Abstract Details

Title Effects of a four-strain probiotic on inflammatory markers in Parkinson's disease: a multicentre randomised controlled trial (the SymPD study)

Topic Movement Disorders

Presentation(s) N5 - Neuroscience in the Clinic: Exploring the Gut-brain Axis (4:35 PM-4:45 PM)

Poster/Presentation
Number 001

Background Pro-inflammatory gut dysbiosis and involvement of the ‘gut-brain’ axis have been described in PD and may be modulated by probiotics use. Preliminary results from the SymPD trial suggest that this four-strain probiotic can enrich the gut microbiota with bacteria having anti-inflammatory properties, reduce ‘time to on’, and non-motor symptoms burden in patients with PD and constipation.

Objective To evaluate the effects of a four-strain probiotic (Lacticaseibacillus rhamnosus, Enterococcus faecium, Lactobacillus acidophilus, Lactiplantibacillus plantarum) on plasma levels of inflammatory markers in patients with Parkinson’s disease (PD) and symptomatic constipation recruited to the SymPD trial.

Design/Methods

A multicentre, randomised, double-blind, placebo-controlled trial of 74 patients with PD and constipation (ROME IV criteria) who were randomised (1:1) to either a four-strain probiotic (n=38) or placebo (n=36). Exploratory outcomes included measuring changes in the plasma levels of inflammatory cytokines such as IFN-γ, TNF-α, IL-6, IL-8, and IL-10 using the Human ProInflammatory Panel 1 Kit from Meso Scale Discovery after 12 weeks of intervention. Within-group changes were tested using the Wilcoxon signed-rank test (p≤0.05 was considered significant).

Results Blood samples from 22 and 19 participants from the active and placebo groups, respectively, were analysed. Significant reductions in the plasma levels of IL-6 (from 1.01±0.49 to 0.81±0.45 pg/mL, p=0.028) and TNF-α (from 2.04±1.40 to 1.69±0.93 pg/mL, p=0.024) were observed in the active treatment group, while a significant increase in the plasma levels of TNF-α (from 1.37±0.42 to 1.69±0.63 pg/mL, p=0.005) was observed in the placebo group.

Conclusions This four-strain probiotic was effective in reducing plasma levels of specific pro-inflammatory cytokines. This anti-inflammatory effect could partly underpin the improvements in motor and non-motor symptoms, particularly in fatigue, in patients with PD and constipation as observed in the SymPD trial.

Authors/Disclosures
Valentina Leta PRESENTER	No disclosure on file
Gargi Mandal (King's College London)	No disclosure on file
Pavlos Zinzalias	No disclosure on file
Juliet Staunton (King's College Hospital)	No disclosure on file
Lucia Batzu	No disclosure on file
Dhaval Trivedi	No disclosure on file
Kristina Rosqvist (Lund University; Skåne University Hospital)	No disclosure on file
Jonathan Timpka	No disclosure on file
Trinette Van Vliet	No disclosure on file
Aleksandra Podlewska, PhD (King's College London)	Miss Podlewska has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Bial . The institution of Miss Podlewska has received research support from Wellcome Trust.
Miriam Parry (King's College Hospital NHS Trust)	No disclosure on file
Daniel van Wamelen	No disclosure on file
Alexandra Rizos (King's College Hospital)	No disclosure on file
Guy Chung-Faye	No disclosure on file
Per Odin	No disclosure on file
Carmine Pariante	No disclosure on file
Alessandra Borsini	No disclosure on file
Kallol R. Chaudhuri, MD, FRCP	Dr. Chaudhuri has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie, Acadia, GSK, Scion, Britannia , Lobsor. Dr. Chaudhuri has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie, Britannia, Scion, Sunovion, UCB, . Dr. Chaudhuri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie, Britannia, UCB, Zambon. Dr. Chaudhuri has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NPJ PD journal. The institution of Dr. Chaudhuri has received research support from Britania Pharmaceuticals, AbbVie, UCB, GKC, Bial, Aacdemic grants: EU, IMI EU, Horizon 2020, Parkinson's UK, NIHR, PDNMG, EU (Horizon 2020), Kirby Laing Foundation, NPF, MRC, Wellcome Trust.