Objective: To analyse the gut microbiome and explore dysbiosis in Indian Parkinson’s Disease patients with and without constipation.

Background: Global studies have associated gut dysbiosis with Parkinson’s disease (PD) pathophysiology, highlighting the importance of the gut-brain axis. Constipation is one of the under-reported prodromal non-motor gastrointestinal symptoms in PD. Constipation influences the gut microbial composition.

Method: 24 PD cases were included in this study, of which 12 subjects were diagnosed with constipation using Rome IV Criteria and 12 subjects without the symptoms of constipation. In addition, 12 healthy spouses of the cases were enrolled as healthy controls (HC). Non-Motor Symptoms were scored with MDS-NMS (Movement Disorder Society Non-Motor Rating Scale). Faecal samples were collected from 36 subjects, and bacterial DNA was extracted using the THSTI (Translational Health Science and Technology Institute) method. Full-length 16S rRNA gene sequencing was performed on the GridION Nanopore sequencer using amplified PCR products. Sequenced data were analysed using the web-based tools BugSeq and MicrobiomeAnalyst.

Results: Demographic details of the subjects are tabulated (Table 1). Gut bacterial profiles of PD patients with and without a history of constipation varied from the healthy controls. Statistically, a significant difference was observed in the alpha-diversity indices (Figure 1) between the groups. Spearman’s correlation analysis indicated the association of the gut microbiome with constipation. Lachnospiraceae NK4A136 group (rs=0.5, p-value=0.02), Dialister (rs=0.49, p-value=0.02), Akkermansia (rs=0.43, p-value=0.06), and Bacteroides (rs=0.43, p-value=0.06), correlated with the symptom of constipation and are possible biomarkers for constipation by LEfSe (Linear discriminant analysis Effect Size) in PD (Figures 2). A higher abundance of Akkermansia and Bacteroides impairs the gut barrier and could drive the disease progression.

Conclusion: The present study provides evidence of gut dysbiosis in Indian PD patients and suggests a possible association of the gut microbiome with constipation in Parkinson’s patients. These findings emphasise the potential of targeting the gut microbiota as a therapeutic strategy for improving constipation symptoms in Parkinson’s disease patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gut-dysbiosis-in-indian-parkinsons-disease-patients-with-constipation/