Martin Clair R, Mayer Emeran A
Nestle Nutr Inst Workshop Ser. 2017;88:45-53. doi: 10.1159/000461732. Epub 2017 Mar 27.
In the last 5 years, interest in the interactions among the gut microbiome, brain, and behavior has exploded. Preclinical evidence supports a role of the gut microbiome in behavioral responses associated with pain, emotion, social interactions, and food intake. Limited, but growing, clinical evidence comes primarily from associations of gut microbial composition and function to behavioral and clinical features and brain structure and function. Converging evidence suggests that the brain and the gut microbiota are in bidirectional communication. Observed dysbiotic states in depression, chronic stress, and autism may reflect altered brain signaling to the gut, while altered gut microbial signaling to the brain may play a role in reinforcing brain alterations. On the other hand, primary dysbiotic states due to Western diets may signal to the brain, altering ingestive behavior. While studies performed in patients with depression and rodent models generated by fecal microbial transfer from such patients suggest causation, evidence for an influence of acute gut microbial alterations on human behavioral and clinical parameters is lacking. Only recently has an open-label microbial transfer therapy in children with autism tentatively validated the gut microbiota as a therapeutic target. The translational potential of preclinical findings remains unclear without further clinical investigation.
在过去5年里，对肠道微生物群、大脑和行为之间相互作用的兴趣呈爆发式增长。临床前证据支持肠道微生物群在与疼痛、情绪、社交互动和食物摄入相关的行为反应中发挥作用。有限但不断增加的临床证据主要来自肠道微生物组成和功能与行为及临床特征以及脑结构和功能之间的关联。越来越多的证据表明，大脑和肠道微生物群存在双向交流。在抑郁症、慢性应激和自闭症中观察到的生态失调状态可能反映了大脑向肠道发出的信号改变，而肠道微生物向大脑发出的信号改变可能在强化大脑改变方面发挥作用。另一方面，西方饮食导致的原发性生态失调状态可能向大脑发出信号，改变摄食行为。虽然在抑郁症患者中进行的研究以及通过此类患者的粪便微生物移植产生的啮齿动物模型表明存在因果关系，但缺乏急性肠道微生物改变对人类行为和临床参数影响的证据。直到最近，一项针对自闭症儿童的开放标签微生物移植疗法才初步验证了肠道微生物群作为治疗靶点的作用。如果没有进一步的临床研究，临床前研究结果的转化潜力仍不明确。
