Tracking the Importance of enteric a-syn pathology in parkinson’s disease

Alpha-synuclein (α-syn) represents one of the most abundant neuronal proteins and its abnormal aggregation is considered a pathological hallmark of Parkinson’s disease (PD). These deposits are frequently found also in the gastrointestinal tract of parkinsonian patients. For that reason, many studies have investigated the distribution of α-syn not only in the central nervous system (CNS) but also in peripheral tissues, including GI track. In the present review, we summarize the last findings regarding the possible correlations between the α-syn pathology and the gut dysfunction in course of PD. According to Braak’s hypothesis, in fact, it is supposed that the initial α-syn pathology originates into the gut and transmit anti-dromically to the dorsal motor nucleus (DMNX) by the vagus nerve, from which it can spread up to different rostral and caudal nervous regions. Notwithstanding, it is still poorly known whether α-syn pathology is directly responsible for the enteric disorders of PD patients. The early identification of intestinal symptoms and of their anatomical correlates, might help in identifying PD patients at the early stages of the disease and might contribute to the designing of early disease modifying therapies.