“…The study suffers from the referral bias from the sampled population and the lack of phenotype classification but provides an additional piece of evidence that chronic inflammation in response to infection may underlie the development of PD (Bower et al, 2006). Taken the emergent role of ApoE (Zhang et al, 2011;Gonzalez et al, 2017), clusterin (CLU) (Falgarone and Chiocchia, 2009;Hong et al, 2016), triggering receptor expressed on myeloid cells 2 (TREM2) in innate immunity (Fahrenhold et al, 2018;Jay et al, 2015;Shi and Holtzman, 2018), and their convergence as risk variants for sporadic AD, it is likely that an altered inflammatory response to exogenous substances in the airways is transferred through the olfactory neuroepithelium to the connected olfactory circuitry. This is supported by the increased infections incidence of viruses in ApoEε4 carriers (HSV-1, HIV1, Hepatitis C, Hepatitis B) (Itzhaki et al, 1997;Burgos et al, 2006;Finch and Morgan, 2007;Burt et al, 2008;Hishiki et al, 2010;Yin et al, 2010) and bacteria (C. Pneumoniae, Gram negative bacteria) (de Bont et al, 1999;Van Oosten et al, 2001;Kattan et al, 2008).…”