ABSTRACT
Progressive neurodegenerative disorders such as Parkinson's disease (PD) have continued to baffle medical science, despite strides in the understanding of their pathology. The inability of currently available therapies to halt disease progression is a testament to an incomplete understanding of pathways crucial to disease initiation, progression and management. Science has continued to link the activities and equilibrium of the gut microbiome to the health and proper functioning of brain neurons. They also continue to stir interest in the potential applications of technologies that may shift the balance of the gut microbiome towards achieving a favourable outcome in PD management. There have been suggestions that an improved understanding of the roles of the gut microbiota is likely to lead to the emergence of an era where their manipulation becomes a recognized strategy for PD management. This review examines the current state of our journey in the quest to understand how the gut microbiota can influence several aspects of PD. We highlight the relationship between the gut microbiome/microbiota and PD pathogenesis, as well as preclinical and clinical evidence evaluating the effect of postbiotics, probiotics and prebiotics in PD management. This is with a view to ascertaining if we are at the threshold of discovering the application of a usable tool in our quest for disease modifying therapies in PD.
ABSTRACT
BACKGROUND: To compare the pattern of vaginal microflora during pregnancy with pattern in early labour using Nugent scoring and determine the effect of these changes on fetal outcome. DESIGN: A prospective longitudinal study. SETTING AND POPULATION: Pregnant women attending antenatal clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between June 2017 and May 2018. METHODS: Consenting pregnant women who attended antenatal clinics were recruited. Vaginal secretions were obtained for Nugent scoring during pregnancy and at presentation in labour. MAIN OUTCOME MEASURES: Prevalence of abnormal vaginal flora in pregnancy and early labour, birth outcome, birth weight, gestational age at delivery, APGAR scores, need for neonatal ward admission. RESULTS: Sixty-seven (33.3%) of pregnant women had abnormal flora which was consistent with bacterial vaginosis. At the presentation of these women in labour, 14.4% of them had bacterial vaginosis thus indicating a significant reduction in abnormal vaginal flora in labour compared to the proportion of abnormal flora in antenatal period (P<0.001). There were no significant differences in the fetal outcomes of mothers with bacterial vaginosis when compared with those with normal vaginal flora (P-value >0.05). CONCLUSIONS: Persistence of abnormal vaginal microflora from pregnancy till early labour did not seem to be associated with poorer foetal outcomes when compared with women with normal vaginal microflora in labour. The possibility of persistent infection or re-infection before labour may justify the need for re-evaluation of vaginal smears in the late third trimester to allow for prompt treatment before the onset of labour. FUNDING: This research work was sponsored by the Tertiary Education Trust Fund, Nigeria (TETFund) with reference number OOU/IBR/010.
