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Reygner J, Delannoy J, Barba-Goudiaby MT, Gasc C, Levast B, Gaschet E, Ferraris L, Paul S, Kapel N, Waligora-Dupriet AJ, Barbut F, Thomas M, Schwintner C, Laperrousaz B, Corvaïa N. Reduction of product composition variability using pooled microbiome ecosystem therapy and consequence in two infectious murine models. Appl Environ Microbiol 2024; 90:e0001624. [PMID: 38651930 PMCID: PMC11107171 DOI: 10.1128/aem.00016-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Growing evidence demonstrates the key role of the gut microbiota in human health and disease. The recent success of microbiotherapy products to treat recurrent Clostridioides difficile infection has shed light on its potential in conditions associated with gut dysbiosis, such as acute graft-versus-host disease, intestinal bowel diseases, neurodegenerative diseases, or even cancer. However, the difficulty in defining a "good" donor as well as the intrinsic variability of donor-derived products' taxonomic composition limits the translatability and reproducibility of these studies. Thus, the pooling of donors' feces has been proposed to homogenize product composition and achieve higher taxonomic richness and diversity. In this study, we compared the metagenomic profile of pooled products to corresponding single donor-derived products. We demonstrated that pooled products are more homogeneous, diverse, and enriched in beneficial bacteria known to produce anti-inflammatory short chain fatty acids compared to single donor-derived products. We then evaluated pooled products' efficacy compared to corresponding single donor-derived products in Salmonella and C. difficile infectious mouse models. We were able to demonstrate that pooled products decreased pathogenicity by inducing a structural change in the intestinal microbiota composition. Single donor-derived product efficacy was variable, with some products failing to control disease progression. We further performed in vitro growth inhibition assays of two extremely drug-resistant bacteria, Enterococcus faecium vanA and Klebsiella pneumoniae oxa48, supporting the use of pooled microbiotherapies. Altogether, these results demonstrate that the heterogeneity of donor-derived products is corrected by pooled fecal microbiotherapies in several infectious preclinical models.IMPORTANCEGrowing evidence demonstrates the key role of the gut microbiota in human health and disease. Recent Food and Drug Administration approval of fecal microbiotherapy products to treat recurrent Clostridioides difficile infection has shed light on their potential to treat pathological conditions associated with gut dysbiosis. In this study, we combined metagenomic analysis with in vitro and in vivo studies to compare the efficacy of pooled microbiotherapy products to corresponding single donor-derived products. We demonstrate that pooled products are more homogeneous, diverse, and enriched in beneficial bacteria compared to single donor-derived products. We further reveal that pooled products decreased Salmonella and Clostridioides difficile pathogenicity in mice, while single donor-derived product efficacy was variable, with some products failing to control disease progression. Altogether, these findings support the development of pooled microbiotherapies to overcome donor-dependent treatment efficacy.
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Affiliation(s)
| | | | | | | | | | | | | | - Stéphane Paul
- Team GIMAP, Centre International de Recherche en Infectiologie, Université Jean Monnet, Saint-Etienne, France
- Inserm, Université Claude Bernard Lyon, Lyon, France
- CIC 1408 Inserm Vaccinology, University Hospital of Saint-Etienne, Saint-Etienne, France
- Immunology Department, iBiothera Reference Center, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Nathalie Kapel
- UMR-S 1139, INSERM, Université Paris Cite, Paris, France
- Service de Coprologie fonctionnelle, Hôpital de la Pitié-Salpêtrière-Charles Foix, AP-HP, Paris, France
| | | | - Frederic Barbut
- UMR-S 1139, INSERM, Université Paris Cite, Paris, France
- National Reference Laboratory for Clostridioides difficile, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- The European Society of Clinical Microbiology and Infectious Diseases Study Group for Clostridioides difficile, Basel, Switzerland
| | - Muriel Thomas
- UMR1319, Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
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Ross K. Psychobiotics: Are they the future intervention for managing depression and anxiety? A literature review. Explore (NY) 2023; 19:669-680. [PMID: 36868988 PMCID: PMC9940471 DOI: 10.1016/j.explore.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/12/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023]
Abstract
Mental health is a public health concern among professional organizations, clinicians, and consumers alike, especially in light of the COVID-19 pandemic. Indeed, the World Health Organization has identified mental health as an epidemic of the 21st century contributing to the global health burden, which highlights the urgency to develop economical, accessible, minimally invasive interventions to effectively manage depression, anxiety, and stress. Nutritional approaches, including the use of probiotics and psychobiotics to manage depression and anxiety, have elicited interest in recent years. This review aimed to summarize evidence from studies including animal models, cell cultures, and human subjects. Overall, the current evidence suggests that 1) Specific strains of probiotics can reduce depressive symptoms and anxiety; 2) Symptoms may be reduced through one or more possible mechanisms of action, including impact on the synthesis of neurotransmitters such as serotonin and GABA, modulation of inflammatory cytokines, or enhancing stress responses through effects on stress hormones and the HPA axis; and 3) While psychobiotics may offer therapeutic benefits to manage depression and anxiety, further research, particularly human studies, is needed to better characterize their mode of action and understand optimal dosing in the context of nutritional interventions.
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Affiliation(s)
- Kim Ross
- Sonoran University of Health Sciences, 2140 E. Broadway Rd. Tempe, AZ 85282, United States.
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Kazem YI, Mahmoud MH, Essa HA, Azmy O, Kandeel WA, Al-Moghazy M, El-Attar I, Hasheesh A, Mehanna NS. Role of Bifidobacterium spp. intake in improving depressive mood and well-being and its link to kynurenine blood level: an interventional study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:223-232. [PMID: 34758244 DOI: 10.1515/jcim-2021-0351] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Evidence for the contribution of the brain-gut-microbiota axis to the depression pathophysiology is increasing nowadays. Disturbed gut microbiota equilibrium along with bad dietary habits both lead to kynurenine pathway abnormalities contributing to the depression pathophysiology. In this respect, many studies are found but the interventional clinical trials are limited. The present interventional study aims to evaluate the impact of Bifidobacterium spp. supplementation together with improving dietary intake on depressive mood and well-being and their correlation with kynurenine blood level in adult Egyptian healthy volunteers. METHODS A number of 98 healthy female volunteers with a mean age of 46.96 ± 1.82 years were selected and enrolled in this study. They were given yogurt enriched with Bifidobacterium spp. daily for eight weeks. Clinical examination as well as questionnaires for the evaluation of psychological well-being and depression were done at base line and after eight weeks of intervention. Fasting blood samples and stool samples were collected from all subjects at baseline and eight weeks after the intervention for the investigation of serum kynurenine concentration, blood hemoglobin, serum transaminases (ALT & AST) serum urea and creatinine as well as fecal Bifidobacterium count. RESULTS Data revealed that both depression and well-being showed highly significant improvement combined with significant drop in kynurenine blood level after intervention. Also, a significant rise in fecal Bifidobacterium count and a significant improvement in hemoglobin level and activity of liver enzymes were recorded. After intervention, a significant negative correlation was recorded between depression and fecal Bifidobacterium count as well as between serum kynurenine level, and well-being. CONCLUSION Bifidobacterium spp. supplementation combined with improvement in dietary intake resulted in improvement of depressive mood and well-being and reduced kynurenine blood level.
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Affiliation(s)
- Yusr I Kazem
- Nutrition & Food Sciences Department, Institute of Food Industries and Nutrition, National Research Centre, Dokki, Cairo, Egypt
| | - Maha H Mahmoud
- Nutrition & Food Sciences Department, Institute of Food Industries and Nutrition, National Research Centre, Dokki, Cairo, Egypt
| | - Hend A Essa
- Nutrition & Food Sciences Department, Institute of Food Industries and Nutrition, National Research Centre, Dokki, Cairo, Egypt
| | - Osama Azmy
- Reproductive Health & Family Planning Department, Medical Research Institute, National Research Centre, Dokki, Cairo, Egypt
| | | | - Marwa Al-Moghazy
- Dairy Sciences Department, Institute of Food Industries and Nutrition, National Research Centre, Dokki, Cairo, Egypt
| | | | - Adel Hasheesh
- Children with Special Needs Department, Institute of Human Genetics and Genome Research, National Research Centre, Dokki, Cairo, Egypt
| | - Nayra S Mehanna
- Dairy Sciences Department, Institute of Food Industries and Nutrition, National Research Centre, Dokki, Cairo, Egypt
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4
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Mentis AFA, Dardiotis E, Katsouni E, Chrousos GP. From warrior genes to translational solutions: novel insights into monoamine oxidases (MAOs) and aggression. Transl Psychiatry 2021; 11:130. [PMID: 33602896 PMCID: PMC7892552 DOI: 10.1038/s41398-021-01257-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/16/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022] Open
Abstract
The pervasive and frequently devastating nature of aggressive behavior calls for a collective effort to understand its psychosocial and neurobiological underpinnings. Regarding the latter, diverse brain areas, neural networks, neurotransmitters, hormones, and candidate genes have been associated with antisocial and aggressive behavior in humans and animals. This review focuses on the role of monoamine oxidases (MAOs) and the genes coding for them, in the modulation of aggression. During the past 20 years, a substantial number of studies using both pharmacological and genetic approaches have linked the MAO system with aggressive and impulsive behaviors in healthy and clinical populations, including the recent discovery of MAALIN, a long noncoding RNA (lncRNA) regulating the MAO-A gene in the human brain. Here, we first provide an overview of the MAOs and their physiological functions, we then summarize recent key findings linking MAO-related enzymatic and gene activity and aggressive behavior, and, finally, we offer novel insights into the mechanisms underlying this association. Using the existing experimental evidence as a foundation, we discuss the translational implications of these findings in clinical practice and highlight what we believe are outstanding conceptual and methodological questions in the field. Ultimately, we propose that unraveling the specific role of MAO in aggression requires an integrated approach, where this question is pursued by combining psychological, radiological, and genetic/genomic assessments. The translational benefits of such an approach include the discovery of novel biomarkers of aggression and targeting the MAO system to modulate pathological aggression in clinical populations.
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Affiliation(s)
- Alexios-Fotios A Mentis
- Public Health Laboratories, Hellenic Pasteur Institute, Vas. Sofias Avenue 127, 115 21, Athens, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University of Thessaly, Panepistimiou 3, Viopolis, 41 500, Larissa, Greece
| | - Eleni Katsouni
- Department of Experimental Psychology, Oxford University, Oxford, UK
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Medical School, Aghia Sophia Children's Hospital, Livadias 8, 115 27, Athens, Greece.
- UNESCO Chair on Adolescent Health Care, Athens, Greece.
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Abashina T, Vainshtein M. Hypothesis: Bacteria benefiting from electromagnetic field in peripheral neuropathy. Electromagn Biol Med 2021; 40:222-226. [PMID: 33455474 DOI: 10.1080/15368378.2021.1874974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
Abstract
Recent research has already been shown widespread locations of bacteria in various tissues and organs of a healthy host organism. These bacteria (hereinafter referred to as persistent microbiota, PM) cause neither noticeable destruction nor toxins production - no immune response can be noticed either. The role of the PM is unknown. The host nervous system is not an exception and can also be inhabited by the PM. We found that various bacteria were capable of benefiting from the electromagnetic field (EMF). The main advantage of these bacteria, apparently, lies in the increasing supply of ionic forms of compounds into the cells. Since microorganisms use the energy of electrical impulses, their possible colonization of the host's nerve circuit will weaken the nerve signals. The presented hypothesis aims to draw attention to the following points: i) microbial colonization of the host nervous system will lead to the weakening of nerve signals, ii) the sensitivity of bacteria to EMF permits to affect on their activity with electromagnetic treatment.
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Affiliation(s)
- Tatiana Abashina
- Federal Research Center "Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences", G.K. Skryabin Institute of Biochemistry and Physiology of Microorganisms Russian Academy of Sciences , Pushchino, Russian Federation
| | - Mikhail Vainshtein
- Federal Research Center "Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences", G.K. Skryabin Institute of Biochemistry and Physiology of Microorganisms Russian Academy of Sciences , Pushchino, Russian Federation
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Ochoa-Repáraz J, Ramelow CC, Kasper LH. A Gut Feeling: The Importance of the Intestinal Microbiota in Psychiatric Disorders. Front Immunol 2020; 11:510113. [PMID: 33193297 PMCID: PMC7604426 DOI: 10.3389/fimmu.2020.510113] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/30/2020] [Indexed: 12/11/2022] Open
Abstract
The intestinal microbiota constitutes a complex ecosystem in constant reciprocal interactions with the immune, neuroendocrine, and neural systems of the host. Recent molecular technological advances allow for the exploration of this living organ and better facilitates our understanding of the biological importance of intestinal microbes in health and disease. Clinical and experimental studies demonstrate that intestinal microbes may be intimately involved in the progression of diseases of the central nervous system (CNS), including those of affective and psychiatric nature. Gut microbes regulate neuroinflammatory processes, play a role in balancing the concentrations of neurotransmitters and could provide beneficial effects against neurodegeneration. In this review, we explore some of these reciprocal interactions between gut microbes and the CNS during experimental disease and suggest that therapeutic approaches impacting the gut-brain axis may represent the next avenue for the treatment of psychiatric disorders.
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Affiliation(s)
| | | | - Lloyd H. Kasper
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
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Reygner J, Charrueau C, Delannoy J, Mayeur C, Robert V, Cuinat C, Meylheuc T, Mauras A, Augustin J, Nicolis I, Modoux M, Joly F, Waligora-Dupriet AJ, Thomas M, Kapel N. Freeze-dried fecal samples are biologically active after long-lasting storage and suited to fecal microbiota transplantation in a preclinical murine model of Clostridioides difficile infection. Gut Microbes 2020; 11:1405-1422. [PMID: 32501140 PMCID: PMC7524285 DOI: 10.1080/19490976.2020.1759489] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Fecal microbiota transplantation is now recommended for treating recurrent forms of Clostridioides difficile infection. Recent studies have reported protocols using capsules of either frozen or freeze-dried stool allowing oral administration in in- and out-patient settings. However, a central question remains the viability, engraftment, and efficacy of the microbiome over time during storage life. This study shows that both the freeze-drying and freezing procedures for fecal samples allowed preserving viability, short-chain fatty acids concentration, and anti-Clostridioides difficile properties of microbiota without significant alteration after storage for 12 months. Fecal transplantation with freeze-dried microbiota allowed engraftment of microbiota leading to clearance of Clostridioides difficile infection in a preclinical murine model with a survival rate of 70% versus 53-60% in mice treated with frozen inocula, and 20% in the untreated group. Moreover, the freeze-dried powder can be used to fill oral hard capsules using a very low amount (0.5%) of glidant excipient, allowing oral formulation. Altogether, this study showed that freeze-dried inocula can be used for the treatment of Clostridioides difficile infection with long-lasting stability of the fecal microbiota. This formulation facilitates biobanking and allows the use of hard capsules, an essential step to simplify patient access to treatment.
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Affiliation(s)
- Julie Reygner
- INSERM UMR-S1139, Université de Paris, Paris, France
| | - Christine Charrueau
- INSERM U1267 CNRS UMR 8258, Chimie ParisTech, PSL Research University, Université de Paris, Paris, France
| | | | - Camille Mayeur
- Micalis Institute, AgroParisTech, INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Véronique Robert
- Micalis Institute, AgroParisTech, INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Céline Cuinat
- Micalis Institute, AgroParisTech, INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Thierry Meylheuc
- Micalis Institute, AgroParisTech, INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | | | - Jérémy Augustin
- Department of Pathology, APHP Sorbonne Université, Pitie-Salpetriere Hospital, Paris, France
| | | | | | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, APHP, Beaujon Hospital, Clichy, France
| | | | - Muriel Thomas
- Micalis Institute, AgroParisTech, INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Nathalie Kapel
- INSERM UMR-S1139, Université de Paris, Paris, France,Department of Coprology, APHP Sorbonne Université, Pitie-Salpetriere Hospital, Paris, France,CONTACT Nathalie Kapel Laboratoire de Coprologie Fonctionnelle, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, 47-83 Boulevard de l’Hôpital, Paris75013, France
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Eslami Shahrbabaki M, Sabouri S, Sabahi A, Barfeh D, Divsalar P, Esmailzadeh M, Ahmadi A. The Efficacy of Probiotics for Treatment of Bipolar Disorder-Type 1: A Randomized, Double-Blind, Placebo Controlled Trial. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:10-16. [PMID: 32377210 PMCID: PMC7193240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Bipolar disorders are among the most common chronic mental disorders. Despite the recent improvement in controlling psychiatric disorders, treatment of bipolar disorders remains a challenge. The aim of this study was to determine the effect of consuming probiotics in patients with bipolar disorder-type 1 compared to the placebo group. Method : This was a permuted blocked randomized clinical trial conducted in Shahid Beheshti mental hospital in Kerman, Iran, from October 2017 to October 2018. Two psychiatrists diagnosed and hospitalized all 38 patients with type 1 bipolar disorder based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Using blind randomized blocking method size 4, patients were divided into 2 groups of placebo and probiotic. Young Mania Rating Scale (YMRS) and Hamilton's Depression Rating Scale (HDRS) were completed at the beginning, week 4, and week 8 of the study by a psychiatry resident. Independent t test, Mann-Whitney and repeated measures ANOVA tests were used. Data were analyzed using SPSS software version 20. Results: There was no significant difference between the 2 groups in age, sex, and severity of mania and depression. Consumption of probiotics reduced the scores of YMRS and HDRS over time in the probiotic group more than the placebo group, but it was not significant. Conclusion: Consumption of probiotics had non-significant effects on improvement and treatment of bipolar type 1 patients. It is suggested that future studies be conducted with different probiotic microbial strains and longer period of treatment.
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Affiliation(s)
- Mahin Eslami Shahrbabaki
- Neurology Research Center, Psychiatry Department of Shahid Beheshti Hospital, Afzalipour Medicine School, Kerman University of Medical Sciences, Kerman, Iran
| | - Saleheh Sabouri
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Abdolreza Sabahi
- Neuroscience Research Center and Institute of Neuropharmacology, Psychiatry Department of Shahid Beheshti Hospital, Afzalipour Medicine School, Kerman University of Medical Sciences, Kerman, Iran
| | - Delaram Barfeh
- Neurology Research Center, Afzalipour Medicine School, Kerman University of Medical Sciences, Kerman, Iran
| | - Parisa Divsalar
- Neuroscience Research Center and Institute of Neuropharmacology, Psychiatry Department of Shahid Beheshti Hospital, Afzalipour Medicine School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdi Esmailzadeh
- Psychiatry Department of Shahid Beheshti Hospital, Neurology Research Center, Afzalipour Medicine School, Kerman University of Medical Sciences, Kerman, Iran.,Corresponding Author: Address: Shahid Beheshti Psychiatric Hospital, Amir-Kabir Intersection, Jomhuri Eslami Boulevard,Tehran, Iran, Postal Code: 7618834115. Tel: 98-9137678205, Fax: 98-3432110931,
| | - Atefeh Ahmadi
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Evrensel A, Ünsalver BÖ, Ceylan ME. Neuroinflammation, Gut-Brain Axis and Depression. Psychiatry Investig 2020; 17:2-8. [PMID: 31587531 PMCID: PMC6992852 DOI: 10.30773/pi.2019.08.09] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022] Open
Abstract
Psychiatric diseases are the manifestations that result from the individual's genetic structure, physiology, immunology and ways of coping with environmental stressors. The current psychiatric diagnostic systems do not include any systematic characterization in regard to neurobiological processes that reveal the clinical picture in individuals who got psychiatric diagnosis. It is obvious that further research in different areas is needed to understand the psychopathology. The problems in the functions of immune system and the correlation of neuroinflammatory processes with psychiatric disorders have been one of the main research topics of psychiatry in recent years and have contributed to our understanding of psychopathology. Recent advances in the fields of immunology and genetics as well as rapidly increasing knowledge on the effects of immunological processes on brain functions have drawn attention to the correlations between psychiatric disorders and immune system dysfunctions. There are still unfilled gaps in the biology, pathophysiology, and treatment of major depressive disorder, which is quite prevalent among the psychiatric disorders, can lead to significant disability, and frequently has a recurrent course. It appears that low-grade chronic neuroinflammation plays a key role in forming a basis for the interaction between psychological stress, impaired gut microbiota and major depressive disorder. In this review, the role of neuroinflammation in the etiopathogenesis of depression and the mechanism of action of the gut-brain axis that leads to this are discussed in the light of current studies.
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Affiliation(s)
- Alper Evrensel
- Department of Psychiatry, Uskudar University, NP Brain Hospital, Istanbul, Turkey
| | - Barış Önen Ünsalver
- Department of Medical Documentation and Secretariat, Vocational School of Health Services, Istanbul, Turkey
| | - Mehmet Emin Ceylan
- Department of Psychology and Philosophy, Uskudar University, Istanbul, Turkey
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