Affiliations: [a] Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| [b] Department of Neurology, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
| [c] Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| [d] Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence:
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Correspondence to: Chin-Hsien Lin, MD, PhD, Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan. Tel.: +886 2 23123456 /Ext 65335; Fax: +886 2 23418395; E-mail: chlin@ntu.edu.tw.
Abstract: Background:Lipopolysaccharide-binding protein (LBP) presents bacterial endotoxin, lipopolysaccharides, to cellular surface pattern receptors for immune responses in the gut-brain axis of Parkinson’s disease (PD). Objective:We investigated whether plasma LBP levels were associated with PD severity and progression. Methods:This study included 397 participants (248 PD patients and 149 controls). We measured participants’ plasma levels of LBP and pro-inflammatory cytokines, including TNF-α, IL-6, andIL-17A. PD patients underwent motor and cognition evaluations at baseline and at a mean follow-up interval of 4.7±2.3 years. We assessed the progression of motor and cognition symptoms based on changes in the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III motor score and Mini-Mental State Examination (MMSE) score, respectively. Results:Plasma LBP levels were lower in PD patients than controls (9.08±2.91 vs. 10.10±3.00μg/ml, p < 0.01). A multiple logistic regression model with adjustment for age, sex, and plasma cytokine levels revealed that reduced plasma LBP levels were associated with increased PD risk (odds ratio 0.816, [95% CI 0.717–0.929], p = 0.002). Among PD patients, LBP levels were correlated with MDS-UPDRS part III motor score after adjustment for confounders (coefficient = 0.636, p = 0.017), but not with MMSE score. Adjusted Cox regression analysis showed that higher plasma LBP levels associated with faster motor progression (adjusted hazard ratio 1.084 [95% CI 1.011–1.163], p = 0.024) during follow-up. Conclusion:Our results demonstrated that plasma LBP levels reflect risk, motor symptom severity and progression in patients with PD.
