Detection Of Idiopathic Parkinson’s Disease In The Colon Submucosal Plexus A-synuclein Positive Inclusions

BackgroundParkinson’s disease(Parkinson’s disease, PD) is a neurodegenerative disease, common in the elderly, is the most common synaptic nucleoprotein disease. It is currently considered to be multi-system disorder comprises symptoms and movement of non-motor symptoms. A typical motor symptoms include resting tremor, bradykinesia, rigidity and gait disorders, also known as "motion four main symptoms." Non-motor symptoms include olfactory dysfunction, autonomic dysfunction, sleep disorders, cognitive dysfunction, Parkinson’s disease has become a "non-sport four main symptoms." These Reflect the Parkinson’s disease in the clinical features of these various disease neurochemistry and neuroanatomy widely in the process of change, not only have the participation of the substantia nigra striatum dopamine, can contain norepinephrine and serotonin to this system, cholinergic frontal lobe and brainstem areas also involved. α- synuclein(an important component of α-synuclein, Lewy bodies) is closely related to the distribution of non-motor symptoms. In addition to the central nervous system, autonomic nervous system and peripheral nervous system involvement and also, the sympathetic nervous system and the parasympathetic nervous system, and other organs are involved and salivary glands. In the motor symptoms, autonomic nerve dysfunction is mainly given priority to with the expression of the gastrointestinal tract, and gastrointestinal function in patients with Parkinson’s attention gradually. About 30% of Parkinson’s disease patients with gastrointestinal dysfunction, constipation is Parkinson’s disease is the most recognized one of the symptoms of gastrointestinal dysfunction. Literature reported that close to 90% chance of Parkinson’s disease occurrence constipation, and with the gradually development of the disease, also gradually rise. The motor symptoms(non- motor symptoms, NMS) in the pathogenesis of Parkinson’s disease can appear in each period, can also be in sports before symptoms appear. The movement cause serious damage to the social function of Parkinson’s disease symptoms and quality of life, even more impact than the motor symptoms, the PD of motor symptoms early recognition and timely treatment, able to timely diagnosis and improves the quality of life of Parkinson’s disease is very important.So far, PD diagnosis mainly depends on clinical manifestation, neuropathology diagnosis can only be used for autopsy studies. According to a large number of studies have shown that alpha-synuclein in widely distributed in Parkinson’s patients. Not only limited to the central nervous system, Louis corpuscle in salivary gland, submandibular gland, adrenal medulla, skin, cardiac plexus and pelvic plexus, sympathetic nerve, the enteric nervous system, etc. It is also found. In the early PD disease can appear a variety of gastrointestinal symptoms, especially constipation, bowel dysfunction, salivate, difficulty swallowing, etc., so we further speculation alpha-synuclein positive inclusions in the early PD formation within the enteric nervous system, so in early Parkinson’s disease through the colon mucosa biopsy for diagnosis of Parkinson’s disease further study, the research is likely to be found in a living patient histopathologic synaptic nucleoprotein, effectively improve the accuracy of the diagnosis of Parkinson’s disease. ObjectiveTo investigate whether the presence of colon submucosal alpha-synuclein may as biological indicators in early diagnosis of Parkinson’s disease, the use of colonoscopy for PD patients with colonic mucosal biopsies, detection of PD patients with colon submucosal plexus alpha-synuclein positive inclusion body form Methods1.This study collected PD patients(duration longer than 6 months) 8 cases for PD1 group, collection of PD patients(duration less than 6 months) 10 cases for PD2 group, 12 cases of normal control group for the NC group. Collected the clinical data of patients with PD, according to the included and exclusion criteria, and UPDRS Ⅲ of PD patients, Hoehn- Yahr classification rating scale. Using the colonoscopy biopsy collection of PD patients with colonic mucosa specimens.2.Using immunohistochemical method and protein imprinting method(western blot) to detect colon submucosal plexus alpha-synuclein positive expression of inclusions3.Statistical analysis was performed using software SPSS17.0 Variable is compared by applying the one-way ANOVA, Bonferroni method or rank sum test A level of significance of p<0.05 was used.Result1.By the immunohistochemical method to detect, PD1 group of six cases of colon submucosal plexus found in alpha-synuclein staining positive, PD2 patients have found in 10 cases of colon submucosal plexus alpha-synuclein inclusions is positive, and all associated with nerve fibers. Not found in the healthy controls(NC group) alpha-synuclein positive inclusions.2.By Western blot method to detect, NC group, the PD1 and PD2 group compared between three groups, colon submucosal alpha-synuclein expression level rise, with the extension of the course difference is statistically significant, p < 0.05) Conclusion1.By colonoscopy for PD patients with colonic mucosal biopsies, colon submucosal plexus alpha-synuclein positive expression of inclusion body, has the potential to be early diagnosis and differential diagnosis of PD biological markers.2.Colon submucosal plexus alpha-synuclein expression levels increase with the duration extension of PD patients.