From the APC Microbiome Institute (Dinan, Cryan) and Departments of Psychiatry and Neurobehavioural Science (Dinan) and Anatomy and Neuroscience (Cryan), University College Cork, Cork, Ireland.
Psychosom Med. 2017 Oct;79(8):920-926. doi: 10.1097/PSY.0000000000000519.
The brain-gut-microbiota axis has been put forward as a new paradigm in neuroscience, which may be of relevance to mental illness. The mechanisms of signal transmission in the brain-gut-microbiota axis are complex and involve bidirectional communications that enable gut microbes to communicate with the brain and the brain to communicate with the microbes. This review assesses the potential usefulness and limitations of the paradigm.
A selective literature review was conducted to evaluate the current knowledge in clinical and preclinical brain-gut-microbiota interactions as related to psychiatric disorders.
Most published studies in the field are preclinical, and there is so far a lack of clinical studies. Preliminary studies in psychiatric populations support the view of a dysbiosis in some conditions, but studies are often small scale and marred by potential confounding variables. Preclinical studies support the view that psychobiotics ("bacteria which when ingested in adequate amounts have a positive mental health benefit") might be of use in treating some patients with mental health difficulties. To date, we have no well-conducted studies in clinical populations, although there are some studies in healthy volunteers. A cocktail of probiotics has been shown to alter brain activity as monitored by functional magnetic resonance imaging, and Bifidobacterium longum was reported to alter brain electrical activity.
It has yet to be convincingly demonstrated that the exciting findings of psychobiotic efficacy demonstrated in preclinical models of psychiatric illness will translate to patients.
脑-肠-微生物群轴已被提出作为神经科学的一个新范式,它可能与精神疾病有关。脑-肠-微生物群轴中的信号传递机制复杂,涉及双向通讯,使肠道微生物能够与大脑进行通讯,大脑也能够与微生物进行通讯。本综述评估了该范式的潜在有用性和局限性。
进行了选择性文献综述,以评估与精神障碍相关的临床前和临床脑-肠-微生物群相互作用的现有知识。
该领域的大多数已发表研究都是临床前研究,目前缺乏临床研究。精神科人群的初步研究支持某些情况下存在生态失调的观点,但研究往往规模较小,存在潜在的混杂变量。临床前研究支持这样一种观点,即益生菌(“当以足够的量摄入时对心理健康有积极影响的细菌”)可能对治疗一些心理健康困难的患者有用。迄今为止,我们在临床人群中没有进行过良好的研究,尽管在健康志愿者中有一些研究。研究表明,益生菌混合物可以改变功能磁共振成像监测到的大脑活动,双歧杆菌被报道可以改变大脑的电活动。
令人兴奋的是,在精神疾病的临床前模型中已经证明了心理生物治疗的有效性,但尚未令人信服地证明这些发现将转化为患者。