% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Nerius:872759,
      author       = {Nerius, Michael and Doblhammer, Gabriele and Tamgüney,
                      Gültekin},
      title        = {{GI} infections are associated with an increased risk of
                      {P}arkinson’s disease},
      journal      = {Gut},
      volume       = {69},
      number       = {6},
      issn         = {1468-3288},
      address      = {London},
      publisher    = {BMJ Publishing Group},
      reportid     = {FZJ-2020-00237},
      pages        = {},
      year         = {2019},
      abstract     = {We have read with interest the recent publication of
                      Perez-Pardo and colleagues1 reporting the role of the TLR4
                      in the gut–brain axis in Parkinson’s disease (PD). These
                      findings prompted us to investigate the role of common GI
                      infections (GIIs) in the pathogenesis of PD. In this
                      prospective cohort study, we assessed the risk of PD in
                      patients who previously suffered from GIIs compared with the
                      control group not exposed to GIIs (table 1). At study entry
                      (1 January 2005), the analysis sample from health claims
                      data of the largest German health insurer consisted
                      of2 28 485 individuals aged 50 years and older, which
                      were followed for a mean time of 8.6 years
                      (median=11.0 years; IQR=7.6 years). PD and GIIs were
                      defined by ICD-10 codes as described in the supplementary
                      material. Overall, 6195 individuals $(2.7\%)$ developed PD
                      and 50 492 individuals $(22.1\%)$ were affected by any GII
                      during the observation period between 2005 and 2015. The
                      most frequent GIIs were those that caused infectious
                      gastroenteritis and colitis of unspecified origin (IGCUs;
                      39 093 individuals, $17.1\%),$ followed by viral
                      intestinal infections (VIIs; 9328 individuals, $4.1\%)$ and
                      bacterial intestinal infections (BIIs; 9298 individuals,
                      $4.1\%).$ The cumulative incidence of PD was significantly
                      higher among individuals with GIIs (p<0.001, online
                      supplementary figure S1). Multivariable analyses (table 2)
                      using Cox regression to compute HRs revealed an increased
                      risk of PD in patients with GIIs when compared with the
                      control group (HR=1.42; $95\% CI$ 1.33 to 1.52). Subgroup
                      analyses (table 2) revealed positive associations of GIIs
                      for men (HR=1.48; $95\% CI$ 1.34 to 1.63), women (HR=1.38;
                      $95\% CI$ 1.27 to 1.50), individuals aged 70 years or
                      older (HR=1.25; $95\% CI$ 1.04 to 1.49) and individuals
                      with (HR=1.40; $95\% CI$ 1.23 to 1.59) or without chronic
                      obstructive pulmonary disease (HR=1.43; $95\% CI$ 1.33 to
                      1.54). To solidify our results, we performed sensitivity
                      analyses and found no remarkable changes compared with our
                      primary analysis (online supplementary table S1). In a
                      secondary analysis, where we considered GIIs separately
                      (online supplementary table S2), BIIs (HR=1.30; $95\% CI$
                      1.12 to 1.50), VIIs (HR=1.31; $95\% CI$ 1.14 to 1.50) and
                      IGCUs (HR=1.34; $95\% CI$ 1.24 to 1.44) were each
                      associated with an increased risk of PD.},
      cin          = {ICS-6},
      ddc          = {610},
      cid          = {I:(DE-Juel1)ICS-6-20110106},
      pnm          = {553 - Physical Basis of Diseases (POF3-553)},
      pid          = {G:(DE-HGF)POF3-553},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31201287},
      UT           = {WOS:000538121200034},
      doi          = {10.1136/gutjnl-2019-318822},
      url          = {https://juser.fz-juelich.de/record/872759},
}