Published online Oct 7, 2015. doi: 10.3748/wjg.v21.i37.10609
Peer-review started: March 3, 2015
First decision: May 18, 2015
Revised: May 28, 2015
Accepted: August 31, 2015
Article in press: August 31, 2015
Published online: October 7, 2015
Core tip: Parkinson’s disease (PD) is characterized by alpha-synucleinopathy affecting all levels of the brain-gut axis. Both clinical and neuropathological evidences indicate that neurodegenerative changes in PD are accompanied by gastrointestinal symptoms that may precede or follow the central nervous system impairment. Dysregulation of the brain-gut-microbiota axis may significantly contribute to the pathogenesis of PD. The gut seems to play a critical role in the pathophysiology of PD representing a rout of entry for a putative environmental factor to initiate the pathological process. The close relationship between gut dysbiosis, intestinal permeability and neurological dysfunction suggests that the gut microbiota modification may provide a promising therapeutic option in PD.