Parkinson's threat 20% lower if you've had appendix out

Parkinson's Disease

Parkinson's Disease

So did some Parkinson's patients.

What's more, after honing in on the specific experiences of about 850 Parkinson's patients, the researchers determined that appendix removal was also associated with a 3.6-year delay in the onset of Parkinson's among those who had the surgery and still developed the disease.

"We're not saying to go out and get an appendectomy", stressed Viviane Labrie of Michigan's Van Andel Research Institute, a neuroscientist and geneticist who led the research team.

But the hunt for the origins of Parkinson's still can not explain why the disease develops in some people but not others.

The global team of scientists reviewed two datasets, including a large registry from Sweden, and found that removal of the appendix was associated with a decreased risk of developing Parkinson's disease. Clumped alpha-synuclein is considered to be a key hallmark of Parkinson's; previously, it was thought to only be present in people with the disease. Life expectancies for those with the disease are significantly shortened, and most patients eventually lose the ability to care for themselves.

It's unclear why the appendix has these clumps in the first place, however. "One of the most common non-motor symptoms in Parkinson's patients is issues with the gastrointestinal (GI) tract".

For years, scientists have hypothesized about what might cause the gut-Parkinson's connection.

So, to learn more about the disease, Labrie and her colleagues turned their focus from the brain to the digestive system.

Doctors and patients have long known there's some connection between the gastrointestinal tract and Parkinson's.

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"Despite having a reputation as largely unnecessary, the appendix actually plays a major part in our immune systems, in regulating the makeup of our gut bacteria and now, as shown by our work, in Parkinson's disease", senior author Viviane Labrie from Van Andel Research Institute in MI told The Guardian. "We have shown that the appendix is a hub for the accumulation of clumped forms of alpha-synuclein proteins, which are implicated in Parkinson's disease". He said he found the study results convincing. The Swedish registry data also had limitations: an earlier study comparing diagnoses in the data set with clinical evaluations showed 70.8% accuracy in Parkinson's diagnosis. The list includes records from nearly 1.7 million patients, some of whom have been tracked for over 50 years.

The study couldn't prove cause and effect, but it found that appendectomy lowered Parkinson's risk by roughly 20 percent.

Parkinson's disease could originate in the appendix, according to one of the largest studies of the neurodegenerative illness. Not only that, but among those who did get the disease it pushed back the age of diagnosis by over three years, though there were differences in these numbers depending on where people lived. Those "abnormally folded alpha-synuclein proteins" are often found in the appendix. Crucially, much of the alpha synuclein there comes in a shortened form that clumps together, like it does in Lewy bodies, more easily than the normal form will. That raises the prospect for developing new therapies created to prevent such protein clumps from escaping the appendix.

But having an appendectomy is no cure for Parkinson's disease, nor does having an appendix cause Parkinson's.

The appendix is clearly not the whole of the story (otherwise removing it would prevent all cases).

The big surprise, according to studies published in the journal Science Translational Medicine: Lots of people may harbor clumps of that worrisome protein in their appendix - young and old, people with healthy brains and those with Parkinson's.

The proteins themselves aren't the sole culprit behind the disease, though.

To inspect appendix tissue, the investigators treated it with proteinase K, which digests free physiological alpha-synuclein but leaves aggregated alpha-synuclein intact. Hannah Devlin at The Guardian reports that it's possible that Parkinson's is triggered by an event in which the protein escapes the appendix and travels to the brain via the vagus nerve.

That meant that Parkinson's risk had dropped by 19.3 percent among those who had had their appendix removed.

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