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Alimentary, my dear Watson? The challenges of enteric α-synuclein as a Parkinson's disease biomarker

Authors

  • Naomi P. Visanji PhD,

    1. Morton and Gloria Shulman Movement Disorders Centre and the Edmund J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada
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  • Connie Marras MD, PhD,

    1. Morton and Gloria Shulman Movement Disorders Centre and the Edmund J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada
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  • Lili-Naz Hazrati MD, PhD,

    1. Tanz Centre for Research in Neurodegenerative Diseases, Krembil Discovery Tower, Toronto, Ontario, Canada
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  • Louis W. C. Liu MD, PhD,

    1. Division of Gastroenterology, Department of Medicine, Toronto Western Hospital, Toronto, Ontario, Canada
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  • Anthony E. Lang MD

    Corresponding author
    1. Morton and Gloria Shulman Movement Disorders Centre and the Edmund J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada
    • Correspondence to: Anthony E Lang, Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8; lang@uhnres.utoronto.ca

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  • Relevant conflicts of interest/financial disclosures: Anthony E. Lang received a 1-year Pilot Project Grant from the Parkinson Society Canada in 2012.

  • Full financial disclosures and author roles may be found in the online version of this article.

ABSTRACT

An accurate early diagnostic test for Parkinson's disease (PD) is a critical unmet need. Recently, independent groups using different histological techniques have reported that the presence of alpha-synuclein (α-syn) in colonic biopsy tissue is able to distinguish living patients with PD from those without the disease. In addition, a further study has suggested that the presence of α-syn in colonic biopsy tissue may be evident in early or even prodromal PD. However, several questions remain regarding the translation of these findings into using the assessment of α-syn deposition in the enteric nervous system as a diagnostic biomarker for prodromal PD. Here we address critical issues related to the location and quantification of enteric α-syn, detection of α-syn with currently available histological techniques, timing of detection of α-syn deposition, and, most crucially, whether enteric α-syn can distinguish those with PD from both healthy individuals and individuals with other related diseases. We conclude that, although enteric α-syn is a very exciting prospect, further studies will be vital to determine whether enteric α-syn deposition has the potential to be the biomarker for prodromal PD that the field so desperately seeks. © 2013 International Parkinson and Movement Disorder Society

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