Understanding the potential causes of gastrointestinal dysfunctions in multiple system atrophy

Colin F Craig; David I Finkelstein; Rachel M McQuade; Shanti Diwakarla

doi:10.1016/j.nbd.2023.106296

Understanding the potential causes of gastrointestinal dysfunctions in multiple system atrophy

Neurobiol Dis. 2023 Oct 15:187:106296. doi: 10.1016/j.nbd.2023.106296. Epub 2023 Sep 14.

Authors

Colin F Craig¹, David I Finkelstein², Rachel M McQuade³, Shanti Diwakarla⁴

Affiliations

¹ Gut Barrier and Disease Laboratory, Department of Anatomy & Physiology, The University of Melbourne, Parkville, VIC 3010, Australia.
² Parkinson's Disease Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia.
³ Gut Barrier and Disease Laboratory, Department of Anatomy & Physiology, The University of Melbourne, Parkville, VIC 3010, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Western Centre for Health Research and Education (WCHRE), Sunshine Hospital, St Albans, VIC 3021, Australia.
⁴ Gut Barrier and Disease Laboratory, Department of Anatomy & Physiology, The University of Melbourne, Parkville, VIC 3010, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Western Centre for Health Research and Education (WCHRE), Sunshine Hospital, St Albans, VIC 3021, Australia. Electronic address: lakshmi.diwakarla@unimelb.edu.au.

PMID: 37714308
DOI: 10.1016/j.nbd.2023.106296

Abstract

Multiple system atrophy (MSA) is a rare, progressive neurodegenerative disorder characterised by autonomic, pyramidal, parkinsonian and/or cerebellar dysfunction. Autonomic symptoms of MSA include deficits associated with the gastrointestinal (GI) system, such as difficulty swallowing, abdominal pain and bloating, nausea, delayed gastric emptying, and constipation. To date, studies assessing GI dysfunctions in MSA have primarily focused on alterations of the gut microbiome, however growing evidence indicates other structural components of the GI tract, such as the enteric nervous system, the intestinal barrier, GI hormones, and the GI-driven immune response may contribute to MSA-related GI symptoms. Here, we provide an in-depth exploration of the physiological, structural, and immunological changes theorised to underpin GI dysfunction in MSA patients and highlight areas for future research in order to identify more suitable pharmaceutical treatments for GI symptoms in patients with MSA.

Keywords: Enteric nervous system; Gastrointestinal dysfunction; Gut; Intestinal permeability; Multiple system atrophy.

Publication types

Review