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Microbiota Gut-Brain Axis and Neurodegenerative Disease. a Systematic Review on Alzheimer’S Disease, Amyotrophic Lateral Sclerosis and Parkinson Disease

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Microbiota Gut-Brain Axis and Neurodegenerative Disease. a Systematic Review on Alzheimer’S Disease, Amyotrophic Lateral Sclerosis and Parkinson Disease Microbiota Gut-Brain Axis and Neurodegenerative Disease. A systematic review on Alzheimer’s disease, Amyotrophic lateral sclerosis and Parkinson Disease Poluyi Edward Oluwatobi, Imaguezegie Grace Ese, Poluyi Abigail Oluwatumininu, Morgan Eghosa DOI: 10.33962/roneuro-2020-016 Romanian Neurosurgery (2020) XXXIV (1): pp. 116-122 DOI: 10.33962/roneuro-2020-016 www.journals.lapub.co.uk/index.php/roneurosurgery Microbiota Gut-Brain Axis and Neurodegenerative Disease. A systematic review on Alzheimer’s disease, Amyotrophic lateral sclerosis and Parkinson Disease Poluyi Edward Oluwatobi1, Imaguezegie Grace Keywords 2 3 Ese , Poluyi Abigail Oluwatumininu , Morgan gut dysbiosis, Eghosa4 central nervous system, gastrointestinal tract, enteric nervous system, 1 Department of Life Science, Clinical Neuroscience, University of neuroimmune system, Roehampton, London, UNITED KINGDOM neuroendocrine system, 2 Lagos University Teaching Hospital, Idi-araba, Surulere, Lagos, autonomic nervous system NIGERIA (ANS) 3 College of Medicine, University of Lagos, NIGERIA 4 Ambrose Alli University, Ekpoma, Edo, NIGERIA Corresponding author: ABSTRACT Poluyi Edward This review highlights the microbiota gut-brain axis and neurodegenerative diseases excluding studies on animal models. Gut microbiota is capable of modulating some Department of Life Science, Clinical brain activities via the microbiota gut-brain axis. A bidirectional communication exists Neuroscience, University of Roehampton, London, between the gastrointestinal (GI) tract and the central nervous system (CNS) in the United Kingdom microbiota gut-brain axis. Gut dysbiosis has been linked to neurodegenerative diseases as a result of the imbalance in the composition of its microbiota, which has [email protected] a damaging effect on the host’s health. The association between the role and mechanism of CNS disease and gut microbial is yet to be fully explored. Although some studies have shown a positive relationship between a rich diverse microbial Copyright and usage. This is an Open Access article, distributed under the terms of the Creative community and the brain of the host, and a negative relationship between microbial Commons Attribution Non–Commercial No dysbiosis, intestinal infection and human brain health, our knowledge, however, is Derivatives License (https://creativecommons .org/licenses/by-nc-nd/4.0/) which permits non- limited due to the inability to identify the major players in this heterogeneous commercial re-use, distribution, and reproduction in any medium, provided the original work is microbial community. unaltered and is properly cited. The written permission of the Romanian Society of Neurosurgery must be obtained for commercial re-use or in order to create a derivative work. INTRODUCTION Clinicians and biomedical researchers have shown great interest in the ISSN online 2344-4959 © Romanian Society of role of gut microbe function and the central nervous system (CNS), Neurosurgery mainly in the modulation of cholecystokinin. However, this has been extended to a generalized description; the microbiota gut –brain axis 1 especially in its link to neurodegenerative disease. The human body First published March 2020 by and its microbial community such as the skin, vaginal mucosa, oral London Academic Publishing www.lapub.co.uk mucosa and most importantly the gut, co-exist in a symbiotic relation- Microbiota Gut-Brain Axis and Neurodegenerative Disease 117 ship. This relationship plays a vital role in health and maturation of glia cells of the CNS. The absence of a neurodegenerative diseases.2 Microbiome is complex host microbiota could result in an altered inherited maternally during vaginal delivery through glial cells number, a decrease in permeability and the vaginal fluid enriched with microbiota. This could halt the development of the blood brain becomes a major player of immune defense and barrier, thus, causing an impaired immune response eventually becomes modified to suit the individual’s resulting in CNS disease.11 unique composition.3,4 Although, invasive pathogen by microbes is not Microbiota concentration is highest in the gut of the only route to the aetiology of neurodegenerative the human body.5 This can be a source of energy for diseases, it has a systemic impact on the microbiota cells as they provide essential micro nutrients such community via the enteric nervous system, immune as thiamine, vitamins A, B, D and K. They also provide system, blood stream, intercellular signaling and the nutrients in form of short chain fatty acids (SCFAs) vagus nerve.5 like acetate, propionate, and butyrate; as the ultimate energy source for colonocytes. When SCFAs The Microbiome Gut-Brain Axis like butyrate, acetate, and propionate are stimulated, The association between the role and mechanism of it could result in an increased production of CNS disease and gut microbial have yet to be fully immunoglobulin (IgG).6 Gut microbiota also serves as explored.11 A bidirectional communication exists a barricade between humans and their environment between the gastrointestinal (GI) tract and the especially in the protection of environmental central nervous system (CNS) in the microbiota gut- hazards3 and when it is disease-free, can prolong the brain axis. This is effective under physiological lifespan of humans.6 conditions in immune defense, digestive system Disruptions of gut microbiota barrier can lead to modulation, perception and sensory response to 7 many diseases. It was previously considered stable visceral stimuli, secondary to its incorporation to the and unique for each individual but has now been CNS, neuroendocrine and neuroimmune systems, 1 reported to have long lasting changes. This could be autonomic nervous system (ANS) and enteric secondary to pathophysiological disruption of short nervous system (ENS).3 Studies have reported four intraluminal regulatory loop that leads to major key section to the gut-brain axis, these include: dysfunction of various cells and microflora, thus, activation of the immune defense, neuroendocrine affecting the enteric nervous system(ENS) within the pathways regulation, autonomic sensorimotor 8 submucosal and muscularis layers of the colon. connections and lastly, the interaction between the Gut dysbiosis has been linked to blood brain barrier and gut microbiota metabolites.2 neurodegenerative diseases as a result of the Microbially derived molecules such as short-chain imbalance in its composition which alters and causes fatty acids (SCFAs), secondary bile acids, and 9 damaging effect on the host’s health. tryptophan metabolites mediate the communication The aim of this review is to highlight the of microbes and the CNS, although CNS modulation microbiota gut-brain axis and functional linkages to via neuroimmune and neuroendocrine mechanisms neurodegenerative diseases such as Alzheimer’s interacts with enterochromaffin cells, mucosal disease (AD), Amyotrophic lateral sclerosis (ALS) and immune system and enteroendocrine cell and Parkinson Disease (PD), excluding animal models. sometimes enters the systemic circulation and penetrates the blood-brain barrier, it still remains DISCUSSION difficult to ascertain if they induce responses only or Communication between gut microbiota and the get to the brain directly via long-distance neural development of the central nervous system signaling with vagal and/or afferents from the spinal (CNS) cord.12 SCFA are the main microbial mediators in the Microbiota which consists of bacteria, viruses, fungi gut–brain axis.2 SCFA are released from action of and other microorganisms can alter adult microbiota in the gut which are further metabolized hippocampus neurogenesis (AHN), thus affecting the by intestinal absorption and finally removed through pathogenesis of symptoms of diseases of CNS.7,10 It urination.11 helps in the permeability and maintenance of the The gut microbiome harbours 150 times more blood brain barrier (BBB) and is important in the genes than the human genome.2 They are Poluyi Edward Oluwatobi, Imaguezegie Grace Ese, Poluyi Abigail Oluwatumininu et al. 118 heterogeneous group of bacterial species, fungi and that the apotheosis of these mechanism of gut viruses found in the gastrointestinal tract having a microbiome-host symbiotic relationship contribute symbiotic relationship with the human host. The to a large extent to the disease pathogenesis in the microbiome plays an important function in genetically-predisposed.14 Microbiota research on metabolism, blood-brain barrier integrity, immune neurodegenerative diseases is still in the infancy defense, secretion, maintaining homeostatic balance stage, interestingly, recent studies have linked the of barrier integrity and coordinating the transfers of potential role of the gut-microbiota axis on central signals through primary afferent pathway of the nervous system (CNS) related conditions and its vagus nerve to the CNS via the gut-brain axis. The influence on the gut brain axis. 5,7,11 Chronic vagus nerves serves as the primary afferent pathway neuroinflammation is a unique feature associated for various factors influencing the formation of with the pathology of most neurodegenerative microbiota, these include: medications, lactation, diseases (ALS, PD, AD).6 Although, bacterial toxin has ingested meal and parturition.11 been linked to the aetiology of neurodegenerative The use of functional imaging, for example, disease, systemic inflammation and its infectious functional magnetic resonance imaging (fMRI) and burden is suggested
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