Parkinson's disease may start in appendix

Leslie Hanson
November 2, 2018

Removal of the appendix after the disease process starts, however, had no effect on disease progression.

Since the protein accumulates as an immune reaction to toxins and bacteria, and the intestinal cul-de-sac called the vermiform appendix is thought to have a role to play as a bomb shelter for gut microflora, it's an obvious place to go digging for a connection.

Parkinson's disease may begin in the appendix, scientists believe, after finding people who have had the vestigial organ removed are less likely to develop the condition.

And analysing the content of people's appendixes showed they contained the same toxic protein - called alpha synuclein - that is found in the brains of Parkinson's patients.

But don't look for a surgeon just yet.

Parkinson's disease could originate in the appendix, according to one of the largest studies of the neurodegenerative illness. Last year, tests revealed that one type of drug could turn destructive proteins into protective ones and partially halt the disease.

Common among the complications of Parkinson's is the onset of gastrointestinal dysfunction - including constipation - which can actually precede mobility loss by as much as 20 years.

Wednesday's research promises to re-energize work to find out why, and learn who's really at risk. And while the relationship between the appendix and Parkinson's is unknown, it may be that the appendix is a source of seeding-competent aggregates of alpha-synuclein which could migrate into the central nervous system through the vagal nerve, she added.

He noted that despite its reputation, the appendix appears to play a role in immunity that may influence gut inflammation. It also affects memory and mood.

"We've got a very complicated situation that we still don't fully understand". He said he found the study results convincing.

For the new study, the scientists studied the role of the appendix in Parkinson's by analysing medical records from the Swedish National Patient Registry, which contains health records on approximately 1.7 million people, and the smaller Parkinson's Progression Markers Initiative, which contains records on 849 Parkinson's cases. It's a sign that the proteins that go on to overcome brain cells in Parkinson's might originate in the digestive system, perhaps in the appendix.


One puzzling caveat: People living in rural areas appeared to get the benefit. Parkinson's is often more common in rural areas, which may be due to exposure to pesticides that are thought to be linked to the disease, Labrie said.

In the Swedish registry, the researchers identified 551,647 people who had an appendectomy, matching each person to two control individuals who didn't have an appendectomy.

"There's potential for [gastrointestinal]-tract based therapies that could block the formation and spread of alpha-synuclein clumps as future, early, and preventative treatments for Parkinson's disease", professor Viviane Labrie from the Center for Neurodegenerative Science at the Van Andel Research Institute in MI said in a press teleconference.

"This is a tissue that most people consider to be a useless organ".

In the second part of the study, Labrie and her team set out to look for these clumps of proteins in the appendix.

Photomicrograph of a region of the substantia nigra in a Parkinson's patient showing Lewy bodies. Whether the appendix was inflamed or not also didn't matter.

"Despite having a reputation as largely unnecessary, the appendix actually plays a major part in our immune systems, in regulating the makeup of our gut bacteria and now, as shown by our work, in Parkinson's disease", senior author Viviane Labrie from Van Andel Research Institute in MI told The Guardian.

"The difference we think is how you manage this pathology", she said - how the body handles the buildup.

The comparison wasn't a mere stab in the dark - there's a growing pool of evidence suggesting for many people, Parkinson's disease starts down below in the gut and travels up the vagal nerve into the brain.

Said Labrie, "There's potential for G.I. tract-based therapies that could block the formation and spread of alpha-synuclein clumps as future, early and preventative treatments for Parkinson's disease".

Other reports by Iphone Fresh

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