Blood transcriptomic alteration following acupuncture in Parkinson's disease: a case report

Purpose: The objective of this case report was to suggest the possibility of blood transcriptomes as therapeutic response biomarker for acupuncture in PD. Acupuncture improved motor symptoms and rearranged cerebral cortical activity of PD patients in our previous study. This is the first report of novel data on gene expression change in one PD patient who received acupuncture and showed improved gait disturbance. Methods: We obtained RNA-seq data from whole blood of the case PD patient after 0, 5, and 8 sessions of acupuncture treatment with evaluation of gait parameters using GAITrite system. We compared alterations of gene expression in PD patients by dopaminergic therapy and acupuncture treatment. Next, expressions of common biomarkers consistently changed in both brain and blood of PD patients were analyzed. Lastly, we performed single-sample gene set enrichment analysis (ssGSEA) using gene sets of Gene Ontology (GO) terms. Results: The case PD patient with acupuncture have improved hypometric gait and enhance hemodynamic response in cerebral cortex in our previous study. In present study, we found that ANKRD22 reported to be upregulated by dopaminergic therapy were significantly increased by acupuncture. In addition, we identified that SYN1, reported to be downregulated in postmortem brain (dopaminergic neurons and striatum) as well as blood, was prominently increased gene by acupuncture. ssGSEA also showed that several pathways of neurotransmission and synaptic vesicle dynamics were enhanced by acupuncture. Conclusions: In this study, we demonstrated that ANKRD22 and SYN1 were upregulated by acupuncture in PD. The loss of PLA2G6, an important paralog ADKRD22, leads to lysosomal dysfunction and similar to α –synuclein overexpression. In addition, SYN1 modulate trafficking and availability for synaptic vesicle. Therefore, we proposed that ANKRD22 and SYN1 is possible as therapeutic response biomarker by confirming enhanced synaptic availability and modulated α-synuclein aggregation by acupuncture in PD.