%0 Journal Article %T The gut-brain axis: is intestinal inflammation a silent driver of ParkinsonĄ¯s disease pathogenesis? %A Madelyn C. Houser %A Mal¨˛ G. Tansey %J Archive of "NPJ Parkinson's Disease". %D 2017 %R 10.1038/s41531-016-0002-0 %X The state of the intestinal environment can have profound effects on the activity of the central nervous system through the physiological contributions of the microbiota, regulation of intestinal barrier function, and altered activity of peripheral neurons. The common language employed for much of the gut-brain communication is the modulation of immune activity. Chronic proinflammatory immune activity is increasingly being recognized as a fundamental element of neurodegenerative disorders, and in ParkinsonĄ¯s disease, inflammation in the intestine appears particularly relevant in pathogenesis. We review the evidence that intestinal dysfunction is present in ParkinsonĄ¯s disease and that it may reflect the earliest manifestations of ParkinsonĄ¯s disease pathology, and we link these findings to dysregulated immune activity. Based on this, we present a model for ParkinsonĄ¯s disease pathogenesis in which the disorder originates in the intestine and progresses with inflammation as its underlying mechanism. More in-depth investigations into the physiological mechanisms underlying peripheral pre-motor symptoms in ParkinsonĄ¯s disease are expected to lead to the development of novel diagnostic and therapeutic measures that can slow or limit progression of the disease to more advanced stages involving debilitating motor and cognitive symptoms %U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445611/