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A28 SCIENCE
Monday 5 noveMber 2018
Appendix removal is linked to lower risk of Parkinson's

By LAURAN NEERGAARD their appendix surgically re-
AP Medical Writer moved decades earlier.
WASHINGTON (AP) — Sci- One puzzling caveat: Peo-
entists have found a new ple living in rural areas ap-
clue that Parkinson's dis- peared to get the benefit.
ease may get its start not in Labrie said it's possible that
the brain but in the gut — the appendix plays a role
maybe in the appendix. in environmental risk fac-
People who had their ap- tors for Parkinson's, such as
pendix removed early in pesticide exposure.
life had a lower risk of get- Further analysis suggested
ting the tremor-inducing people who developed
brain disease decades Parkinson's despite an ear-
later, researchers reported ly-in-life appendectomy
Wednesday. tended to have symptoms
Why? A peek at surgically appear a few years later
removed appendix tis- than similarly aged pa-
sue shows this tiny organ, tients.
often considered useless, A COMMON PROTEIN
seems to be a storage de- That kind of study doesn't
pot for an abnormal pro- prove that removing the
tein — one that, if it some- appendix is what reduces
how makes its way into the the risk, cautioned Dr. An-
brain, becomes a hallmark drew Feigin, executive di-
of Parkinson's. rector of the Parkinson's
The big surprise, according institute at NYU Langone
to studies published in the Health, who wasn't in-
journal Science Translation- volved in Wednesday's re-
al Medicine: Lots of people search.
may harbor clumps of that So next, Labrie's team ex-
worrisome protein in their amined appendix tissue
appendix — young and from 48 Parkinson's-free
old, people with healthy people. In 46 of them, the
brains and those with Par- appendix harbored the ab-
kinson's. normal Parkinson's-linked
But don't look for a surgeon protein.
just yet. So did some Parkinson's pa-
"We're not saying to go out tients. Whether the appen-
and get an appendecto- dix was inflamed or not also
my," stressed Viviane Labrie This microscope image provided by the Van Andel Research Institute in October 2018 shows an didn't matter.
of Michigan's Van Andel abnormal protein that is a hallmark of Parkinson’s disease clumped inside the appendix. That's a crucial finding be-
Research Institute, a neuro- Associated Press cause it means merely har-
scientist and geneticist who boring the protein in the gut
led the research team. isn't enough to trigger Par-
After all, there are plenty ors and movement difficul- Parkinson's Foundation gus nerve, which connects kinson's, Labrie said. There
of people who have no ty that lead to a Parkinson's chief scientific officer the body's major organs to has to be another step that
appendix yet still develop diagnosis. James Beck, who also the brain. Abnormal alpha- makes it dangerous only for
Parkinson's. And plenty of Wednesday's research wasn't involved, agreed synuclein is toxic to brain certain people.
others harbor the culprit promises to re-energize that "there's a lot of tantaliz- cells involved with move- "The difference we think is
protein but never get sick, work to find out why, and ing potential connections." ment. how you manage this pa-
according to her research. learn who's really at risk. He noted that despite its There have been prior thology," she said — how
THE GUT CONNECTION "This is a great piece of the reputation, the appendix clues. People who de- the body handles the build-
Doctors and patients have puzzle. It's a fundamental appears to play a role in cades ago had the vagus up.
long known there's some clue," said Dr. Allison Willis, immunity that may influ- nerve cut as part of a now- Her team plans additional
connection between the a Parkinson's specialist at ence gut inflammation. The abandoned therapy had a studies to try to tell.
gastrointestinal tract and the University of Pennsyl- type of bacteria that live reduced risk of Parkinson's. The reservoir finding is com-
Parkinson's. Constipation vania who wasn't involved in the gut also may affect Some smaller studies have pelling, Feigin said, but an-
and other GI troubles are in the new studies but says Parkinson's. suggested appendecto- other key question is if the
very common years before her patients regularly ask But if it really is common mies, too, might be protec- abnormal protein also col-
patients experience trem- about the gut link. to harbor that Parkinson's- tive — but the results were lects in healthy people's in-
linked protein, "what we conflicting. testines.
don't know is what starts it, Labrie's team set out to find And Penn's Willis adds an-
what gets this whole ball stronger evidence. other caution: There are
rolling," Beck said. First, the researchers ana- other unrelated risks for
For years, scientists have lyzed Sweden's huge na- Parkinson's disease, such as
hypothesized about what tional health database, suffering a traumatic brain
might cause the gut-Par- examining medical records injury.
kinson's connection. One of nearly 1.7 million people "This could be one of many
main theory: Maybe bad tracked since 1964. The avenues that lead to Par-
"alpha-synuclein" protein risk of developing Parkin- kinson's disease, but it's
can travel from nerve fibers son's was 19 percent lower a very exciting one," she
in the GI tract up the va- among those who had said.q