Objective: To investigate the correlation between the methylation status of the catechol-o-methyltransferase (COMT) gene promoter region and its mRNA expression level in peripheral blood and the occurrence and development of Parkinson's disease (PD). Methods: Peripheral blood samples from 80 PD patients and 61 healthy controls in our hospital were collected as the PD group and the control group, respectively. The COMT mRNA expression level in peripheral blood was detected by quantitative real-time PCR (Q-PCR). The methylation status of the COMT gene promoter region was detected by methylation-specific PCR. Results: The methylation level of COMT promoter region in peripheral blood of PD group was significantly lower than that of control group (P＜0.05), and the mRNA level was significantly higher than that of control group (P＜0.05). Mid-to-late-stage PD patients had a lower degree of COMT promoter methylation and higher mRNA expression than early-stage patients, and the differences were statistically significant (P＜0.05). In the PD group, a significant negative correlation was found between peripheral blood COMT mRNA and the methylation status of its promoter region (r=-0.316, P=0.004); COMT mRNA was positively correlated with the total UPDRS score (r=0.274, P=0.014), UPDRS motor symptom score (r=0.328, P=0.003), and UPDRS non-motor symptom score (r=0.256, P=0.022). Binary logistic regression analysis showed that increased COMT mRNA expression level was a risk factor for PD onset (OR=2.583, 95%CI: 1.106-6.033, P=0.028), while a hypermethylated state of the COMT promoter region and hypercholesterolemia were protective factors against PD onset (OR=0.266, 95%CI: 0.117-0.607, P=0.002; OR=0.470, 95%CI: 0.252-0.876, P=0.018, respectively). Conclusion: PD patients exhibit decreased methylation levels and upregulated mRNA expression of the COMT promoter in peripheral blood, which dynamically evolve with the worsening of Hoehn-Yahr stage. Hypomethylation of the COMT promoter may participate in the pathological process of Parkinson's disease by promoting its gene transcription.
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