Department of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran.
Psychosomatic Medicine Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Clin Nutr. 2019 Apr;38(2):522-528. doi: 10.1016/j.clnu.2018.04.010. Epub 2018 Apr 24.
Disturbance in the equilibrium of the gut microbiota has been involved in the pathophysiology of depression. Probiotics have the potential to healthfully modulate the gut microbiome. Prebiotics could also be effective by stimulation of growth of some bacterial species in the gut microbiota.
The aim of this double blind clinical trial, was to compare the effect of supplementation with the probiotic and prebiotic on the Beck Depression Inventory (BDI) score as a primary outcome as well as the kynurenine/tryptophan ratio and tryptophan/branch chain amino acids (BCAAs) ratio as secondary outcomes in patients with major depressive disorder (MDD).
One hundred and ten depressed patients were randomly assigned to receive the probiotic (Lactobacillus helveticus and Bifidobacterium longum), prebiotic (galactooligosaccharide) or placebo for 8 weeks. Serum tryptophan and BCAAs were measured by HPLC, and kynurenine by ELISA kit. Dietary intake and physical activity of the participants were recorded at baseline.
A total of 81 subjects (aged 36.5 ± 8.03 y; mean (95% CI), 2.27 (1.76-2.93) y of depression duration) completed the trial (28 in the probiotic group, 27 in the prebiotic group, and 26 in the placebo group). From baseline to 8 weeks, probiotic supplementation resulted in a significant decrease in BDI score (17.39-9.1) compared to the placebo (18.18-15.55) and prebiotic (19.72-14.14) supplementation (p = 0.042). Inter-group comparison indicated no significant differences among the groups in terms of serum kynurenine/tryptophan ratio and tryptophan/BCAAs ratio. However, the kynurenine/tryptophan ratio decreased significantly in the probiotic group compared to the placebo group after adjusting for serum isoleucine (p = 0.048). In addition, the tryptophan/isoleucine ratio increased significantly in the probiotic group when compared to the placebo group (p = 0.023).
Overall, 8 weeks of probiotic supplements to subjects with MDD resulted in an improvement in BDI score compared with placebo whereas no significant effect of prebiotic supplementation was seen. Study was registered in IRCT.ir under IRCT2015092924271N1.
肠道微生物群平衡的干扰与抑郁症的病理生理学有关。益生菌具有调节肠道微生物群的健康潜力。益生元也可以通过刺激肠道微生物群中某些细菌的生长来发挥作用。
本双盲临床试验的目的是比较补充益生菌和益生元对主要抑郁症（MDD）患者贝克抑郁量表（BDI）评分的影响，以及对犬尿氨酸/色氨酸比和色氨酸/支链氨基酸（BCAA）比的影响作为次要结果。
110 名抑郁患者被随机分配接受益生菌（瑞士乳杆菌和长双歧杆菌）、益生元（半乳糖寡糖）或安慰剂治疗 8 周。通过 HPLC 测量血清色氨酸和 BCAA，通过 ELISA 试剂盒测量犬尿氨酸。在基线时记录参与者的饮食摄入和身体活动。
共有 81 名受试者（年龄 36.5±8.03 岁；平均值（95%CI），2.27（1.76-2.93）岁；抑郁持续时间 2.27 岁）完成了试验（益生菌组 28 人，益生元组 27 人，安慰剂组 26 人）。从基线到 8 周，益生菌补充剂可显著降低 BDI 评分（17.39-9.1），而安慰剂（18.18-15.55）和益生元（19.72-14.14）补充剂（p=0.042）。组间比较表明，三组间血清犬尿氨酸/色氨酸比和色氨酸/BCAA 比无显著差异。然而，在调整血清异亮氨酸后，益生菌组的犬尿氨酸/色氨酸比与安慰剂组相比显著降低（p=0.048）。此外，与安慰剂组相比，益生菌组的色氨酸/异亮氨酸比显著增加（p=0.023）。
总体而言，与安慰剂相比，8 周的益生菌补充剂可改善 MDD 患者的 BDI 评分，而益生元补充剂无显著效果。研究在 IRCT.ir 注册，注册号为 IRCT2015092924271N1。
