Fight Aging!

The composition of the gut microbiome changes with age in ways that harm long-term health, via growth in inflammatory species versus loss of species producing beneficial metabolites. This is well demonstrated in a range of species, including extensive human data. Presently widely available probiotic and prebiotic approaches only produce short-term adjustment in the balance of microbial popultions, but there are a few alternative approaches to adjust the gut microbiome that do produce permanent change with a single course of treatment. One of these is fecal microbiota transplantation. In animal studies, fecal microbiota transplantation from young donors to aged animals rejuvenates the composition of the gut microbiome, improves health, and extends life span.

Data suggests that some age-related conditions are associated with an altered gut microbiome, including Alzheimer's disease and Parkinson's disease. Interestingly, Parkinson's disease includes intestinal symptoms such as constipation that have motivated researchers to conduct some small trials of fecal microbiota transplantation; neurological symptoms of the condition were also improved as a result. Beyond this there is as yet little clinical evidence for effects of fecal microbiota transplantation in the context of aging. More data would be very useful, as this form of therapy is readily conducted, costs little, and certainly could be more widely used than is presently the case given a larger body of supporting evidence.

The application of fecal microbiota transplantation in Parkinson's disease

Parkinson's disease (PD) is a multisystem neurodegenerative disorder characterized by the aggregation of α-synuclein (α-syn) in dopaminergic neurons of the substantia nigra. The pathogenesis of PD remains incompletely understood, and disease-modifying therapies are lacking. Emerging evidence suggests that gut microbiota and their metabolites influence both intestinal and central nervous system (CNS) functions via the microbiota-gut-brain axis (MGBA). Recent studies have identified dysbiosis in the gut microbiota of PD patients, which may contribute to disease progression through two primary mechanisms: First, increased intestinal permeability, allowing pro-inflammatory factors and microbial metabolites to affect the enteric nervous system (ENS) and subsequently spread to the CNS via the vagal neurons; Secondly, disruption of the Blood-Brain barrier (BBB), leading to neuroinflammation and aberrant α-syn aggregation, ultimately resulting in dopaminergic neuron degeneration.

Fecal microbiota transplantation (FMT) has demonstrated significant efficacy in alleviating PD-associated constipation, characterized by an increased abundance of Firmicutes and decreased proportions of Proteobacteria and Bacteroidetes in treated patients. These microbial compositional changes correlate with effective amelioration of both constipation and tremor symptoms. In 2021, a study demonstrated that FMT significantly reduces Bacteroides abundance while increasing Prevotella and Blautia populations in PD patients with constipation. These microbial alterations were associated with marked improvements in PD symptoms. Another group conducted colonoscopic infusion of donor FMT in six PD patients, demonstrating significant improvements in motor symptoms, non-motor symptoms, and constipation over a six-month observation period. In 2024 researchers conducted a nasoduodenal FMT trial involving 43 early-stage PD patients. Post-transplantation assessments revealed significant improvements in both motor symptoms and constipation compared to baseline. Notably, the study also demonstrated FMT-mediated enhancement of cognitive functions, including amelioration of anxiety, depressive symptoms, and sleep disturbances.