Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

Ishizuka, Mitsuru; Shibuya, Norisuke; Takagi, Kazutoshi; Hachiya, Hiroyuki; Tago, Kazuma; Suda, Kotaro; Aoki, Taku; Kubota, Keiichi

doi:10.1177/0003134821989034

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…17,34 Two studies have shown that appendectomy is associated with an increased risk of subsequent PD, perhaps owing to the preceding inflammatory state of appendicitis, 35,36 but others have not found an association. 37 Research results are sparse and mixed as to whether specific infections increase risk of PD, with Helicobacter pylori and hepatitis C virus infections emerging as particularly relevant. [38][39][40] Case counts were too low for H pylori in our data to examine this association independently, and the confidence intervals were too wide to interpret any association between viral hepatitis and PD.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have examined whether infections are associated with PD, with one hypothesized mechanism of action being central nervous system inflammation as a consequence of systemic infection . Two studies have shown that appendectomy is associated with an increased risk of subsequent PD, perhaps owing to the preceding inflammatory state of appendicitis, but others have not found an association . Research results are sparse and mixed as to whether specific infections increase risk of PD, with Helicobacter pylori and hepatitis C virus infections emerging as particularly relevant .…”

Section: Discussionmentioning

confidence: 99%

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Long-term Risk of Parkinson Disease Following Influenza and Other Infections

et al. 2021

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Influenza has been associated with the risk of developing Parkinson disease, but the association is controversial. OBJECTIVE To examine whether prior influenza and other infections are associated with Parkinson disease more than 10 years after infection. DESIGN, SETTING, AND PARTICIPANTS This case-control study used data from 1977 to 2016 from the Danish National Patient Registry. All individuals with Parkinson disease, excluding those with drug-induced parkinsonism, were included and matched to 5 population controls on sex, age, and date of Parkinson diagnosis. Data were analyzed from December 2019 to September 2021. EXPOSURES Infections were ascertained between 1977 and 2016 and categorized by time from infection to Parkinson disease diagnosis. To increase specificity of influenza diagnoses, influenza exposure was restricted to months of peak influenza activity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-term Risk of Parkinson Disease Following Influenza and Other Infections

et al. 2021

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“…Most studies examining the influence of the appendix in humans have been observational and have investigated the association between appendicectomy status and disease states, such as ulcerative colitis [14][15][16][17][18], Crohn's disease [14,15,19], Clostridioides difficile infection [20][21][22][23], colorectal cancer [24][25][26], diverticular disease [27], ischaemic heart disease [28], myocardial infarction [29], rheumatoid arthritis [30], Parkinson's disease [31], and mood disorders [32]. Findings in studies of each disorder have been equivocal, with little consensus as to whether prior appendicectomy is likely protective, a risk factor, or of little relevance to disease.…”

Section: Introductionmentioning

confidence: 99%

Prior Appendicectomy and Gut Microbiota Reestablishment in Adults After Bowel Preparation and Colonoscopy

McGuinness,

O'Hely,

Stupart

et al. 2024

Preprint

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Emerging evidence suggests that the human vermiform appendix is not a vestigial organ, but rather an immunological organ of biological relevance. It is hypothesised that the appendix acts as a bacterial ‘safe house’ for commensal gut bacteria and facilitates re-inoculation of the colon after disruption through the release of biofilms. To date, no studies have attempted to explore this potential mechanistic function of the appendix. We conducted a pre-post intervention study in adults (n=59) exploring reestablishment of the gut microbiota in those with and without an appendix after colonic disruption via bowel preparation and colonoscopy. Gut microbiota composition was measured one week before and one month after bowel preparation and colonoscopy using 16S rRNA sequencing. We observed between group differences in gut microbiota composition between those with (n=45) and without (n=13) an appendix at baseline. These differences were no longer evident one-month post-procedure, suggesting that this procedure may have ‘reset’ any potential appendix-related differences between groups. Both groups experienced reductions in gut microbiota richness and shifts in beta diversity post-procedure, with greater changes in those without an appendix, and there were five bacterial genera whose re-establishment post-procedure appeared to be moderated by appendicectomy status. This small experimental study provides preliminary evidence of a potential differential reestablishment of the gut microbiota after disruption in those with and without an appendix, warranting further investigation into the potential role of the appendix as a microbial safe house.

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“…To date, empirical studies have been inconsistent, and two large meta-analyses failed to find a beneficial effect on lowering PD rates after appendicectomy. 8,9 There are a few known factors such as age, sex, race, and diseases of the colon that are possibly associated with appendicitis. We matched closely on such factors thereby removing potential bias if these same factors were associated with PD.…”

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confidence: 99%