Narrative Review: Intestinal α-Syn Oligomers as a Novel Pharmacological Target for Parkinson's Disease.

BACKGROUND AND AIMS: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons and neurological dysfunctions. The aggregation of abnormal α-synuclein (α-Syn) is closely associated with neuronal damage and acts as the major pathogenic driver mediating neurotoxicity. As critical intermediates in the aggregation cascade, α-Syn oligomers are regarded as the most neurotoxic species, which are widely distributed in both the central and peripheral nervous systems and contribute to the initiation and progression of PD. The gut-brain axis has attracted increasing attention, with a focus on the generation and propagation of gut-derived α-Syn oligomers, which can be promoted by chronic gut inflammation, gut microbiota dysbiosis, genetic mutations, and environmental factors. In this paper, we systematically elaborate on the formation of α-Syn oligomers and their transmission into the central nervous system, discuss existing therapeutic strategies targeting α-Syn oligomers, and analyze emerging prospects for future interventions.

RESULTS: This review integrates and analyzes available evidence regarding the biogenesis, gut-to-brain propagation, and pathogenic roles of α-Syn oligomers in PD. It also summarizes the current progress of therapeutic approaches targeting α-Syn oligomers and evaluates their potential value.

CONCLUSION: This review not only provides novel insights into pathogenetic mechanisms of PD but also highlights the therapeutic feasibility of targeting gut-derived α-Syn oligomers as a potential strategy for PD treatment.