Spinal cord stimulation for concurrent improvement of consciousness and spasticity following severe traumatic brain injury: a case study.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder increasingly recognized for its strong association with gastrointestinal dysfunction [,,]. A common hypothesis proposes that PD may begin in the gut. In this scenario, microbial imbalance compromises the intestinal barrier, allowing pro-inflammatory molecules like lipopolysaccharide (LPS) to enter the bloodstream [,,]. This process can then set off a neuroinflammatory cascade, which ultimately contributes to the loss of dopaminergic neurons in the substantia nigra (SN) []. Despite the central role of this axis in PD pathogenesis, targeted therapeutic strategies remain underdeveloped. Thus, interventions aimed at restoring gut barrier integrity and reducing gut-driven neuroinflammation represent a promising therapeutic direction for PD. Sodium hyaluronate (SH) is a glycosaminoglycan (GAG) found in the extracellular matrix of cells []. It is widely recognized for its roles in maintaining tissue homeostasis, exerting anti-inflammatory and antioxidant effects, and promoting tissue repair [,]. Increasing evidence highlights its critical role in gastrointestinal health, particularly in preserving gut barrier integrity and modulating microbiota composition [,]. These properties make SH an ideal candidate drug for the intervention of PD. SH has been proven to improve intestinal permeability in colitis models and reduce pro-inflammatory signals in liver injury models, indicating its ability to provide barrier protection and immune regulation [,]. Therefore, SH may intercept the key drivers of PD pathology on the microbiota–gut–brain axis (MGBA) by enhancing the intestinal barrier, reducing systemic inflammatory responses, and promoting microbial balance. It is worth noting that SH is an endogenous substance [], and it has been safely orally used as a food ingredient in multiple regions, which significantly enhances its feasibility for application []. Therefore, oral administration of SH becomes a reasonable and promising strategy to target the intestinal-mediated inflammation and barrier dysfunction in PD, opening up a new avenue for the treatment of PD and worthy of further research.