Finding the Missing Link: Connecting the Appendix and Parkinson’s Disease

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When most people think of Parkinson's disease, the appendix likely does not immediately come to mind. Now, it should.

In the largest, most comprehensive study of its kind, a team of Van Andel Institute scientists—led by Viviane Labrie, Ph.D.—has identified the appendix as a potential starting point for Parkinson's disease. What does this groundbreaking discovery mean for you?

This study is revolutionary, to say the least, and was conducted by a team of Van Andel Institute scientists, led by Dr. Viviane Labrie in collaboration with Dr. Patrik Brundin, Dr. Lena Brundin and postdoctoral fellow Dr. Bryan Killinger.

Their extraordinary work establishes the appendix as a reservoir for disease-associated proteins that play a major role in Parkinson's onset and progression, and opens exciting new avenues for the development of potential new preventative and treatment measures.

The findings also solidify the role of the gut and immune system in the genesis of the disease, and reveal that the appendix acts as a major reservoir for abnormally folded alpha-synuclein proteins, which are closely linked to Parkinson's onset and progression.

"Parkinson's affects more than 7 million people and their families around the world," said Labrie, an assistant professor at Van Andel Research Institute (VARI) and senior author of the study. "By 2040, that number is expected to double. Our study points to the gut, specifically the appendix, as having a major role in the early aspects of Parkinson's, and gives us new insight that we hope will translate into ways to prevent and better treat this devastating disorder."

Because there are no definitive tests for Parkinson's, people often are diagnosed after motor symptoms such as tremor or rigidity arise. By then, the disease typically is quite advanced, with significant damage to the area of the brain that regulates voluntary movement. On the other hand, appendectomies had no apparent benefit in people whose disease was linked to genetic mutations passed down through their families—a group that comprises fewer than 10 percent of cases.

The study indicates that removing the appendix early in life reduces the risk of developing Parkinson's disease by 19 to 25 percent and an appendectomy can delay disease progression in people who go on to develop Parkinson's, pushing back diagnosis by an average of 3.6 years.

Labrie and her team also found clumps of alpha-synuclein in the appendixes of healthy people of all ages as well as people with Parkinson's, raising new questions about the mechanisms that give rise to the disease and propel its progression. 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.

Does this mean you should run to the doctor to get your appendix removed? Well, not exactly.

"One of the important things to remember is that we saw changes in risk for Parkinson's disease only if an appendectomy occurred two decades before the onset of Parkinson's disease or even longer, so only early appendectomies were protective," said Labrie.

"But even still, removing the appendix may change how your immune system and your microbiome works. So you may show changes in risk for Parkinson's disease, but you might also change the risk for other diseases that we don't fully understand yet, so we're really just starting to understand the role of the appendix in Parkinson's disease."

Learn more about the study.

Written by Sarah Suydam, Staff Writer for West Michigan Woman.

Photo courtesy of Van Andel Institute.

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