administrations may require, for example, capsule implantation, which involves removing feces in a way that can destroy many of the potentially beneficial cells, microorganisms, enzymes, and biochemicals. need to be processed.

Previous studies conducted by DuPont looked at transplants performed using fresh, frozen, and freeze-dried feces. “This study encouraged us to think about providing frozen or fresh samples in the future,” DuPont said.

“Research on Parkinson’s disease [similar research for] Other neurodegenerative diseases. “Multiple sclerosis and Alzheimer’s disease are likely to follow, and we may well have similar success stories,” he hypothesized.

Santens said the team behind the latest study is conducting further research on the microbial composition of various participants in relation to the recent findings.

“We hope that the results of this pilot study will be taken into consideration to obtain funding for a larger, multicenter trial.” […] “We are also looking at patient profiles to identify subgroups that may be the best candidates for this treatment,” he told us.