A Systematic Review of Fecal Matter Transplant and Its Impact on Levodopa Metabolism and Gastrointestinal Function in Parkinson’s Disease
Pranay Marlecha1, Sweta Sahu2, Tirath Patel3, Kushi Singh4, Nikhilesh Anand5, Bharathi Gadad5
1Kempegowda Institute Of Medical Sciences, 2JJM Medical College, 3Trinity Medical Sciences University School of Medicine, 4Gujarat Medical Education and Research Society, 5University of Texas Rio Grande Valley, Edinburg, Texas
Objective:
To assess the effects of Fecal Matter Transplant (FMT) on motor and non-motor symptoms, gastrointestinal (GI) function, and gut microbiome changes in Parkinson’s disease (PD) patients.
Background:
Parkinson’s disease is a neurodegenerative disorder linked to gut microbiome imbalances through the gut-brain axis. GI dysfunction is common in PD, and the gut microbiome may play a role in disease progression. Fecal Matter Transplant (FMT) has shown success in restoring microbial balance for conditions like Clostridioides difficile infection, but its therapeutic potential in PD remains uncertain.
Design/Methods:
A systematic review was conducted using PubMed and other databases, focusing on studies that included PD patients (Population), FMT (Intervention), and outcomes related to motor/non-motor symptom improvement, GI function, and microbiome alterations (Outcome). Duplicates, case reports, and reviews were excluded. The review focused on placebo-controlled trials with robust outcome measures.
Results:
Twelve studies, including five placebo-controlled trials, were reviewed. Motor symptom improvements were inconsistent, with several studies showing no significant differences between FMT and placebo groups. However, FMT consistently improved GI function and resulted in favorable microbiome shifts. Faster progression of PD symptoms in placebo groups, indicated by increased levodopa-equivalent daily doses (LEDD), suggested FMT might influence levodopa metabolism via gut microbiota
Conclusions:
While FMT shows promise in improving GI health and altering the microbiome in PD patients, its effect on motor symptoms remains unclear. Future studies should aim to standardize FMT protocols, identify key microbial species, and further investigate the gut-brain axis in PD. These advancements could lead to more targeted therapies and improved patient outcomes.
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