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. 2020 Feb 10;16(7):1135-1152.
doi: 10.7150/ijbs.42257. eCollection 2020.

Parkinson's Disease: A Comprehensive Analysis of Fungi and Bacteria in Brain Tissue

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Parkinson's Disease: A Comprehensive Analysis of Fungi and Bacteria in Brain Tissue

Diana Pisa et al. Int J Biol Sci. .

Abstract

Parkinson's disease (PD) is characterized by motor disorders and the destruction of dopaminergic neurons in the substantia nigra pars compacta. In addition to motor disability, many patients with PD present a spectrum of clinical symptoms, including cognitive decline, psychiatric alterations, loss of smell and bladder dysfunction, among others. Neuroinflammation is one of the most salient features of PD, but the nature of the trigger remains unknown. A plausible mechanism to explain inflammation and the range of clinical symptoms in these patients is the presence of systemic microbial infection. Accordingly, the present study provides extensive evidence for the existence of mixed microbial infections in the central nervous system (CNS) of patients with PD. Assessment of CNS sections by immunohistochemistry using specific antibodies revealed the presence of both fungi and bacteria. Moreover, different regions of the CNS were positive for a variety of microbial morphologies, suggesting infection by a number of microorganisms. Identification of specific fungal and bacterial species in different CNS regions from six PD patients was accomplished using nested PCR analysis and next-generation sequencing, providing compelling evidence of polymicrobial infections in the CNS of PD. Most of the fungal species identified belong to the genera Botrytis, Candida, Fusarium and Malassezia. Some relevant bacterial genera were Streptococcus and Pseudomonas, with most bacterial species belonging to the phyla Actinobacteria and Proteobacteria. Interestingly, we noted similarities and differences between the microbiota present in the CNS of patients with PD and that in other neurodegenerative diseases. Overall, our observations lend strong support to the concept that mixed microbial infections contribute to or are a risk factor for the neuropathology of PD. Importantly, these results provide the basis for effective treatments of this disease using already approved and safe antimicrobial therapeutics.

Keywords: Parkinson's disease; fungal infection; neurodegenerative diseases; next-generation sequencing; polymicrobial infections.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Fungal structures in different CNS regions from one PD patient (PD1) analyzed by immunohistochemistry. Six CNS regions (medulla, MD; mesencephalon, MS; hypothalamus, HT; pons, PN; callosal body, CB; and caudate and lenticular nuclei, CLN) of PD1 were processed for immunohistochemistry as described in Materials and Methods. Parafin sections (5 µm) were immunostained with rabbit polyclonal antibodies against C. albicans, C. glabrata, S. racemosum and P. betae (green). Samples were then immunostained with a mouse monoclonal antibody against human α-tubulin (red). Finally, nuclei were stained with DAPI (blue). Scale bar: 5 µm.
Figure 2
Figure 2
Immunohistochemistry analysis of CNS regions from five PD patients (PD2-PD6). Three CNS regions (motor cortex, MC; medulla, MD; and mesencephalon, MS) from five PD patients (PD2-PD6) were inmunostained with a rabbit polyclonal antibody against C. albicans (green) and a mouse monoclonal antibody against human α-tubulin (red). Nuclei were stained with DAPI (blue). Scale bar: 5 µm.
Figure 3
Figure 3
Orthogonal projections and 3D analyses of CNS sections from PD patients. Immunohistochemistry was carried out as described in Figure 1. Orthogonal projections (panels A-C) and different stacks from a 3D image (panels D-H) (see also Movies S1-S5) from different sections and PD patients. Panels A and D-F: PD1 and panels B, C and G,H: PD4. Panels A, D-F: CLN region; panels B,C and G: MC region and panel H: MD region. Panels A and D-F: samples were immunostained with an anti-P. betae antibody (green) and panels B,C and G,H: samples were immunostained with an anti-C. albicans antibody (green). Nuclei were stained with DAPI (blue). All scale bars: 5 µm.
Figure 4
Figure 4
Hyphal structures in CNS sections of PD patients detected by an anti-chitin antibody. Several regions from different PD patients were processed for immunohistochemistry analysis as described in Materials and Methods using anti-chitin (green) and anti-human α-tubulin (red) antibodies. Nuclei appear in blue. Scale bar: 20 µm for panels A-D and 5 μm for panels E-J.
Figure 5
Figure 5
Distribution of fungal families and genera in six PD patients after NGS analyses. Computational analyses of the sequences obtained on the Illumina platform using Qiime classified the data fungal families and genera. Panel A shows the results of fungal families obtained from motor cortex, medulla and mesencephalon of PD patients. Panel B shows the results of fungal genera obtained from motor cortex, medulla and mesencephalon of PD patients. Asc: Ascomycota, Bas: Basidiomycota, Chy: Chytridiomycota.
Figure 6
Figure 6
Principal component analysis of the fungal species detected in different CNS regions of PD patients. 3D principal component analysis scatter plots of PD patients and control subjects. Panel A shows the distribution between different regions of six PD patients. Panel B shows the distribution between PD patients (plots in blue) and control subjects (plots in red). The UniFrac method was used to calculate this parameter. MC, motor cortex; MD, medulla; MS, mesencephalon; LFC, lateral frontal cortex; ERH, enthorinal cortex; and SC, spinal cord.
Figure 7
Figure 7
Detection of peptidoglycan in CNS sections from PD patients using immunohistochemistry. PD samples were processed as described in Materials and Methods. Samples were first immunostained with an anti-peptidoglycan antibody (green) and then with an anti-C. albicans antibody (red). DAPI staining of nuclei appears in blue. Scale bar: 5 µm.
Figure 8
Figure 8
Distribution of bacterial phyla and classes in CNS samples from PD patients. Computational analyses of the sequences obtained using NGS were carried out with Qiime program. Bacterial phyla and classes obtained with this program are shown. Panel A shows bacterial phyla detected in MC, MD and MS of PD patients. Panel B shows bacterial classes detected from MC, MD and MS of PD patients.
Figure 9
Figure 9
Principal component analysis of bacterial species in different CNS regions from six PD patients. 3D principal component analysis scatter plots of PD patients and nine control subjects. Panel A shows the distribution between different regions of six PD patients. Panel B shows the distribution between PD patients (plots in orange) and control subjects (plots in green). The UniFrac method was used to calculate this parameter. MC, motor cortex; MD, medulla; MS, mesencephalon; ERH, enthorinal cortex.
Figure 10
Figure 10
Fungal antigens in corpora amylacea detected in CNS sections from PD patients. Different sections from PD patients were incubated with rabbit polyclonal antibodies against C. albicans (panels A-D), P. betae (panels E-H), S. racemosum (panels I-K) and chitin (L-O), shown in green, and a monoclonal antibody against human α-tubulin, shown in red. Panels A, E-G and I-K: patient PD1; panels B and L: PD2; panels C and M: PD3; panels N and O: PD4 and panels D and H: PD5. Panels A, C, L and N: motor cortex; panels B, F and J: mesencephalon; panels D and E, H-I, M and O: medulla; panel G: pons; and panel K: hypothalamus. DAPI appears in blue. Scale bar: 20 µm.

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References

    1. Zhu MY. Noradrenergic Modulation on Dopaminergic Neurons. Neurotox Res. 2018;34:848–59. - PubMed
    1. Gardner RC, Yaffe K. Epidemiology of mild traumatic brain injury and neurodegenerative disease. Mol Cell Neurosci. 2015;66:75–80. - PMC - PubMed
    1. Khan AU, Akram M, Daniyal M, Zainab R. Awareness and current knowledge of Parkinson's disease: a neurodegenerative disorder. Int J Neurosci; 2018. pp. 1–39. - PubMed
    1. Poewe W, Seppi K, Tanner CM, Halliday GM, Brundin P, Volkmann J. et al. Parkinson disease. Nat Rev Dis Primers. 2017;3:17013. - PubMed
    1. Aldridge GM, Birnschein A, Denburg NL, Narayanan NS. Parkinson's Disease Dementia and Dementia with Lewy Bodies Have Similar Neuropsychological Profiles. Front Neurol. 2018;9:123. - PMC - PubMed

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