JPD: plasma short-chain fatty acids can be used as biomarkers for differential diagnosis of multiple system atrophy and Parkinson's disease

In April 2021, Chief Physician Xiao Qin published an online publication entitled "Plasma Short-Chain Fatty Acids Differences in Multiple System Atrophy from Parkinson's Disease" in the Journal of Parkinsons disease.
——Research paper
on plasma short-chain fatty acids as biomarkers for the differential diagnosis of multiple system atrophy and Parkinson's disease.

Multiple system atrophy (MSA) is a sporadic, adult-onset, relatively rapidly progressive neurodegenerative disease characterized by Parkinson-like symptoms, cerebellar ataxia, autonomic dysfunction, and pyramidal signs
.

Multiple system atrophy is divided into two subtypes according to clinical symptoms: Parkinsonism is called MSA-P (parkinsonism dominant MSA) type; Prominent manifestations of cerebellar ataxia are called MSA-C (cerebellar dominant MSA) type
.

As neurodegenerative diseases, MSA and Parkinson's disease (PD) overlap in clinical symptoms and often have similar clinical manifestations, so it is difficult to distinguish between the two by clinical symptoms alone, especially MSA-P type and PD.

MSA disease progresses relatively rapidly, and is temporarily effective or even ineffective in levodopa treatment, and there is currently only symptomatic treatment, lack of specific treatment
.
Therefore, early diagnosis and early intervention of MSA are of great significance
for the diagnosis and treatment of MSA.

In recent years, more and more studies have confirmed that intestinal flora disorders are closely related to neurodegenerative diseases, such as MSA and PD.

Short-chain fatty acids (SCFAs) are metabolites
produced primarily by the fermentation of dietary fiber by colonic bacteria.

Only one article has reported low levels of fecal SCFAs in MSA patients
.
Although domestic studies have found that there are also changes in the blood of MSA patients, there are currently no literature reports on changes
in SCFAs in the blood of MSA patients.

In this study, plasma SCFAs from 25 MSA patients, 46 PD patients and 46 healthy controls were extracted by gas chromatography-mass spectrometry (GC-MS), and the differential plasma SCFAs of MSA patients and PD patients were screened, and it was found that MSA patients had lower
plasma acetic acid concentrations than healthy controls.
Compared with PD patients, plasma acetic acid and propionic acid concentrations were lower
in patients with MSA and MSA-P.

Background: Multiple system atrophy and Parkinson's disease overlap in clinical symptoms and often have similar clinical manifestations, making it difficult to distinguish
between the two by clinical symptoms alone.
Short-chain fatty acids (including butyric acid, acetic acid, and propionic acid), mainly produced by fermented dietary fiber by colonic bacteria, are found at low
levels in the feces of patients with multisystem atrophy.
However, changes in short-chain fatty acid content in the blood of patients with multisystem atrophy remain unstudied
.

Objective: In this study, this study explores the changes of plasma short-chain fatty acid content in patients with multisystem atrophy and clarifies their potential differential diagnostic ability
.

Methods: The plasma short-chain fatty acid content of 25 patients with multisystem atrophy, 46 patients with Parkinson's disease and 46 healthy controls was detected by gas chromatography-mass spectrometry, and their demographic and clinical data
were evaluated.

Results: Patients with multisystem atrophy had lower plasma acetic acid concentrations than healthy controls.
Compared with patients with Parkinson's disease, plasma acetic acid and propionic acid concentrations were lower in patients with multisystem atrophy and multisystem atrophy in patients with Parkinson's disease
.
After the analysis of the subjects' operating characteristic curves, the area under the subjects' operating characteristic curves in patients with multisystem atrophy and healthy controls was 0.
68 (95% confidence interval 0.
55–0.
81).
The combination of acetic acid and propionic acid was 0.
82 (95% confidence interval, CI: 0.
71–0.
93) in patients with multisystem atrophy and Parkinson's disease, and 0.
89 (95% CI: 0.
80–0.
97)
in patients with multisystem atrophy Parkinson's and Parkinson's disease.

Conclusion: The concentration of plasma short-chain fatty acids in patients with multisystem atrophy is reduced
.
Combined acetic acid and propionic acid concentrations can be used as potential biomarkers for the differential diagnosis of multiple system atrophy and Parkinson's disease
.