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Role of Chronic Infection and Inflammation in the Gastrointestinal Tract in the Etiology and Pathogenesis of Idiopathic Parkinsonism
Author(s) -
Dobbs R. John,
Dobbs Sylvia M.,
Weller Clive,
Bjarnason Ingua T.,
Oxlade Norman L.,
Charlett André,
AlJanabi Mazin A.,
Kerwin Robert W.,
Mahler Robert F.,
Price Ashley B.
Publication year - 2005
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/j.1523-5378.2005.00331.x
Subject(s) - parkinsonism , medicine , gastroenterology , helicobacter pylori , helicobacter , gastric emptying , immunology , stomach , disease
Background. Neuronal damage in idiopathic parkinsonism may be in response to ubiquitous occult infection. Since peptic ulceration is prodromal, Helicobacter is a prime candidate. Aim. To consider the candidature of Helicobacter in parkinsonism with cachexia. Methods. We explore the relationship between being underweight and inflammatory products in 124 subjects with idiopathic parkinsonism and 195 controls, and present the first case‐series evidence of efficacy of Helicobacter eradication, in parkinsonism advanced to the stage of cachexia. Results. Association of a low body mass index with circulating interleukin‐6 was specific to parkinsonism ( p = .002), unlike that with antibodies against Helicobacter vacuolating‐toxin and cytotoxicity‐associated gene product ( p < .04). Marked reversibility in both cachexia and disability of idiopathic parkinsonism followed Helicobacter heilmannii eradication in one case, Helicobacter pylori eradication in another, follow‐up being ≥ 3.5 years. The latter presented with postprandial bloating, and persistent nausea: following eradication, radioisotope gastric‐emptying returned towards normal, and upper abdominal symptoms regressed. Reversibility of their cachexia/disability contrasts with the outcome of anti‐ Helicobacter therapy where eradication repeatedly failed (one case), and in non‐ Helicobacter gastritis (three cases). Anti‐parkinsonian medication remained constant. Intestinal absorption and barrier function were normal in all. Conclusion. Categorization, according to presence or absence of Helicobacter infection, was a useful therapeutic tool in late idiopathic parkinsonism.