Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

ABSTRACTIn recent years, several studies have investigated the potential of immunohistochemical detection of α‐synuclein in the gastrointestinal tract to diagnose Parkinson's disease (PD). Although methodological heterogeneity has hindered comparability between studies, it has become increasingly apparent that the high sensitivity and specificity reported in preliminary studies has not been sustained in subsequent large‐scale studies. What constitutes pathological α‐synuclein in the alimentary canal that could distinguish between PD patients and controls and how this can be reliably detected represent key outstanding questions in the field. In this review, we will comment on and compare the variable technical aspects from previous studies, and by highlighting some advantages and shortcomings we hope to delineate a standardized approach to facilitate the consensus criteria urgently needed in the field. Furthermore, we will describe alternative detection techniques to conventional immunohistochemistry that have recently emerged and may facilitate ease of interpretation and reliability of gastrointestinal α‐synuclein detection. Such techniques have the potential to detect the presence of pathological α‐synuclein and include the paraffin‐embedded tissue blot, the proximity ligation assay, the protein misfolding cyclic amplification technique, and the real‐time quaking‐induced conversion assay. Finally, we will review 2 nonsynonymous theories that have driven enteric α‐synuclein research, namely, (1) that α‐synuclein propagates in a prion‐like fashion from the peripheral nervous system to the brain via vagal connections and (2) that gastrointestinal α‐synuclein deposition may be used as a clinically useful biomarker in PD. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Original publication

DOI

10.1002/mds.26480

Type

Journal article

Journal

Movement Disorders

Publisher

Wiley

Publication Date

02/2016

Volume

31

Pages

193 - 202