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脑肠轴与帕金森病：肠道-大脑相互作用研究进展

赵玉蕊¹, 尤浩军^1,2, 雷静^1,2,*

¹延安大学感觉与运动疾病转化医学研究中心，延安 716000；²疼痛精准治疗与康复陕西省高等学校重点实验室，延安 716000

摘要

帕金森病(Parkinson's disease, PD)是一种以运动功能障碍为主要特征的进行性神经系统退行性疾病，主要病理表现为中脑黑质神经元内α-突触核蛋白(α-synuclein, α-Syn)异常聚集及多巴胺能神经元(dopaminergic neurons, DAn)缺失。胃肠道(gastrointestinal tract, GI)症状是PD 的常见非运动症状之一。已知，脑与肠道通过副交感神经和肠神经系统(enteric nervoussystem, ENS)的神经节构成的双向信息传递通路被称作脑肠轴。肠道微生物群失调可能是PD起源和病理发展的关键驱动因素之一，在病理性α-Syn 向中枢神经系统(central nervous system, CNS)传播并促进PD进展中发挥重要作用。本文综述了肠道微生物群失调在PD发生和发展中的作用，包括其对肠道屏障、神经炎症及α-Syn 病理传播的影响，并探讨靶向脑肠轴的诊疗策略，包括菌群移植、迷走神经刺激、Toll 样受体4 (Toll-like receptor 4, TLR4)拮抗剂、运动训练等，为PD诊断和治疗提供依据。

关键词： 脑肠轴; 帕金森病; 肠道微生物群; α-突触核蛋白

Gut-brain axis and Parkinson's disease: research progress on the gut-brain interaction

ZHAO Yu-Rui¹, YOU Hao-Jun^1,2, LEI Jing^1,2,*

¹Center for Translational Medicine Research on Sensory-Motor Diseases, Yan'an University, Yan'an 716000, China；²Key Laboratory of Pain Precision Treatment and Rehabilitation of Shaanxi Province Higher Education Institutions, Yan'an 716000, China

Abstract

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor dysfunction. The main pathological manifestations are abnormal accumulation of α-synuclein (α-Syn) in substantia nigra neurons and loss of dopaminergic neurons (DAn). Gastrointestinal (GI) symptom is one of the common non-motor symptoms in PD. It is known that the brain and gut communicate via the parasympathetic nerves and the enteric nervous system (ENS), forming a bidirectional pathway called the gut-brain axis. Dysbiosis of the gut microbiota may be a key driver in the origin and pathological progression of PD, playing an important role in the spread of pathological α-Syn to the central nervous system (CNS) and thereby promoting the progression of PD. This article reviews the mechanism of gut microbiota dysbiosis in the pathogenesis and progression of PD, including its effects on intestinal barrier integrity, neuroinflammation, and pathological α-Syn transmission, and discusses the diagnosis and therapeutic strategies targeting the gut-brain axis, including microbiota transplantation, vagus nerve stimulation, Toll-like receptor 4 (TLR4) antagonists, exercise training, etc., providing new insights for the diagnosis and treatment of PD.

Key words: gut-brain axis; Parkinson''s disease; gut microbiota; α-synuclein

收稿日期：　　录用日期：

通讯作者：雷静　　E-mail:

DOI: 10.13294/j.aps.2026.0021

引用本文：

赵玉蕊, 尤浩军, 雷静. 脑肠轴与帕金森病：肠道-大脑相互作用研究进展[J]. 生理学报 2026; 78 (3): 501-512.

ZHAO Yu-Rui, YOU Hao-Jun, LEI Jing. Gut-brain axis and Parkinson's disease: research progress on the gut-brain interaction. Acta Physiol Sin 2026; 78 (3): 501-512 (in Chinese with English abstract).