Hospital-treated infectious diseases, infection burden and risk of Parkinson disease: An observational and Mendelian randomization study.

Brain Behav Immun

Bioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, Guangdong, China; Division of Emerging Interdisciplinary Areas, Center for Aging Science, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China. Electronic address:

Published: August 2024

AI Article Synopsis

  • - The study investigates the link between infections and the development of Parkinson's disease (PD), finding that hospital-treated infections increase PD risk, notably from neurological and lower respiratory infections.
  • - Data from the UK Biobank were used to assess the impact of infection burden over time and specific types of infections on PD incidence, revealing a dose-response relationship with increasing infection episodes correlating with higher PD risk.
  • - Both observational and genetic analyses suggest a causal link between infections and PD, highlighting the need for further research in this area.

Article Abstract

Background: Experimental and cross-sectional evidence has suggested a potential role of infection in the ethology of Parkinson's disease (PD). We aim to examine the longitudinal association of infections with the incidence of PD and to explore whether the increased risk is limited to specific infection type rather than infection burden.

Methods: Based on the UK Biobank, hospital-treated infectious diseases and incident PD were ascertained through record linkage to national hospital inpatient registers. Infection burden was defined as the sum of the number of infection episodes over time and the number of co-occurring infections. The polygenic risk score (PRS) for PD was calculated. The genome-wide association studies (GWAS) used in two-sample Mendelian Randomization (MR) were obtained from observational cohort participants of mostly European ancestry.

Results: Hospital-treated infectious diseases were associated with an increased risk of PD (adjusted HR [aHR] 1.35 [95 % CI 1.20-1.52]). This relationship persisted when analyzing new PD cases occurring more than 10 years post-infection (aHR 1.22 [95 % CI 1.04-1.43]). The greatest PD risk was observed in neurological/eye infection (aHR 1.72 [95 % CI 1.32-2.34]), with lower respiratory tract infection (aHR 1.43 [95 % CI 1.02-1.99]) ranked the second. A dose-response association was observed between infection burden and PD risk within each PD-PRS tertile (p-trend < 0.001). Multivariable MR showed that bacterial and viral infections increase the PD risk.

Conclusions: Both observational and genetic analysis suggested a causal association between infections and the risk of developing PD. A dose-response relationship between infection burden and incident PD was revealed.

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http://dx.doi.org/10.1016/j.bbi.2024.06.016DOI Listing

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