Abstract
Parkinson’s disease (PD) is a severe neurodegenerative disease characterized by disabling
motor alterations that are diagnosed at a relatively late stage in its development, and non-motor
symptoms, including those affecting the gastrointestinal tract (mainly constipation), which start much
earlier than the motor symptoms. Remarkably, current treatments only reduce motor symptoms,
not without important drawbacks (relatively low efficiency and impactful side effects). Thus, new
approaches are needed to halt PD progression and, possibly, to prevent its development, including
new therapeutic strategies that target PD etiopathogeny and new biomarkers. Our aim was to review
some of these new approaches. Although PD is complex and heterogeneous, compelling evidence
suggests it might have a gastrointestinal origin, at least in a significant number of patients, and
findings in recently developed animal models strongly support this hypothesis. Furthermore, the
modulation of the gut microbiome, mainly through probiotics, is being tested to improve motor
and non-motor symptoms and even to prevent PD. Finally, lipidomics has emerged as a useful
tool to identify lipid biomarkers that may help analyze PD progression and treatment efficacy in a
personalized manner, although, as of today, it has only scarcely been applied to monitor gut motility,
dysbiosis, and probiotic effects in PD. Altogether, these new pieces should be helpful in solving the
old puzzle of PD.
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