Takeshige-Amano, H. | bioRxiv Science

bioRxiv2025

Leveraging the salivary microbiome profile to stratify REM sleep behavior disorder and synucleinopathies

Few studies have explored noninvasive biomarkers of synucleinopathies, including Parkinsons disease (PD), and rapid-eye-movement behavior disorder (RBD), a prodromal stage for these conditions. Human oral/salivary microbiomes are altered in PD, highlighting their potential role in both PD pathogenesis and diagnosis. We analyzed 249 salivary microbiomes of controls and patients with idiopathic RBD and various synucleinopathies, including two subgroups divided based on the presence of RBD symptoms, through both cross-sectional and longitudinal studies. The microbiome composition was strikingly similar between patients with RBD and early PD exhibiting RBD symptoms. The area under the curve range for distinguishing RBD from controls and each synucleinopathy was 0.85-0.94. We further performed pseudotime trajectory analysis of the microbiome compositional space; populations with low diversity, enriched Streptococcus, and depleted Neisseria exhibited a brief pseudotime transition from RBD to early PD. Our findings suggest that early PD-like salivary dysbiosis manifests during RBD, allowing for the stratification of synucleinopathies through the innovative use of salivary microbiome profiles.

neuroscience↗

bioRxiv2023

Connection between drug-mediated neurotransmission and salivary microbiome

Salivary microbiome alterations associated with cognitive function have been reported in patients with neurodegenerative diseases1-3. Gut microorganisms can modulate therapeutic efficacy via drug metabolism4-7. Additionally, several drugs against diabetes and inflammatory bowel disease can lead to microbial dysbiosis8-10. However, the effect of central nervous system (CNS) drug use on the microbiome remains unknown. Here, we show that the usage of anti-dementia drugs, including donepezil and memantine, more largely affects the salivary microbiome composition than the gut microbiome composition. We observed salivary microbiome diversity reduction in patients with neurodegenerative diseases who received N-methyl-D-aspartate receptor inhibitor drugs. Furthermore, the use of acetylcholine-modulating drugs contributed to the salivary microbiome composition, suggesting that the salivary microbiome responds to changes in CNS drug-induced cerebral acetylcholine and glutamate levels. Multivariate analysis adjusted with or without the use of anti-dementia drugs demonstrated that the difference in the salivary microbiome correlated with cognitive function. We show the unique salivary microbiome structure of CNS drug users, suggesting the possibility of monitoring pharmacokinetics using the salivary microbiome. Our results also provide evidence of the presence of the microbiome-oral-brain axis and will accelerate the elucidation of the interplay between the salivary microbiome and neurodegeneration.

microbiology↗