Detection of Phosphorylated Alpha-Synuclein in the Muscularis Propria of the Gastrointestinal Tract Is a Sensitive Predictor for Parkinson’s Disease

Figure 2

Immunohistochemical analyses of patients with premotor PD. Immunohistochemistry for α-synuclein (αSyn) (a–d, f), and phosphorylated α-synuclein (pαSyn) (e, g–i). (a, b, d, e, g) Sections of the stomach of patient P1; (c, h) sections of the stomach of patient P2; (f) section of the colon of patient P5; (i) sections of the stomach of patient P3. (b) High magnification view of the dotted square in (a, d, e) are serial sections. Black circles indicate myenteric plexus (c) and submucosal plexus (d, e). MP, muscularis propria; SM, submucosa. Accumulations of αSyn are observed in the nerve bundle in the MP (arrow in (a)), intramuscular nerve fibers ((b), small arrows), myenteric plexus (c), and submucosal plexus (d), but not in the mucosa (f). pαSyn-positive aggregates are observed in the nerve bundles in the MP (arrows in (g, h)) and submucosal plexus (arrow in (i)). In patient P1, the submucosal plexus with high accumulation of αSyn (d) shows no staining for pαSyn (e). Scale bar: 100 μm (a, c), 50 μm (d–g), and 20 μm (b, h, i).

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